Multiple personality disorder as perpetrator of child abuse.

An eighteen-month-old Alaskan girl suffered transient coma with multiple superficial contusions when injured by her multiple personality disturbed caretaker. The relative disinterest in multiple personality disorder as a psychiatric diagnosis among American trained practitioners is reflected in the great difficulty encountered by child protection workers while seeking psychotherapy for this disturbed family. The public health nurse, pediatrician, and social workers of the child protection team were unsuccessful in attempting to secure psychiatric therapy for this child batterer. Multiple factors, other than psychiatric community disinterest in multiple personality disorders, influenced these unsuccessful attempts. Legal process delays, strongly punitive community attitudes, tired and nearly "burned out" child protection workers, and conflicting psychological and psychiatric consultant opinions are described. A brief review of multiple personality disorder traits is given with emphasis on the common childhood exposure to abuse and violence among reported multiple personality subjects. Despite the obvious hope by the eighteen-month-old child's parents for effective help to reconstitute her family, the multiple factors described show institutional neglect and abuse which has made such recovery impossible to date. A plea is made to all persons involved with child abuse and neglect to more accurately diagnose and treat multiple personality disorders in abusive parents.