Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical and Neuropsychology - 1 > CPch.8.1 - Dissociate Disorders > Flashcards

CPch.8.1 - Dissociate Disorders Flashcards

1
Q

Dissociative Disorders - Basics

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Dissociation?

A

When some aspect of emotion, memory or experience becomes inaccessible consciously (meaning that the person decides to make this aspect non-accessible)
!!! Core feature of every dissociative disorder !!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the Functions and Causes of Dissociation?

A
  • (Function): Avoidance response to protect person from consciously experiencing stressful events or reliving a stressful/traumatic experience
    (e.g. people in military, Vietnam)
  • Sleep disturbance contributes to it
    Combined the above two can lead to dissociation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the steps that can lead from childhood trauma to dissociation, according to the functions and causes of Dissociation?

A

1/. Childhood trauma
2/. Avoidance Response + Sleep disturbance due to traumatic memory or post-traumatic effects
3/. Childhood Dissociation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 Dissociative Disorders

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 3 main dissociative disorders?

A
  • Depersonalization/Derealization Disorder
  • Dissociative Amnesia
  • Dissociative Identity Disorder (or multiple Personality Disorder)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the comorbidity of Dissociative Disorders in general?

A
  • Mood Disorders
  • BPD
  • Schizophrenia
  • Conversion Disorder
  • PTSD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

(Depersonalization/Derealization Disorder)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the definition of Depersonalization/Derealization Disorder?

A

The patient experiences detachment from self (depersonalization) and from reality (derealization)
(Usually if you experience either Deperson. or Derealiz., you experience the other one as well)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the symptoms of Depersonalization/Derealization Disorder?

A
  • Feeling as if you’re outside your own body and as if you’re observing the world far away from yourself
  • View world “through a fog”
  • Emotionally/physically numb
    -… (and some more)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the criteria for diagnosing Depersonalization/Derealization Disorder?

A

Symptoms must:
- be persistent or recurrent
- not be due to psychosis
- not be due to effects of a substance (drugs, medication etc.)
- (symptoms cause distress in various areas of life)
- (Disturbance isn’t better explained by any other mental disorder)
(Diagnosis usually occurs in adolescents -> Disorder also starts usually in adolescence, not a diagnostic problem or bias)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the comorbidity of Depersonalization/Derealization Disorder?

A
  • 90% of people with Depersonalization/Derealization Disorder will also experience anxiety disorders or depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is one concern that clinicians must take into account when diagnosing Depersonalization/Derealization Disorder?

A

Clinicians must rule out disorders with common symptoms, such as ASD, PTSD
- Depersonalization is common during panic attacks, and during ketamine and hallucinogens in general

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

(Dissociative Amnesia)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the definition of Dissociative Amnesia?

A

Lack of conscious access to memory, which happens after a very stressful or traumatic experience.
(A person with Dissociative Amnesia has so much amnesia (forgetfulness) that it’s too much for it to be an ordinary forgetfulness)
!!! Procedural memory is intact, holes in memory are only in autobiographical memories !!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Usually what leads to Dissociative Amnesia?

A

Amnesia involves info about a traumatic event(s). BUT:
- Not all amnesias follow immediately after trauma (back to factors of PTSD and how it can manifest years after trauma)
- Dissociative amnesia is rare even among those who have been through very intense trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the general criteria for Dissociative Amnesia?

A
  • (symptoms cause distress in various areas of life)
  • (Disturbance isn’t better explained by any other mental disorder)
  • Symptoms aren’t attributable to the effect of a certain substance (drugs, medication etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the Fugue Subtype?

A

Memory loss is more extensive, and people wander away from home and their lives. Some even take on a different life (different name, job etc.)
MAIN ASPECTS:
- Person assumes new identity
- Bewildered wandering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is this change of identity brief or prolonged?

A

Brief. Change doesn’t crystallize (become stable)
- Recovery is also possible, it just takes some time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Freud’s explanation for Dissociative Amnesia?

A

According to the psychodynamic theory, people with Dissociative Amnesia repress.
Repression -> when people suppress unacceptably painful memories from their consciousness. What are the mechanisms though for repression?
(Researchers have been trying to find out the mechanisms behind repression)

21
Q

What big question has arisen through studying Dissociative Amnesia? What are some explanation?

A

How does memory work under stress?
- According to Dissociative Amnesia, memory gets worse under stress
- Numerous studies though have shown that the more stressful/traumatic an event, the more consolidated it is in our memory
- Also, under intense stress, we focus more on the central features of the threat, and not the peripheral features of our environment. Thus it makes sense that we remember the stressful event/stimulus more.
Explanation for Dissociative Amnesia:
- Extreme levels of stress hormone interfere with memory formation

22
Q

(Dissociative Identity Disorder)

A
23
Q

What is the definition of Dissociative Identity Disorder?

A

Like Dissociative Amnesia, only the Amnesia is so severe that the person looses his self of sense or identity
- There are at least 2 different and distinct personality states (ways of being, thinking, feeling and behaving) acting independently from each other

24
Q

What are the general criteria for DID?

