A. DISSOCIATIVE DISORDERS Flashcards
Define dissociative disorder.
loss in usual integrated function of conciousness, memory, identity, emotions, motor control and/or perception.
Dissociative Identity Disorder
Define/characterize Dissociative Identity disorder.
-presence of more than one personality state as a result of a fragmented state of self.
- feature of other dissociative disorders ( e.g amnesia, de-personalization and de-realization)
- predominantly develops in victims of significant chronic/ childhood trauma.
Classify Dissociative disorders. (DDDOU)
- Dissociative Identity disorder
- Dissociative amnesia
- De-personalization/De-realization
- Other specified dissociative disorders
- Unspecified dissociative disorders
What is the Hallmark of dissociative identity disorder?
Presence of two or more personalities/ experience of possession.
Note
When one personality exerts its effects, the others are turned off.
Name the two forms of Personality state manifestations.
- Possessive form
- Non-possessive form
Describe possessive form of DID
manifests as behaviors under the control of a ‘‘spirit’’ or supernatural being
highly overt alternate personality
Describe the non-possessive form of DID
subtle discontinuity which persist for a long period of time
What is Dissociative fugue?
a state of amnesia where one ends up in an unexpected place with no memory of how they got there.
Note
-Amnesia is DID is not only limited to traumatic/stressful events.
The diagnostic criteria of Dissociative Identity disorder (DID).
A - disruptionof identity manifested as 2 or more distinct personalities states dominating at different times.
B - extensive memory lapse in autobiography information, daily occurrences and/or traumatic events.
C - Not due to the effect of substance or another medical condition
D - The condition causes significant distress/impairment in social or occupational functioning.
Description of criterion A of Dissociative Identity disorder
- sense of alteration/discontinuity of sense of self
- de–personalization
- may experience perception of voices
- may report their body not feeling like its thier’s
Brief description of criterion B of Dissociative Identity disorder
- patient reports with Dissociative amnesia which may manifest in three ways:
1. Gaps in remote memory of personal life events
2. Lapse in dependable memory (e.g a well learned skill)
3. Discovery of evidence of their daily actions that they don’t recollect doing (e.g finding an unexplained object in their possessions)
Epidemiology of DID
- rare (<1%)
- greater in women
- high evidence of comorbid PTSD, major depressive disorder, eating disorder and BPD
>70% of patients attempt suicide or other frequent attempts of self-mutilation
What is the treatment for Dissociative identity disorder?
Standard tx - psychotherapy
(with focus on safety, stabilization and sx reduction)
Pharmacotherapy - SSRI’s (target the comorbid depression/PTSD sx)
- Prazosin - target nightmares
- Naltrexone - reduce self-mutilation
Dissociative Amnesia
Define DA.
Dissociative amnesia is the inability to recall important information usually of traumatic/stressful nature, that is not explained by ordinary forgetfulness.
How do you distinguish dissociative amnesia from any other conditon that results in amnesia?
In Dissociative Amnesia, procedural memory is preserved
Comment on the Epidemiology of Dissociative amnesia.
- Greater in women
- approximately 1-3% of the general population
- occurs against the backdrop of a physical/psycho-social stressor.
Name the Types of Dissociative amnesia.
Localized
Generalized
Continuous
Systematized
Selective
Describe Briefly
Localized dissociative Amnesia
failure to recall events during a defined period of time
(most common)
Selective DA
individual recalls some but not all events during a defined period of time.
Generalized DA
Complete loss of one’s life story
May lose Semantic memory (previous knowledge about the world)
May lose Procedural memory (access to a well learned knowledge/skill)
Continuous DA
forget all new events as they occur.
Systematized DA
exhibit loss of memory for a specific category of information
Comment on the Epidemiology of Dissociative Amnesia
- greater in females
- Lifetime prevalence - 6-7%
