Dissertation/Thesis Abstract

An analysis of the efficacy of extinction as an intervention in the modification of switching in patients with Dissociation Identity Disorder
by Canaris, June, Ed.D., University of San Francisco, 2008, 130; 3317688
Abstract (Summary)

The paucity of scientific research on treatment interventions for the dissociative population is well recognized (Pope, Barry, Bodkin & Hudson, 2006; Putnam, 1997; Sar & Ross, 2006). The purpose of this study was to determine if the switching behavior that occurs exclusively in Dissociative Identity Disorder is reduced or eliminated by applying an extinction protocol.

Extinction has been used successfully to treat a wide variety of behavioral problems, including self injurious behavior in developmentally delayed children (Lang, 2003), bizarre vocalizations in paranoid schizophrenics (Liberman, Teigen, Patterson & Baker, 1973; Wilde, Masuda, O'Connor & Baham, 2001), and food refusal in underweight, normal and developmentally delayed toddlers (Lerman & Iwata, 1995, 1996).

The results of the present investigation replicated the successes found within the aforementioned studies by using an extinction protocol in a multiple-baseline design across three participants with Dissociation Identity Disorder. The switching behavior was operationalized by using the criteria outlined by Putnam (1989, 1997). Baseline was established by the researcher and an independent rater counting the number of switches over a 50-minute session. The extinction protocol was implemented when the switching behavior showed a stable trend. During the intervention phase, the researcher and rater counted the number of switches over a 50-minute session. Substantial reductions in the switching behavior of two dissociative participants were realized and would likely have occurred with Participant 3 had the study not been terminated.

Behavioral markers identified by Greaves (1989), which are “precursor” events to final integration, were seen across the three participants with the implementation of this study's extinction protocol: co-presence, co-consciousness, internal dialogues, and negotiations between the alters. All three participants experienced an additional marker not identified by Greaves: “Catching one's self prior to switching” with the extinction intervention. In addition to the treatment technique's efficacy and scientific integrity, is its conceptual simplicity, uncomplicated implementation, cost-effectiveness, and no requirements for complex apparatus.

In conclusion, the findings of this study underline two significant facts: (1) the severity of the disorder is not incompatible with a parsimonious treatment approach and (2) evidence-based research tested the merits of the procedure, producing an efficacious treatment intervention.

Indexing (document details)
Advisor: Zlutnick, Steven
School: University of San Francisco
School Location: United States -- California
Source: DAI-B 69/05, Dissertation Abstracts International
Subjects: Behaviorial sciences, Psychotherapy, Psychology, Experiments
Keywords: Dissociation, Dissociation identity disorder, Extinction, Extinction & dissociation, Intervention, Reduction of switching in dissociative patients, Switching, Switching in DID, Treatment intervention for dissociation
Publication Number: 3317688
ISBN: 978-0-549-65756-9
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