Dissociative Identity Disorder and its Effect on Academic Achievement - Research Proposal Example

How aware are lecturing staff in higher education of Dissociative Identity Disorder (DID), the condition and its effect on academic achievement? BY YOU YOUR SCHOOL INFO HERE DATE HERE 1.0 Introduction Dissociative Identity Disorder (DID) Disorder is a form of mental illness in which the afflicted individual exhibits, at a minimum, two distinct personalities or identities which influence behaviour patterns (Lynn, Lilienfeld, Merckelbach, Giesbrecht and Van Der Kloet, 2012; Merskey, 1995; WHO, 1993). Symptoms of DID include significant memory impairment which causes the individual to forget activities and behaviours that occurred during periods of consciousness with alternate personalities (APA, 2004). “The essential feature of the Dissociative Disorder is a disruption in the usually integrated functions of consciousness, memory, identity or perception” (APA, 2000: 519). Dissociative Identity Disorder is usually supplemented with symptoms of psychosis and the majority of those diagnosed with the disorder have histories of significant trauma (Spiegel, Loewenstein, Lewis-Fernandez, Sar, Simeon, Vermetten and Cardena, 2011; Foote and Park, 2008). In studies targeting samples of the general population, it has been determined that the prevalence of DID is only 1 to 3 percent of the total global population (Sar, Akyuz and Dogan, 2007; Johnson, Cohen, Kasen and Brook, 2006). Of particular interest with this mental disorder is the potential prevalence of DID among students of higher education. There is a significant gap in available empirical studies indicating the prevalence of DID amongst university students and the extent to which educators maintain awareness of the challenges of this disorder and its potential impact on academic achievement. Hence, this proposed study can provide new knowledge about lecturer training and available information resources to assist in effectively teaching students with legitimately-diagnosed DID. 1.1 Aim and research question The aim of this study is to determine whether educators are effectively equipped with knowledge that can assist in providing more productive teaching for students with Dissociative Identity Disorder. The study’s research question is: To what extent do higher education lecturers understand the complexities and realities of DID in the learning environment when working with students manifesting DID symptoms? 2. Literature review This chapter conducts an in-depth examination of the limited available literature on symptoms associated with the condition in an attempt to apply this knowledge to the academic environment. With such a limited volume of empirical studies available illustrating educator competency and knowledge of DID amongst higher education students, this review of literature focuses on situations involving primary-aged students supported by previous research studies on this topic. This may or may not be applicable to older students with higher levels of cognitive reasoning and ability to abstractly assess their own mental condition, however it provides an appealing underpinning for potential impact on academic achievement for students with DID in the higher education environment and the potential role of lecturer in managing a classroom where DID is present. 2.1 Known symptoms of DID “The accurate identification of DID among students illustrating symptoms of DID is especially challenging because they often experience other problems such as mood disorders, anxiety or psychotic disorder” (Levy and Swanson, 2011: 75). The onset of DID can be either gradual or sudden onset (Sar, 2011), hence if a student maintains symptoms of DID, can an educator who might theoretically be aware of the condition effectively contend with learning challenges of an afflicted student? Several studies have found that students, as a result of recurring sleep disturbances, exhibit dissociative characteristics such as proneness for fantasy, but do not necessarily have legitimate DID (Fassler, Knox, and Lynn, 2006; Giesbrecht, Jongen, Smulders and Merckelbah, 2006). In legitimate cases of student DID, the pupil may suddenly strike other students, begin swearing or begin shouting as a result of a potential trigger which occurs when disparate parts begin controlling awareness and behaviour patterns (ISSTD, 2014). Having no legitimate memory of this dissociative episode, the student may remain adamant that these disturbances even occurred, which would cause disruption in teaching effectiveness and impact student achievement (Yehuda, 2005). Now, these dissociative episodes, as described by Yehuda, are relevant for primary school-aged youths, however there are limited empirical studies focusing on students of higher education. However, Merckelbach, Rassin and Muris (2000) found that university students maintaining dissociative symptoms manifest schizoid-type behaviours which include lack of attention, slowed executive functioning, cognitive processing speed reductions, and difficulty sustaining long-term memory (Baier, 2010; Van Os and Kapur, 2009). Hence, manifestation of any or all of these symptoms as a result of dissociation would theoretically cause significant classroom disturbances and difficulty in providing effective teaching outcomes for students with substantial disconnect between reality and cognitive functioning. It was also recognised by Levy and Swanson (2011) that Dissociative Identity Disorder is supplemented by manifestation of psychotic disturbances. Psychosis is deemed to be an abnormal mental disturbance characterised by dissociation from reality that can include sustainment of disturbing delusions, catatonia and even prevalence of hallucinations with a significant impairment of