Read the following vignette. Based on your understanding of factors associated with the development of certain complex psychological disorders, identify the primary contributing factor in Alex's history and explain its significance.

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Factors associated with Dissociative Identity Disorder (DID) include:
- severe childhood trauma (physical, emotional or sexual) or stress caused by seeing someone else experience trauma, that can lead to distorting reality;
- creating alters (the person's alternate personalities); 
- being unable to interpret events caused by situational factors;
- having the ability to dissociate (feeling disconnected from others and yourself.

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