Causes & Risk Factors of Dissociative Identity Disorder
Trauma and dissociation are closely entwined, with our brains often doing what they can to protect us from overwhelming harm. However, dissociating long-term, such as after childhood trauma, can carry significant mental health impacts, including the risk of dissociative identity disorder (DID).
This severe type of dissociative disorder is often complex to understand and diagnose, although there are clear environmental factors that can lead to DID. Understanding these factors is not only useful for DID prevention but also for someone’s unique treatment.
If you’re concerned about dissociative disorder development in yourself or a loved one, a mental health professional can help you get to the root causes. They can also assist you in accessing the right form of treatment based on your needs.
This article can also help you better understand the risk factors of dissociative identity disorder by exploring:
- What dissociative identity disorder is and its symptoms
- How traumatic events can lead to dissociation
- Potential causes of DID
- Other risk factors for developing DID
- Triggers that could cause DID episodes in adulthood
- Where to find professional support
Overview of Dissociative Identity Disorder
Dissociative identity disorder (DID) is the most severe dissociative disorder, with profound and persistent impacts on daily life, mental health, and behavior. Therefore, understandably, it can be extremely distressing for those who have it and their loved ones.
DID is characterized by ongoing dissociative symptoms, amnesia, and the presence of alternate identities (“alters”). Alters typically function independently of each other, so they tend to have their own memories and ways of expressing themselves.1
Additionally, when someone with DID switches between alters, they may exhibit trance-like behavior, eye-rolling, or changes in their posture.1 Once they’re inhabiting a different identity, they may experience amnesia because alters often don’t have access to each other’s memories. For instance, someone may come across a new item they don’t remember buying because another alter was in control at the time of making the purchase.2
Other dissociative symptoms can be organized into two categories: depersonalization (DP) and derealization (DR).
Depersonalization relates to one’s own self, such as not recognizing their reflection in mirrors or feeling as though they’re an observer of their own actions. In contrast, derealization is focused on the external environment; for example, the world feeling dreamlike, or familiar spaces seeming strange.3
These unnerving and distressing symptoms stem from a disruption to the person’s sense of self, often caused by trauma at a young age. For instance, traumatic events before the age of five can have a tremendous impact on the development of identity and sense of self.1 This is especially the case if a child isn’t sufficiently supported after trauma.
Therefore, treatment for DID typically focuses on addressing trauma, and this can be done through several therapies. There is no medication specifically for DID, though some may be prescribed antipsychotics or mood stabilizers to help with symptom management.1
How Does Trauma Cause Dissociation?
Trauma can be a single event or a series of events that are life-threatening or physically and emotionally harmful. In other words, if an event is traumatic, it typically has long-lasting effects on someone’s physical, mental, social, emotional, or spiritual well-being.4
As a result of this impact, trauma can cause dissociation in the following ways.
Activating the Fight-Freeze-Flight System:
Often, a traumatic event activates our “fight-freeze-flight” system, helping us to react to and protect ourselves from a threat. So, when the brain registers a trauma, it can dissociate and try to “block out” what’s happening. This is a protective measure, shielding us from experiencing the full blow of the event.5
Interacting With Biology and Environment:
Not everyone will react in the same way to the same traumatic event. Things like age and genetics can determine a threshold for how much overwhelm our brains can tolerate. In addition, compared to living in an unsafe household, having a supportive family can help children be more resilient to traumatic events – changing how they process them.5
Causing Flashbacks and Intrusive Thoughts:
Later in life, the brain may allow someone to see small glimpses of previous traumatic memories, which is why some with DID experience flashbacks and intrusive thoughts.5 When traumatic memories resurface for people with dissociative tendencies, scientists observe slowed heart rates and reduced activity in the amygdala (the brain’s emotional center). This demonstrates how dissociation is used by the brain to reduce stress.3
Contributing to Mental Health Conditions:
Trauma and dissociation are not only linked with DID. This self-protective brain function is also seen in other trauma-related disorders caused by disruptions to selfhood in early life. For example, borderline personality disorder (BPD).
