title: Toward an etiology of dissociative identity disorder: a neurodevelopmental approach.
abstract: This article elaborates on Putnam's "discrete behavioral states" model of dissociative identity disorder (Putnam, 1997) by proposing the involvement of the orbitalfrontal cortex in the development of DID and suggesting a potential neurodevelopmental mechanism responsible for the development of multiple representations of self. The proposed "orbitalfrontal" model integrates and elaborates on theory and research from four domains: the neurobiology of the orbitalfrontal cortex and its protective inhibitory role in the temporal organization of behavior, the development of emotion regulation, the development of the self, and experience-dependent reorganizing neocortical processes. The hypothesis being proposed is that the experience-dependent maturation of the orbitalfrontal cortex in early abusive environments, characterized by discontinuity in dyadic socioaffective interactions between the infant and the caregiver, may be responsible for a pattern of lateral inhibition between conflicting subsets of self-representations which are normally integrated into a unified self. The basic idea is that the discontinuity in the early caretaking environment is manifested in the discontinuity in the organization of the developing child's self.
authors.affiliation: University of Washington, Bothell, Washington, USA. forrestk@u.washington.edu
authors.forename: K A
authors.initials: KA
authors.lastname: Forrest
mesh_terms: D000339:Affect / Q000502:physiology; D000647:Amnesia / Q000503:physiopathology; D002648:Child; D002649:Child Abuse / Q000523:psychology; D009105:Dissociative Identity Disorder / Q000209:etiology* / Q000503:physiopathology; D004532:Ego; D004777:Environment; D006801:Humans; D008568:Memory / Q000502:physiology; D009433:Neural Inhibition / Q000502:physiology; D010465:Perception / Q000502:physiology; D017397:Prefrontal Cortex / Q000503:physiopathology; D002666:Psychology, Child; D013850:Thinking / Q000502:physiology