social cognition (Fusar-Poli, Deste, Smieskova, Barlati, Yung, Howes, Stieglitz, Vita, McGuire and Borgwardt, 2012). Such manifestations of psychosis alongside DID symptoms can include hearing voices, maintaining paranoid thoughts and a phenomenon known as waxy flexibility in which the afflicted maintains limited response to stimuli or sustains an immobile position (Ungvari, Goggins, Leung, Lee and Gerevich, 2009). Sinawi, Nandhagopal, El Guenedi, Obaid and Al-Asmi (2013) present a case study of a 19 year old university student who manifested catatonic behaviours, standing virtually immobile for several hours at a time. Over time, this student began to lose speech abilities, withdrew from social environments and refused to attend to his personal hygiene. Teaching students that exhibit such characteristics is not simplistic. It is recommended that educators first attempt to reduce stress in the classroom which can serve as a trigger for such episodes, set realistic learning goals, work diligently to encourage student participation in-class and conduct regular meetings with parents and the student to discuss issues or solutions to the social problems common with catatonic symptoms (AFE, 2006). Individuals with DID that manifest symptoms of catatonia have reported a potent inability to regulate their anxious states as part of the psychotic attributes commonly associated with DID (Northoff, Krill, Eckert, Russ and Pflug, 1998). Having described the potential symptoms that might be exhibited by individuals with Dissociative Identity Disorder with supplementary psychotic behaviours, it begs the question as to whether educators are being provided with ample information about the complexities of DID that could serve as potential barriers for establishing an appropriate learning curriculum and act as a detriment to academic achievement. 2.2 Potential challenges in identifying legitimate DID symptoms There is a difficulty in determining whether a student of higher education actually maintains legitimate DID. Kluft (1985, 1986) found that the presence of multiple personalities can be faked by university students. Spanos (1994: 148) supports these findings with empirical evidence, offering that samples of normal college students can be led to “create what appears to be an alter personality under the right environmental conditions” According to Kluft (1986), in most legitimate instances of Dissociative Identity Disorder, victims attempt to mask memory lapses when they occur, work diligently to hide their alter personalities, and attempt to pass as being normal with high levels of success in this endeavour (Kluft, 1986). Hence, are today’s lecturers in higher education aware that students may attempt to gain attention when sustaining other mental disorders (other than DID), manifesting false symptoms of DID? Are educators aware of how to assess and diagnose legitimate cases of DID in their student populations in order to effectively respond? Again, due to the lack of empirical data on educator awareness, it is difficult to assess the extent of knowledge and expertise which exists in contemporary higher education classrooms to discern genuine versus deceptive DID symptom manifestation from students. 2.3 Summary Though there is a tremendous gap in knowledge literature on the potential level of awareness for higher education lecturers on DID and its impact on academic achievement, this review of literature served as a foundation for understanding the illness, its potential challenges and understanding whether an educator is actually working with a legitimate case of DID in the classroom. Because of this significant limitation in knowledge, a primary study targeting a sampling of current lecturers in higher education can serve to close this research gap. 3.0 Methodology There is not enough empirical data available on the topic under study to develop a workable hypothesis. Hence, the research study will be exploratory, a relevant approach when there is a need to build a new familiarity with a phenomenon and when theory is too generalised to develop a hypothesis (Stebbins, 2001). In most exploratory research studies, qualitative research provides for understanding of the “how”, “when” and “why” a situation occurs, but fails to provide knowledge of “how many” or “how often” (Babbie, 2007). Hence, this exploratory study will utilise a mixed methodology in order to gain the richness and depth of understanding required on a topic in which there is limited historical empirical data. To effectively answer the research question, to what extent do higher education lecturers understand the complexities and realities of DID in the learning environment when working with students manifesting DID symptoms?, the study will utilise surveys and interviews with relevant lecturer professionals in the higher education environment. The use of qualitative research (the interview) is justified in a situation in which the researcher is unsure of what exactly should be measured (Miles, Huberman and Saldana, 2013). The gap in available research literature on the topic creates a phenomenon in which interpretation of the scenario relies on using inference to achieve a very comprehensive and intensive description of the phenomenon (Miles and Huberman 1994). The qualitative research approach allows an opportunity for the researcher to become personally engaged in the phenomenon being studied to improve researcher competencies in both data collection and potential academic best practice pertaining to lecturer responses and strategy developments for working with DID students. The mixed methodology inclusive of quantitative research methods is also justified as it provides a further scientific understanding of the phenomenon being measured which reduces opportunity