Interestingly, about 64% of people who meet the diagnostic criteria for BPD also meet the criteria for DID – especially when relational trauma such as neglect is present.6 Therefore, some experts suggest these conditions could exist on a spectrum because trauma doesn’t always result in multiple identities, but there are some shared outcomes.7 For example, difficulties with close relationships and PTSD symptoms.
The Causes of DID
As mentioned, early trauma is considered to be the main contributing factor to DID. In many cases, dissociation and the development of alters can be seen as an extreme survival strategy for enduring and overcoming the most difficult forms of abuse. It is the mental compartmentalization, emotional numbing, and detachment from disturbing emotions.7
The following information breaks down some different forms of early trauma that could lead to DID.
Early Abuse:
The early trauma that could cause dissociative identity disorder might be physical, emotional, or sexual abuse.
More specifically, DID can also stem from caregiver neglect or abuse that disrupts the process of child-parent attachment. In addition, abuse can crucially involve the violation of boundaries, which are essential for developing a secure sense of self and a safe concept of the world and others.7
Parenting Style:
Another childhood factor that could contribute to DID is experiencing an authoritarian parenting style. For instance, children with extremely rigid, critical, or intolerant parents may suffer verbal and physical abuse, causing them to feel persistently unsafe at home. Long-term stress of this kind can result in complex post-traumatic stress, as well as DID.7
Perhaps paradoxically, some people with DID may have had parents who inverted the normal parent-child relationship. “Parentification” is when children are called upon to take on adult responsibilities, such as difficult housework or childcare. Alternatively, some parents may require their children to be confidants and friends.7 Therefore, alter personalities could be an attempt for children to parent themselves, and dissociation could be a way for them to ignore their own unmet needs.8
Biology, Personality, and Society:
The tendency to dissociate may also have a genetic component or be influenced by someone’s inherent temperament. So, while the familial conditions we’ve discussed are strongly correlated with DID, there may be other factors that predispose someone.7 For example, the need to dissociate could also come from societal and cultural sources, such as community violence, war, poverty, or certain religious traditions.7
While early childhood trauma is considered to be the main cause of DID, there are a number of other risk factors that can contribute to the condition. We cover these in the next section.
Other DID Risk Factors
While trauma can be considered the main risk factor for developing DID, there are more specific risk factors that can further contribute to the disorder.
For example, children are more likely to be maltreated if they’re under the age of four, unwanted, or have an intellectual disability.10 Parents are also more likely to mistreat their children if they:
- Have been mistreated themselves
- Lack awareness of child development
- Have a mental health condition
- Struggle to bond with their newborns
- Misuse drugs or alcohol
- Have low self-esteem
The risk of abuse is also increased if there’s violence between family members or the family is isolated in their community. Families may also be impacted by societal factors such as inadequate housing, high levels of unemployment and poverty, and easy access to drugs.10
Plus, when children consistently experience their caregivers as frightening or violent, they’re more likely to develop a disorganized attachment style. In this style, an inner conflict typically occurs in which the child views their caregiver as both a source of love and fear. In adulthood, this can show up as adults both craving and fearing intimacy.11
DID and disorganized attachment involve a lack of self-integration, where someone’s thoughts, feelings, and behaviors are fragmented and don’t seem to come from a cohesive sense of self. Further, both show signs of detachment, though this is more extreme in those with DID.9
As previously mentioned, there may also be a genetic component to dissociation. Though research is inconsistent, some studies suggest dissociation could be linked to certain stress hormones and neurotransmitters (such as serotonin and dopamine). Therefore, trauma may activate or worsen certain biological pathways in people who are predisposed to dissociation.12
What Triggers DID Episodes?
Understanding the causes of someone’s DID is often essential to the treatment process, but they’ll also benefit from recognizing what’s causing their episodes in the present. This means understanding their DID triggers and the things that cause them to switch between alters.
