Warwick Middleton

University of Queensland | UQ · School of Medicine

Until recently the widespread reality of ongoing incestuous abuse during adulthood had attracted no systematic research. The scientific literature was limited to the occasional case study and brief anecdotal references. This minimal literature was supplemented by biographical works written by or about victims of this form of abuse, and by press rep...

Although the subject of ongoing incestuous abuse during adulthood has never been addressed in a systematic way in the professional literature, accounts of such cases have been appearing for many years. The Josef Fritzl case added a new impetus to reporting such abuses in the popular press. The current study presents 44 such cases from 24 countries...

Series of patients fulfilling diagnostic criteria for Dissociative Identity Disorder (DID), otherwise known as multiple personality disorder, have particularly been reported on in North America and increasingly in other countries. The present study investigated the trauma and past treatment histories, symptom profiles and dissociative phenomenology...

Literature and clinical experience suggest that some people experience atypical, complicated or pathological bereavement reactions in response to a major loss. Three groups of community-based bereaved subjects--spouses (n = 44), adult children (n = 40), and parents (n = 36)--were followed up four times in the 13 months after a loss. A 17-item scale...

Maladaptive Daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising, which causes clinically significant distress and functional impairment in academic, vocational, and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive, and detrimental to one’s life. It involves detachme...

Objective: This study aimed to explore the experience of therapists whose clients report incestuous abuse continuing into adulthood. Method: Ten Australian therapist-participants were recruited through professional forums. After giving informed consent, they completed a semistructured interview. Therapists were asked about their experiences of prov...

Objectives: Dissociative identity disorder (DID) and schizophrenia-spectrum disorders (SSD) share some overlapping phenomenological features making accurate diagnosis more difficult. Childhood abuse and depersonalization have been associated with psychotic symptoms across psychological disorders but their relationship to psychotic phenomenology re...

Some evidence in non-clinical groups suggests that the relationship context in which dissociation is experienced might moderate its association with shame. The current study used vignettes detailing either dissociative symptoms or the expression of sadness occurring in three different relationship contexts: with a friend, an acquaintance, or when a...

This Australian study examined 310 respondents’ retrospective reports about the quality of their relationship with their caregivers during their childhood to identify the dynamics that predict clinical levels of dissociation in adulthood. The sample comprised 277 university participants and 32 inpatients and outpatients receiving treatment for a di...

When the grim histories of people with Dissociative Identity Disorder (DID) come to light, many people wonder how these abuses can have gone on for so many years undetected. Surely if it was that bad, the child would tell someone, and that person would tell the authorities, and the perpetrators would be jailed? For some onlookers, the lack of effec...

Previous research has shown that the relationship between childhood abuse and the presence of auditory hallucinations is mediated by dissociation, specifically depersonalization and absorption. The current study assessed dissociation as a mediator of the relationship between childhood abuse and auditory hallucination frequency, characteristics and...

Objective: Discontinuities in memory are the hallmark symptoms of most dissociative disorders but are also reported by patients diagnosed with related disorders, including PTSD. Memory discontinuity is most evident in dissociative identity disorder (DID), where patients may report amnesia in 1 identity for information available in other identities...

The Australian history of the false memory (FM) movement has similarities to that of the UK and America, but also important differences that are rarely described in the literature. This article, through an examination of cross-discipline professional literature, media reports, and the personal observations of the second author, describes the histor...

This Australian study explores a person’s self-reported exposure to childhood abuse to identify the characteristics that are predictive of clinical levels of dissociation in adulthood. The final sample comprised 303 participants, including 26 inpatients and outpatients (24 females and two males) receiving treatment for a dissociative disorder (DD),...

This Australian study explores a person’s self-reported exposure to childhood abuse to identify the characteristics that are predictive of clinical levels of dissociation in adulthood. The final sample comprised 303 participants, including 26 inpatients and outpatients (24 females and two males) receiving treatment for a dissociative disorder (DD),...

Amnesia is a core diagnostic criterion for Dissociative Identity Disorder (DID), however previous research has indicated memory transfer. As DID has been conceptualised as being a disorder of distinct identities, in this experiment, behavioral tasks were used to assess the nature of amnesia for episodic 1) self-referential and 2) autobiographical m...

Dissociative experiences have been associated with diachronic disunity. Yet, this work is in its infancy. Dissociative identity disorder (DID) is characterized by different identity states reporting their own relatively continuous sense of self. The degree to which patients in dissociative identity states experience diachronic unity (i.e., sense of...

Firmly held beliefs that have a delusional quality are commonly experienced in those with schizophrenia spectrum disorders (SSD) and have been reported in those with dissociative identity disorder (DID). However, no study to date has compared delusional belief content and characteristics between these diagnostic groups. This study examined delusion...

