Polyfragmented Dissociative Identity Disorder
DID (or the similar form of DDNOS) sometimes involves a very large number of alternate identities (also known as alters, alternate personalities, personalities, dissociated personality states or parts, dissociated self-states or multiple personalities, :118).
Some professionals state this involves over one hundred alters, while others refer to “dozens” of alters. :4, . The alters may include fragments. Such large numbers of alters are likely to be caused by cult abuse, ritual abuse, or another form of extreme, sadistic abuse which extends over long periods of time and often involves multiple abusers. :4, :133
A larger number of alters results in less obvious physical signs of switching. :27 Polyfragmented DDNOS can be particularly difficult to diagnose. 
DID became known as Multiple Personality Disorder with the release of the DSM-III in 1980, until the name changed to Dissociative Identity Disorder in the 1990s. During this time Polyfragmented DID was referred to as Complex Multiple Personality Disorder (Complex MPD).:306
1 Haddock D, (2001). The Dissociative Identity Disorder Sourcebook. McGraw-Hill, ISBN 0737303948.
2 Kluft, R. P. & Fine, C. G. (1993). Clinical Perspectives on Multiple Personality Disorder. American Psychiatric Pub, ISBN 0880483652.
Miller, A. (2014). Becoming Yourself: Overcoming Mind Control and Ritual Abuse. Karnac Books. ISBN 1782412182.
3 Miller, A. (2011). Healing the unimaginable: Treating ritual abuse and mind control. Karnac Books. ISBN 1780499094.
4 Chu, James A. (2011). Rebuilding Shattered Lives: Treating Complex PTSD and Dissociative Disorders, 2nd edition. John Wiley & Sons, ISBN 1118015061.
5 International Society for the Study of Trauma and Dissociation. (2011). [Chu, J. A., Dell, P. F., Van der Hart, O., Cardeña, E., Barach, P. M., Somer, E., Loewenstein, R. J., Brand, B., et al.] Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12, 115–187. DOI: 10.1080/15299732.2011.537247.
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