In general, stressful events can trigger DID symptoms out of dormancy, but different people have unique stressors.13 Due to what we know about the familial circumstances that can cause DID, we may be able to foresee certain triggers being particularly strong. For example, DID triggers may include:
- Social dynamics that put someone into a “victim,” “rescuer,” or “perpetrator” role
- Reminders of their abuse, for example, an aggressive person or sexual media
- Feeling trapped in a social dynamic or physical space
- Ups and downs within close and intimate relationships
- Different emotional states. For example, feeling maternal in some circumstances while seeking reassurance in others
These triggers are a rough guide to what may cause someone to switch between alters.13 However, sometimes there may not be a clear reason for switching.
In fact, in the beginning, even therapy may be a psychological risk factor for DID episodes, as it can bring up painful memories. Nevertheless, bringing alters into the therapeutic space is typically crucial to the healing process.14
Mission Connection: Get Support for Dissociation Today
While you may have a mental health predisposition to dissociating or having a dissociative disorder, it’s never too late to seek help. Treatment for DID typically involves careful and compassionate trauma-informed therapy designed to help people process and integrate their trauma. Medication may also enter the picture if you need help managing any co-occurring symptoms that impact your quality of life.
At Mission Connection, we offer a range of in-person, online, and group therapies, as well as inpatient options for those needing more comprehensive support. Reach out today to enquire more about our treatment options and how we can support you towards a more peaceful, integrated life.
References
- Mitra, P., & Jain, A. (2023, May 16). Dissociative Identity Disorder. PubMed; National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK568768/
- TraumaDissociation. (n.d.). Dissociative Experiences Scale – II. Retrieved September 11, 2025, from https://traumadissociation.com/des?utm_source=chatgpt.com
- Murphy, R. J. (2023). Depersonalization/derealization disorder and neural correlates of trauma-related pathology: A critical review. Innovations in Clinical Neuroscience, 20(1–3), 53–59. https://pmc.ncbi.nlm.nih.gov/articles/PMC10132272/
- Yadav, G., & Gunturu, S. (2024). Trauma-Informed therapy. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK604200/
- Texas A&M University. (2016, December 9). Can you unconsciously forget an experience? ScienceDaily. Retrieved August 31, 2025, from https://www.sciencedaily.com/releases/2016/12/161209081154.htm
- Chapman, J., Jamil, R. T., & Fleisher, C. (2024). Borderline personality disorder. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430883/
- Bistas, K., & Grewal, R. (2024). Unraveling the Layers: Dissociative Identity Disorder as a Response to Trauma. Cureus, 16(5). https://doi.org/10.7759/cureus.60676
- Lackie, B. (1999). Trauma, invisibility, and loss: multiple metaphors of parentification. In N. D. Chase (Ed.) Trauma, invisibility, and loss: Multiple metaphors of parentification (pp. 141-153). SAGE Publications, Inc., https://doi.org/10.4135/9781452220604.n8
- Lyons-Ruth, K., Dutra, L., Schuder, M. R., & Bianchi, I. (2006). From Infant Attachment Disorganization to Adult Dissociation: Relational Adaptations or Traumatic Experiences? Psychiatric Clinics of North America, 29(1), 63–86. https://doi.org/10.1016/j.psc.2005.10.011
- World Health Organization. (2024, November 5). Child maltreatment. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/child-maltreatment
- Lawler, M. J., & Talbot, E. B. (2012). Disorganized Attachment – an overview. ScienceDirect Topics. Www.sciencedirect.com. https://www.sciencedirect.com/topics/psychology/disorganized-attachment
- Rajkumar, R. P. (2022). The Molecular Genetics of Dissociative Symptomatology: A Transdiagnostic Literature Review. Genes, 13(5), 843. https://doi.org/10.3390/genes13050843
- Şar, V., Dorahy, M., & Krüger, C. (2017). Revisiting the Etiological Aspects of Dissociative Identity Disorder: a Biopsychosocial Perspective. Psychology Research and Behavior Management, 10(10), 137–146. https://doi.org/10.2147/prbm.s113743
- Şar, V. (2014). The Many Faces of Dissociation: Opportunities for Innovative Research in Psychiatry. Clinical Psychopharmacology and Neuroscience, 12(3), 171–179. https://doi.org/10.9758/cpn.2014.12.3.171