wide diversity from different countries. A 1996 essay suggested three possible causes for the sudden increase of DID diagnoses, among which the author suspects the first being most likely: The result of therapist suggestions to suggestible people, much as Charcot's hysterics acted in accordance with his expectations. Psychiatrists' past failure to recognize dissociation being redressed by new training and knowledge. Dissociative phenomena are actually increasing, but this increase only represents a new form of an old and protean entity: "hysteria". Dissociative disorders were excluded from the Epidemiological Catchment Area Project. North America DID is considered a controversial diagnosis and condition, with much of the literature on DID still being generated and published in North America, to the extent that it was once regarded as a phenomenon confined to that continent. Although research has appeared discussing the appearance of DID in other countries and cultures and the condition has been described in non-English speaking nations and non-Western cultures, these reports all occur in English-language journals authored by international researchers who cite Western scientific literature and are therefore not isolated from Western influences. Etzel Cardeña and David Gleaves believed the overrepresentation of DID in North America was the result of increased awareness and training about the condition. History Early references In the 19th century, "dédoublement", or "double consciousness", the historical precursor to DID, was frequently described as a state of sleepwalking, with scholars hypothesizing that the patients were switching between a normal consciousness and a "somnambulistic state". An intense interest in spiritualism, parapsychology and hypnosis continued throughout the 19th and early 20th centuries, running in parallel with John Locke's views that there was an association of ideas requiring the coexistence of feelings with awareness of the feelings. Hypnosis, which was pioneered in the late 18th century by Franz Mesmer and Armand-Marie Jacques de Chastenet, Marques de Puységur, challenged Locke's association of ideas. Hypnotists reported what they thought were second personalities emerging during hypnosis and wondered how two minds could coexist. In the 19th century, there were a number of reported cases of multiple personalities which Rieber estimated would be close to 100. Epilepsy was seen as a factor in some cases, and discussion of this connection continues into the present era. By the late 19th century, there was a general acceptance that emotionally traumatic experiences could cause long-term disorders which might display a variety of symptoms. These conversion disorders were found to