This paper investigated a 60-item version of the Multidimensional Inventory of Dissociation (MID) with the potential to capture the full range of dissociative symptoms that characterize each of the dissociative disorders (DD). The 28-item Dissociative Experiences Scale (DES) was designed to capture a wide range of dissociative phenomena, but colleg...

This paper investigated a 60-item version of the Multidimensional Inventory of Dissociation (MID) with the potential to capture the full range of dissociative symptoms that characterize each of the dissociative disorders (DD). The 28-item Dissociative Experiences Scale (DES) was designed to capture a wide range of dissociative phenomena, but colleg...

In the December 2012 issue of the Journal, Joel Paris, MD wrote an article about the current status of Dissociative Identity Disorder (DID) and the dissociative disorder field in general. He suggests that DID is merely a "fad", and that there is no credible evidence to connect traumatic experiences with the development of DID. We refute several of...

This paper examines the phenomenon of ongoing incest during adulthood, a form of extreme trauma that has only attracted detailed research since 2013. Yet, a significant percentage of individuals who satisfy diagnostic criteria for Dissociative Identity Disorder are victims of this form of extreme but hidden abuse. The victims of such abuse typicall...

Commentary response to the paper by Ross and subsequent commentaries by Miller and Ross, focuses on the historical backdrop to the issue of alleged SRA and how the International Society for the Study of Trauma and Dissociation (ISSTD) has interfaced with such allegations.

This paper represents additional background to a recently published commentary in Frontiers in the Psychotherapy of Trauma and Dissociation concerning alleged satanic ritual abuse, maladaptive daydreaming, false memories and organized abuse. Such issues are referenced here to the first individual the author knowingly diagnosed as having Dissociativ...

An Interview with Frank Putnam. Part One: The Early Years: Child Abuse Research, Dissociation and the Formation of the Society

While evidence suggests a division between two qualitatively distinct forms of dissociation, no scale has been specifically designed to differentiate between them. This study describes the development and validation of the Detachment and Compartmentalization Inventory (DCI). The DCI was developed from dissociation theory, 29 existing dissociation s...

This paper represents additional background to a recently published commentary in Frontiers in the Psychotherapy of Trauma and Dissociation concerning alleged satanic ritual abuse, maladaptive daydreaming, false memories and organized abuse. Such issues are referenced here to the first individual the author knowingly diagnosed as having Dissociativ...

An understanding of the modern construction of dissociative disorders and psychotic disorders rests on an appreciation of the historical forces shaping their evolution. This chapter focuses on the history of dissociation and psychosis, particularly as it relates to the concepts of hysteria and schizophrenia, from around the time of the Enlightenmen...

Individuals with dissociative identity disorder (DID) often report having no access to autobiographical experiences encoded by other identities. This research used the autobiographical Implicit Association Test (aIAT) to determine whether there was transfer of episodic self-referential memory events across amnesic identities. Nineteen DID individua...

Individuals with dissociative identity disorder (DID) often report having no access to autobiographical experiences encoded by other identities. This research used the autobiographical Implicit Association Test (aIAT) to determine whether there was transfer of episodic self-referential memory events across amnesic identities. Nineteen DID, 16 DID s...

An Interview with Dr Colin Ross MD: Dr Colin Ross MD, served as President of ISSTD (which was then known as ISSMP&D), during one of the most turbulent periods of ISSTD history. Colin became President-Elect in 1992, served as President in 1993 and Immediate Past President in 1994. The False Memory Syndrome Foundation was formed in 1992.

Interview with Richard Kluft.

In a recent article published in the ISSTD News (see below), details were given about the 2018 ISSTD Media Written Award going to the six Australian Royal Commissioners for the Royal Commission into Institutional Responses to Child Sexual Abuse. An opportunity arose for the ISSTD to publicly present Commissioner Atkinson with his award at a meeting...

Introduction Chapter. The book is derived from the Journal of Trauma and Dissociation special (double) issue

Abstract In the 1970s, a band of intelligent and inquiring professionals acquired a critical mass as they rediscovered the sort of patient that Josef Breuer had grappled to understand when he first encountered Bertha Pappenheim in 1880. Just over a century after Breuer ceased treating Bertha Pappenheim, a society dedicated to the study of dissocia...

Dissociative disorders are characterised by the disruption and discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behaviour. In depersonalisation/derealisation disorder, the person’s perception of the self and surroundings is altered and they may feel detached from...

This study examined shame and responses to it in adult dissociative disorder (DD; n = 24) and comparison psychiatric (n = 14) samples. To investigate how helpful different therapeutic responses are after shame disclosures in therapy, participants heard two vignettes from "mock" patients disclosing a) shame and b) surprise. Participants rated the he...

