- Developmental trauma is a primary aetiological factor in DID and can lead to misdiagnosis given symptom overlap with other psychiatric and neurological conditions.
- Inconsistent parenting and intense paternal pressure foster narcissistic vulnerability, acute narcissistic rage, and may precipitate identity fragmentation with dissociative amnesia.
- An empathetic, mirroring psychotherapeutic approach supporting the disrupted grandiose self was associated with marked reduction in dissociative symptoms; further research warranted.
Case Rep Psychiatry. 2026 Aug 7;2026:1403303. doi: 10.1155/crps/1403303. eCollection 2026.
ABSTRACT
Developmental trauma is a primary etiological factor in dissociative identity disorder (DID) and may lead to misdiagnosis due to symptom overlap with other psychiatric and neurological conditions. This case report describes an adolescent male with pronounced narcissistic vulnerability. The patient’s background features an inconsistent parenting style-characterized by both overprotection and severe criticism-and significant paternal pressure to achieve academic success and embody an idealized, wise persona. Chronic exposure to these psychosocial stressors is hypothesized to have contributed to acute narcissistic rage, potentially associated with dissociative identity fragmentation. The initial clinical presentation involved functional neurological symptoms, which progressed to distinct identity states with amnesia. Treatment focused on supporting the patient’s disrupted grandiose self-structure through an empathetic, mirroring psychotherapeutic approach. This intervention was associated with a marked reduction in dissociative symptoms. Further research is needed to clarify the complex role of narcissistic vulnerabilities in the development of dissociative identity presentations.
PMID:42571217 | PMC:PMC13451853 | DOI:10.1155/crps/1403303
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