for introducing error into analysis of findings, hence improving study validity. The survey instrument being utilised for this study will be developed using a Likert-type scale with ranked categories between 1 and 5, where 1 = not at all, 3 = a neutral response, and 5 = substantially. Limited the number of categories for participant selection is rationalised as when participants are given numerous response categories, they often have a difficult time conducting productive discrimination which tends to deplete response validity (Al-Khalifa and Peterson, 2002). This study will take a quantitative approach to research, utilising surveys developed with a Likert-type scale with a ranking structure between 1 and 5, where 1 = strongly agree and 5 = strongly disagree; a score of three will represent neutrality. When a survey instrument maintains substantial volumes of response categories, consumers have a difficult time discriminating productively which can reduce validity of responses (Al-Khalifa and Peterson 2002). The use of Likert scales are advantageous in quantitative research since it is symmetric, where there are equal volumes of potentially negative or positive sentiments related to the criteria being investigated (Burns and Burns 2008). This Likert scale instrument is also justified as the most appropriate research instrument for this study as responses cannot be effectively refuted due to the ability of the researcher to execute rather simple mathematical computations and analyses. This approach does not compel participants to commit to a firm stand associated with response categories by being coerced to provide no or yes responses which makes responding less complicated for the recruited sample. It is probable that some respondents selected for this study will sustain a certain level of indecision about an identified issue and the Likert scale, using only five criteria, provides opportunities to sustain this neutral position. Coding becomes more simplistic using the Likert survey instrument as only a singular mathematical representation serves to characterise participant sentiment and response (Trochim, 2006). The interviews will be constructed as semi-structured research instruments, allowing for some level of free expression by participants about their attitudes, experiences and competencies in understanding Dissociative Identity Disorder and its relationship to the educational process. The semi-structured interview template is less invasive to the participant and allows for effective two-way communications between participant and researcher (FAO, 2008). Because there is a plethora of knowledge collection required associated with the research topic which is not supported by vast volumes of historical empirical data, gaining multiple and multi-faceted responses from participants will be absolutely critical in understanding the extent to which modern lecturers maintain knowledge and experience about DID and its role in teaching and student achievement outcomes. 3.1 Recruitment The researcher will attempt to recruit between 20 and 30 currently-employed lecturers in the higher educational environment to gain a broader perspective of the phenomenon and its relationship to educational practices. The recruitment ideology will consist of a random sampling method, a technique that eliminates bias from the selection methodology. Simple random sampling identifies a subset of participants from a larger population, selected entirely by chance, where each selected individual maintains equal probability of being selected during each stage of the sampling procedure. As there is such a substantial gap in literature describing awareness levels of today’s lecturers on the condition of Dissociative Identity Disorder that does not identify any specific demographics or other characteristics that might be more beneficial for study recruitment, the simple random sampling technique ensures that the study is devoid of classification error and is justified in the situation where the researcher maintains limited knowledge about the dynamics and characteristics of the broader educator population. The researcher will make contact with relevant university administrative personnel to gain approvals to conduct a small-scale, non-invasive research study on DID and educator knowledge of this phenomenon. The researcher will inquire to school administration about the benefits of gaining diverse perspectives from multiple educators in different domains of knowledge (i.e. business, social sciences, marketing, media studies, sociology, psychology, etc.). Once gaining approval and identifying potential participants likely to participate, surveys will be distributed to selected educators who will be given a one week deadline for completion and return of the completed instruments, utilising the assistance and inter-professional competencies of the university administrative team to facilitate dissemination of the surveys and collection. Interviews will also be coordinated with school administration, identifying six different educators with varying backgrounds and expertise to provide more richness to the study investigation. Upon making contact with those identified, interviews will be scheduled for between 30 and 45 minutes each where questions pertaining to DID, its symptoms, and potential impact on student academic achievement will be communicated. 