This paper examines Kluft’s construct of “weaponized sex” through the prism of long-term clinical and research involvement with individuals subjected to ongoing sexual abuse during adulthood, a group that by definition has been exposed to more sexual abuse and for longer than any other defined victim population. Examples of the same sort of phenome...

Controversy exists regarding the merits of exposure-based treatments for posttraumatic stress disorder (PTSD) versus a phased approach when prominent dissociative symptoms are present. The first aim of this study was to examine the degree to which diagnosing dissociation in two traumatized patients’ vignettes influenced clinicians’ preference for p...

Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertain...

Objectives: Elevated shame and dissociation are common in dissociative identity disorder (DID) and chronic posttraumatic stress disorder (PTSD) and are part of the constellation of symptoms defined as complex PTSD. Previous work examined the relationship between shame, dissociation, and complex PTSD and whether they are associated with intimate re...

Objectives: To conduct a preliminary study comparing different trauma and clinical populations on types of shame coping style and levels of state shame and guilt. Methods: A mixed independent groups/correlational design was employed. Participants were recruited by convenience sampling of 3 clinical populations-complex trauma (n = 65), dissociati...

Only a select number of studies have examined different forms of child maltreatment in complex dissociative disorders in comparison to other groups. Few of these have used child abuse-related chronic PTSD and mixed psychiatric patients with maltreatment as comparison groups. This study examined child sexual, physical and emotional abuse, as well as...

Until recently the widespread reality of ongoing incestuous abuse during adulthood had attracted no systematic research. The scientific literature was limited to the occasional case study and brief anecdotal references. This minimal literature was supplemented by biographical works written by or about victims of this form of abuse, and by press rep...

Whilst a growing body of research has examined dissociation and other psychiatric symptoms in severe dissociative disorders (DDs), there has been no systematic examination of shame and sense of self in relationships in DDs. Chronic child abuse often associated with severe DDs, like dissociative identity disorder, is likely to heighten shame and rel...

Objective: Despite its long and auspicious place in the history of psychiatry, dissociative identity disorder (DID) has been associated with controversy. This paper aims to examine the empirical data related to DID and outline the contextual challenges to its scientific investigation. Methods: The overview is limited to DID-specific research in...

3RD Fisherman: "Master, I marvel how the fishes live in the sea." 1ST Fisherman: "Why, as men do a-land -- the great ones eat up the little ones." [William Shakespeare (1564-1616), Pericles (1606-08), Act 2, Scene 1].

Although the subject of ongoing incestuous abuse during adulthood has never been addressed in a systematic way by the professional literature, accounts of such cases have been appearing for many years. The Josef Fritzl case added a new impetus to reporting such abuses in the popular press. This study presents 51 such cases from 25 countries that ap...

an important problem that has implications both for research and for treatment. Is it possible that in the mentally ill with early abuse histories we are dealing with the effects of serious neurobiological and psychological sequelae in genetically susceptible persons, rather than a disease entity? Institutions have been held accountable by the Roya...

Individual cases of adult incestuous abuse have surfaced repeatedly in the lay and professional literature of the past 1.5 centuries without it occasioning systematic investigation, such as the reporting of a case series of individuals subjected to such extreme abuse. Yet substantial numbers of patients with dissociative identity disorder at the ti...

Individual cases of adult incestuous abuse have surfaced repeatedly in the lay and professional literature of the last one and a half centuries without it occasioning systematic investigation, such as the reporting of a case series of individuals subjected to such extreme abuse. Yet substantial numbers of patients with Dissociative Identity Disorde...

Abstract This qualitative study examined factors contributing to the development and successful treatment of psychogenic non-epileptic seizures (PNES), in civilian men. In-depth interviews were conducted with therapist-client dyads comprising two male clients who had been successfully treated for PNES and their therapists. A theory-building case st...

No abstract available.

There are few topics in modern life that are more repugnant to consider than the abuse of a child by the very persons entrusted with his care. K. B. Oettinger (1968, p. v) [1]. While the etiological significance of early trauma and abuse for mental health difficulties has long been on the periphery of psychological thought, it has rarely taken cent...

Psychogenic nonepileptic seizures (PNES), somatoform symptoms that diminish quality of life, can be difficult to treat. A previously proposed conceptualization of PNES is further developed using grounded theory methodology to explore the understandings of therapists who successfully treated clients with PNES. Participants conceptualized PNES as non...

Little is known about similarities and differences in voice hearing in schizophrenia and dissociative identity disorder (DID) and the role of child maltreatment and dissociation. This study examined various aspects of voice hearing, along with childhood maltreatment and pathological dissociation in 3 samples: schizophrenia without child maltreatmen...

Describes a psychogenic theory of history, arguing that childrearing and the interpersonal expression of love impact upon the national and international arenas with greater force than any bomb. The author discusses the role of mothers in political progress, our psychological dependency on our enemies, and the concept of the "social alter"--that par...