Familial and social support as protective factors against the development of dissociative identity disorder.

The incidence of dissociative identity disorder (DID) is strongly correlated with exposure to serious physical and sexual abuse. Although studies of more than 1,000 DID sufferers indicate that severe child abuse is a predisposing factor in 95% to 98% of cases (B. Braun, 1988), abuse alone is not, in fact, predictive of DID (B. Rind & P. Tromovitch, 1997). Disorganized/disoriented attachment style and the absence of social and familial support, in combination with abuse history, best predict DID (D. Howe, 2006; R. Kluft, 1984; K. Lyons-Ruth, L. Dutra, M. Schuder, & I. Bianchi, 2006). Individuals who are securely attached are less likely to develop serious psychopathology in the event of abuse and are more likely to build a strong extrafamilial system of support--also a protective factor against psychopathology (S. Asher & J. Parker, 1989; D. Howe, M. Brandon, D. Hinings, & G. Schofield, 1999; G. Ladd & B. Golter, 1988). Recognition of the significance of secure attachment and familial and social support as protective factors against the development of DID suggests social intervention as an important area of research to mitigate the psychological consequences of insecure attachment, social disconnection, and abuse.