title: Can the DSM-5 differentiate between nonpathological possession and dissociative identity disorder? A case study from an Afro-Brazilian religion.
abstract: The aim of this article is to examine whether the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are able to differentiate between nonpathological religious possession and dissociative identity disorder (DID). We use the case study of an individual who leads an Afro-Brazilian religious group (Umbanda), focusing on her personal development and possession experiences from early childhood to the present, spanning a period of more than 40 years, and examine these data following DSM-5 criteria for DID (300.14). Her experiences of possession can be broken into 2 distinct stages. In the 1st stage (childhood and early adulthood), she displayed intrusive thoughts and a lack of control over possession states, which were associated with a heightened state of anxiety, loneliness, amnesia, and family conflict (meeting all 5 criteria for DID). In the 2nd stage (late 20s up to the present), she regularly experienced possession states but felt in control of their onset and found them religiously meaningful. In this 2nd stage, she only fulfilled 3 criteria for DID. We question the accuracy of diagnosing this individual with DID in her earlier life and suggest that the DSM-5 criteria fail to address the ambiguity of affect surrounding possession experiences (positive at the individual level, negative at the interpersonal level) and lack a clearer acknowledgment of the prevalence of possession and other unusual experiences in general populations.
authors.affiliation: a Centre for Research in Psychology, Behaviour & Achievement , Coventry University , Coventry , England.|b NUPES-Research Center in Spirituality and Health, School of Medicine , Federal University of Juiz de Fora , Minas Gerais, Brazil.
authors.forename: Romara
authors.initials: R
authors.lastname: Delmonte
authors.affiliation: b NUPES-Research Center in Spirituality and Health, School of Medicine , Federal University of Juiz de Fora , Minas Gerais, Brazil.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Lucchetti
authors.affiliation: b NUPES-Research Center in Spirituality and Health, School of Medicine , Federal University of Juiz de Fora , Minas Gerais, Brazil.
authors.forename: Alexander
authors.initials: A
authors.lastname: Moreira-Almeida
authors.affiliation: a Centre for Research in Psychology, Behaviour & Achievement , Coventry University , Coventry , England.
authors.forename: Miguel
authors.initials: M
authors.lastname: Farias
mesh_terms: D001938:Brazil; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D009105:Dissociative Identity Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012069:Religion and Psychology; D013483:Superstitions
keywords: Diagnostic and Statistical Manual of Mental Disorders; Dissociative identity disorder; Fifth Edition; possession; spiritual experiences