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“Given that recent research has demonstrated the complex psychopathology of DID, equating the disorder with one specific but broadly denned behavior (multiple identity enactment) is clearly unwarranted. The latter should be conceptualized as one observable behavior that may or may not be related to a feature of the disorder (identity alteration). As an analogy, equating major depressive disorder with "acting sad" would be similarly unwarranted because the former is a complex depressive disorder characterized by a clear group of depressive symptoms, whereas the latter is one specific behavior that may or may not be related to one of the symptoms of the disorder (sad affect). One could also easily generate a list of factors that affect whether one acts sad that would have little relevance to the complex psychopathology of depressive disorders.”

“Identity alteration is a more general term for the objective behaviors that are manifestations of the assumption of different identities (Steinberg, 1993). It includes not only behaving like a different person but also disremembered behaviors, finding possessions for which one cannot account, hearing voices and carrying on internal or written dialogues between dissociated ego states, spontaneous age regressions to traumatic events, and referring to oneself as "we." Overtly behaving as if one were a different person does not appear to be typical of the clinical presentation of DID...”