RESUMO
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.
Assuntos
Transtorno Dissociativo de Identidade/diagnóstico , Transtorno Dissociativo de Identidade/psicologia , Religião e Psicologia , Brasil , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Pessoa de Meia-Idade , SuperstiçõesRESUMO
Este trabalho tem como objetivo analisar a estruturação do diagnóstico de Transtorno de Personalidade. Inicialmente, o trabalho percorre o território conceitual com o qual, desde sua origem na passagem do século XVIII para o XIX, a psiquiatria procurou nomear, explicar e compreender as personalidades consideradas anormais. Em seguida promove-se uma discussão acerca das concepções de personalidade, normalidade e patologia que circunscrevem a categoria, orientada a partir do estudo de seus diferentes modelos diagnósticos presentes no DSM-5. Por fim busca-se compreender a relevância atual do diagnóstico de transtorno de personalidade através da análise de alguns exemplos de seu uso em contextos médico, legal e literário. O objetivo é o de entrever o lugar ocupado por esse diagnóstico, especialmente o do tipo Antissocial, no imaginário cultural presente
This work analyzes the processes through which the diagnosis of personality disorder has been structured. First, it covers the conceptual territory through which, from its origin in the passage of the eighteenth century to the nineteenth, psychiatry sought to name, to explain and to understand the so called abnormal personalities. This first step is followed by comments on the concepts of personality, normality and pathology that take part in the construction of this psychiatric category as it exists today. In order to do this, the structure of different diagnostic models present in the DSM-5 is analyzed. Finally, we seek to understand the current relevance of the diagnosis of personality disorder by taking into consideration examples of its use in medical, legal and literary contexts, in order to shed some light over the place occupied by this diagnosis, especially the anti-social type, in today's cultural landscape