Neuroanatomical Predictors of Suicidality in Women with Dissociative Identity Disorder

Linnell, Lilly-Beth

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Neuroanatomical Predictors of Suicidality in Women with Dissociative Identity Disorder

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Dissociative Identity Disorder (DID) occurs when an individual has two or more separate identities (or personality states; DSM-5, 2013). While those who have DID are more likely to engage in self-harm, suicide attempts, and completed suicides (Kluft, 1995; Webermann et al., 2016; Foote et al., 2008; Galbraith & Neubauer, 2000; Tanner et al., 2017), much of the research on suicide has excluded individuals with DID (Foote, et al., 2008). One reason for this exclusion is that it becomes difficult to identify and treat suicidal ideations and behaviors when an individual has multiple, often competing, identities. Moreover, traditional methods of studying suicidality (e.g., self-report and diagnostic measures) are less reliable when an individual completes it with one identity and then another identity emerges (see Rifkin, et al., 1998 for more on this issue). Given the limited research, the current study seeks to examine suicidality with individuals with DID. To account for the complexities of understanding suicidality with individuals with DID, we rely on structural MRI images which can help us assess the current suicide risk as well as history of suicide attempts based on cortical thickness (width of the gray matter in the cortex) and subcortical volume of associated regions (width of white matter of subcortical regions) (Tahedl, 2020). We chose cortical thickness and subcortical volume because research has shown that as they are important neurological characteristics that are greatly influenced by genetic influences, psychiatric and mood disorders, etc. (Bas-Hoogendam et al., 2018; Xu et al., 2020; Zhao et al., 2017) and have significant associations to intellectual ability, social cognition, and other aspects of cognition including verbal recall and visuospatial functioning (Menary et al., 2013; Serra et al., 2020; Sowell et al., 2008). Thus, this study aims to develop a neuroanatomical foundation of suicidality in DID to be used towards achieving a better understanding of the neural mechanisms behind suicidality for those with DID.

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