Resolved: multiple personality disorder is an individually and socially created artifact.

Where's hysteria now that we need it? With DSM-IV, psychiatrists have developed a common language and a common approach to diagnosis. But in the process of operationalizing diagnoses, we may have lost some concepts about patient behavior. The term "hysteria" disappeared when DSM-III was published; without it, psychiatrists have been deprived of a scientific concept essential to the development of new ideas: the null hypothesis. This loss hits home with the epidemic of multiple personality disorder (MPD). The work of Talcott Parsons (1964), David Mechanic (1978), and Isidore Pilowsky (1969) taught psychiatrists to appreciate that phenomena such as hysterical paralyses, blindness, and pseudoseizures were actually behaviors with a goal: achieving the "sick role." Inspired by Parsons, Mechanic and Pilowsky used the term "abnormal illness behavior" in lieu of hysteria. Their approach eliminated the stigma of malingering that had been implied in hysteria and indicated that patients could take on such behavior without fraudulent intent. They were describing an old reality of medical experience. Some people-experiencing emotional distress in the face ofa variety oflife circumstances and conflictscomplain to doctors about physical or psychological symptoms that they claim are signs of illness. Sometimes they display gross impairments of movement or consciousness; sometimes the features are subtle and changing. These complaints prompt doctors to launch investigations in laboratories, to conduct elaborate and sometimes dangerous studies of the brain or body, and