Brand and colleagues (2009) article reports the findings of a naturalistic, cross-sectional study that investigated the efficacy of community-based treatment of patients with dissociative identity disorder. The authors point out that 53% of patients with borderline personality disorder have a comorbid dissociative disorder (DD), including 11% who met the criteria for dissociative identity disorder (DID). Moreover, patients with DD have complex presentations with high levels of comorbid psychiatric difficulties such as PTSD, treatment resistant anxiety and depression, personality disorders and relational problems including borderline personality disorder, substance abuse, eating disorders, self-destructiveness, and suicidality.
Because patients with DD frequently present with a plethora of other disorders, their treatment requires complex pharmacological and therapeutic approaches. Moreover, because of the complexity involved in treating patients with DD and comorbid conditions, these patients are usually excluded from research that tests the efficacy of treatment approaches. Brand and colleagues (Brand, et al., 2009) are thus trying to fill a significant gap in the research literature regarding DD.
The study included a sample of 292 therapists and 280 patients. All therapists participating in the study were recruited from the registry of the International Society for the Study of Trauma & Dissociation (ISSTD) and all participants had received formal training for treating patients with DD. Inclusion criteria required that the therapists were currently working (for the last three months) in the field of treating patients with DD. The inclusion criteria for patients were quite broad, as substance abuse, psychosis, hospitalization, or eating disorders were not considered exclusion criteria. This approach allowed, according to the authors, to make generalizations that previous studies were unable to make due to the fact that the...