Dissociative Disorders
摘要
There is ongoing confusion regarding the terminology and classifications used to describe dissociation and dissociative disorders. This includes terms such as somatic symptom disorders, conversion disorders, dissociative disorders, Briquet syndrome, depersonalization disorder, and split personality disorder, among others, often with unclear distinctions among these diagnostic categories. To better understand the psychopathology of dissociative symptoms, it is essential to consider the origins of these disorders, the cultural and historical context in which they emerged, and how they have evolved into their current form. The concept of dissociation was introduced by Pierre Janet in late nineteenth-century France, primarily to diagnose female patients who were mostly presenting with hysteria. This was during a period and in a setting where hysteria was predominantly associated with women. Before Janet, Charcot had proposed a psychological explanation for hysteria, suggesting that traumas acted as triggers and that somatic symptoms were the primary manifestations. Later, Freud challenged the notion of conversion mechanisms, instead proposing a dissociative explanation for hysteria. Both of these concepts have persisted in modern psychopathological discussions, leading to significant confusion in the use of terminology. In this chapter, we aim to clarify the confusion caused by the varied terms and argue that there is insufficient evidence to support the idea that dissociative disorders are predominantly found in women.