3.2 Data analysis Mean analysis will be conducted upon return of the completed survey instruments in order to determine the average level of knowledge regarding DID, teaching best practices, and awareness of DIDs impact on student achievement. This methodology provides a common average sentiment of the participant group and can be charted in table format to ensure ease of presentation and simplistic analyses by the audience upon publication. Interview data will be transcribed and content analysis utilised to determine any potential correlations, discrepancies, or opinion regarding such phenomenon as availability of knowledge for educators on this illness, its challenges in a higher education classroom environment, strategies for improving educational outputs for challenged students afflicted with this disease, and general opinion about DID and its role in facilitating effective education. Further consultation with secondary literature in the domains of psychology, sociology and education (i.e. journals and industry reports) will supplement analysis of interview findings to supplement the existing gap in researcher expertise in these domains that are vital for conducting a competent and dependable analysis. Gaining perspectives on further symptoms of DID, as compared to participant responses and opinion, will enhance the legitimacy of analyses conducted and authenticate researcher competency to conduct such an analysis. Any notable correlations, such as demographics or domain of expertise with like respondents, will be charted using appropriate graphs if such correlations are identified. Upon distributing the survey instruments and conducting the interview process, all respondents recruited will be asked for their tenure, domain of teaching expertise, gender, age, educational background, and other relevant characteristics. This approach could be highly valuable in understanding whether it is only certain domains of educational expertise that maintain higher (or lower) comprehension of DID which could, if identified, provide recommendations for improving educator competency in institutions of higher learning or in school administration toward improving education of DID for contemporary lecturers. This strategy might also identify that tenure is directly correlated with level of knowledge of DID and its impact on student achievement or serve to explain why some lecturers might have more potent and effective strategies for improving the academic achievement outcomes for students who have fallen victim to DID. 4.0 Ethical issues The ethical concerns of this proposed study are quite insignificant. As justified by law, student privacy is of the utmost concern to educators and is an obligation of this profession. Upon conducting the interview process, recruited participants will be told reminded not to mention any student names in their (potential) experiences with Dissociative Identity Disorder. Both the interview participants and the survey participants will be distributed a consent form which indicates there will be no compensation for participation in both the qualitative and quantitative portions of the study and guaranteed individual anonymity upon publication of the study’s findings. Otherwise, all participants in this study are of adult age, hence none of the ethical considerations common in studies utilising minor-aged youths are applicable here. Furthermore, the researcher maintains rather strong opinion about DID and the social stigmas that often pervade social and professional aspects of lifestyle for those afflicted. It will be crucial to maintain objectivity when interviewing using the semi-structured approach and it will be an objective to ensure that all responses are given fair consideration. Personal biases and opinion will not be introduced into the study and, to ensure this, the researcher will, pre-interview, consult with appropriate literature offering strategies to eliminate all forms of bias and prejudice when constructing the interview questions and facilitating discussion. 5.0 Limitations of the proposed study The first and most significant limitation of the study is the volume of participants being recruited for interview and survey participation. Tangible student limitations (i.e. financial and geographic) forbid recruitment of a large sample group from disparate regions of the country. It could be a phenomenon that education about DID is more prevalent in certain regions of the UK which might cluster knowledge in certain geographic areas. If the student maintained the capacity and co-research support necessary to achieve a broader perspective from a much larger sample group, it might identify educational disparities and knowledge management activities related to DID and the educational environment from a regional perspective. A larger sample group might provide new knowledge about how to improve regional education for lecturers on the DID phenomenon to enhance knowledge production throughout the country. A larger sample population recruited might also provide more valuable information that could be representative of the holistic educator population throughout the whole of the United Kingdom that might be limited by regional characteristics and cultural influence. Yet another limitation of this study is the lack of researcher capability to conduct a more in-depth investigation, a case study approach, that would entail productive observation, focus group administration, and direct interviews with students who actually maintain DID symptoms. By including students into the study as participants under investigation, it could provide very unique understandings of the complexities of the mental illness and how it manifests itself in a higher education environment. This process of recruiting real-world case study participants would provide a richer set of findings about the phenomenon of DID in order to make comparisons as to whether the knowledge that might be held by today’s lecturers is even relevant as compared to actual symptomology for this difficult condition. 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The language of dissociation, Journal of Trauma and Dissociation, 6(1), pp.9-29. Read More