Psychological factors in the etiology, progression, and treatment of MPD syndrome.

The evidence is abundant and clear: psychological factors do have an important role in the etiology, progression, and treatment of MPD syndrome. These findings have implications for therapists who wish to understand the disorder and to manage patients appropriately. In regard to etiology, they should appreciate the impact of psychological traits and states on the development of symptoms of MPD syndrome, but they should not waste time and energy in measuring or analyzing specific psychological factors in individual patients. In regard to perpetuation of the disorder, they should understand that some patients will not respond to conventional treatment despite the best efforts of any competent therapist. Finally, in regard to treatment, they should recognize the importance of nonspecific factors such as placebo effects, doctor-patient interactions, and spontaneous recoveries in the treatment response. This awareness will enhance their effectiveness as therapists and will help them to avoid using excessive or radical treatment methods.