Comorbid Disorders

Disorders that are often comorbid with DID/OSDD do not arise from the disorder itself, but rather from the circumstances which caused it. Since DID/OSDD necessitates that childhood trauma is present in order for it to form, it is linked to many other disorders that also arise from childhood trauma.

The primary responses to childhood trauma are most often PTSD, dissociative disorders, and borderline personality disorder. Secondary responses to childhood trauma include substance abuse disorders, eating disorders, somatoform disorders, and obsessive-compulsive disorder.²⁰

• Posttraumatic symptoms or PTSD are logical consequences of childhood abuse. Adults with traumatic backgrounds often experience many different kinds of intrusive recollections of the abuse, as well as emotional numbing and attempts to avoid reminders of the abuse.²⁰


• Dissociation appears to be an available psychological defense for abused children whose limited coping capacities are overwhelmed by extremely traumatic events. Dissociation enables such events to be “forgotten,” or at least emotionally distanced. Many such traumatized individuals have ongoing dissociative symptoms or develop dissociative disorders persisting into adulthood.²⁰


• Symptoms of borderline personality disorder—including ongoing relational disturbances, difficulty tolerating intense affects, impulsivity, and self-hate anemptiness—are consequences of the failures of attachment and the inadequate care and protection that are common in dysfunctional and abusive families.²⁰

Survivors of childhood trauma also frequently become involved in a variety of behaviors that have an addictive quality, including repetitive self-harm as a way of self-soothing, risk-taking behaviors, compulsive spending, and eating-disordered behaviors. In fact, in a significant minority of patients with eating disorders, childhood trauma seems to be a powerful contributor to their compulsive eating, fasting, exercising, and purging.²⁰

Data in the general population has shown high lifetime prevalences for alcohol and drug use disorders among those who experience PTSD: for alcohol abuse, 52% of men and 28% of women; for drug abuse, 35% of men and 27% of women.²¹