A
  • (symptoms cause distress in various areas of life)
  • (Disturbance isn’t better explained by any other mental disorder)
  • Disturbance isn’t part of a broadly accepted cultural or religious practice
  • Symptoms aren’t attributable to the effects of a substance (drugs, medication etc.)
25
Q

What are some relevant factors that might lead to or maintain DID?

A
  • Emotion dysregulation
  • Sleep dysregulation
  • Hyper-associativity (Key cognitive feature of REM Sleep: Illogical, surprising, or weakly-linked activated memories or memory fragments, which are activated either sequentially or in parallel)
  • Meta-cognition
  • Alexithymia (a.k.a. emotional blindness: One’s difficulty in recognizing, describing and expressing their emotions)
  • Fantasy-prone personality (lifelong, extensive, and deep involvement in fantasy)
26
Q

What are some characteristics of a DID patient’s different personalities?

A
  • They emerge at different times, and are different from each other (sometimes even polar opposites)
  • Each personality takes over a person’s activities and life when in command,
  • Different personalities are unaware of each other (have no knowledge of other personalities existence), and have no memory of each other. -> The patient is able though to recognize the gaps in his memory, which are when another identity that the one in control in the present, were in control
27
Q

What are some other symptoms of DID?

A
  • Voices of “supposed” other identities, or echoes of them(patient doesn’t know these other voices are from other personalities, clinician can make that observation by meeting and observing each different personality)
  • Hallucinations
  • Headaches
  • Suicide or self-injury attempts
  • Depersonalization and Amnesia
28
Q

When is DID usually diagnosed?

A

Adulthood, although symptoms are thought to date back to childhood

29
Q

What is the Comorbidity and and gender differences of DID?

A
  • Comorbidity: PTSD, MDD, SSD, 50% of people with DID also have BPD
  • More women than men have DID
30
Q

Epidemiology

A
31
Q

What is the general prevalence of each Dissociative Disorder?

A
  • Dep./Der. Disorder: 0.8% of general population
  • Dissociative Amnesia: 1.8% of general population
  • DID: 1.5% of general population
32
Q

How did awareness for Dissociative Disorders increase throughout history?

A

Before 1800’s: no reports for DID or Dissociative Amnesia
- Reports for DID increased in 1970’s because of:
~ increase in diagnostic criteria
~ increase in literature on DID
~ increased reference in media
- Reports for Dissociative Amnesia and Fugue subtype increased in 1887 with Albert Dadas
~ Because of this case, more and more similar cases were reported in the following years, and awareness on Dissociative Amnesia has been raised ever since

33
Q

Etiology

A
34
Q

What is the etiology for Dep./Der. Disorder?

A
  • Problems in how brain integrates info from different sensory and bodily sources -> atypical activity in brain regions integrating info from sensory cortex areas
  • Symptoms may be induced when various neural signals from sensory and bodily cues are mismatched (visual distortion goggles experiment) ->
    !!! Symptoms can arise even in people without the disorder through this phenomenon !!!
  • Underactive brain regions involved in processing bodily cues in response to an emotion/emotional experience (brain region is ACC) -> explain feelings of physical/emotional numbness
35
Q

What are the 2 models that explain the causes for DID?

A
  • Posttraumatic model
  • Socio-cognitive model
36
Q

What are the two main statements of the posttraumatic model state?

A
  • Some people are more likely to use dissociation to cope with trauma
  • Dissociation is the key reason people develop multiple personalities after trauma
37
Q

What does the model state about children?

A
  • Abused children have an increased risk for developing dissociative symptoms
  • Children that dissociate have an increased risk for developing psychological symptoms after trauma
38
Q

What are two concerns/problems with this model?

A
  • How well does childhood abuse predict tendencies for adults to dissociate?
  • People are biased in if to describe a childhood event as a traumatic event
39
Q

What does the socio-cognitive model state?

A

Abused people seek explanation for their symptoms and distress, and their alternate personality states appear in response to therapists, exposure to media references of DID, or other cultural influences
(DID cases increased when DID become more well-known -> Maybe DID is iatrogenic, meaning that it develops within treatment)

40
Q

What does the socio-cognitive model state as the main cause for DID?
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

A

DID is caused by role-playing of symptoms in patients with history of abuse.
(People don’t just have multiple personalities that are out of their control. They know that they’re creating/acting out different personalities, and they know which one of their personalities is their true one. They just try to bury this truth as much as possible and convince themselves that they have multiple personalities which are out of their control, in order to avoid facing their trauma or taking any responsibility)

41
Q

What is some evidence in favor of this model?

A
  • DID symptoms can easily be role-played
  • Therapists reinforce DID symptoms
  • There is implicit memory in DID patients
42
Q

How can therapists reinforce DID symptoms?

A

In the beginning, the patient has no knowledge of other personalities. The therapist tries to unbury past experiences and name alternate personality states. This leads to patients being able to identify more and more personalities as treatment progresses

43
Q

What is a therapeutic method that has been criticized as evoking symptoms of DID instead of helping cure them?

A

Hypnosis (in the past was used all the time to cure DID, but in most cases actually did the opposite -> increased or induced DID symptoms)

44
Q

How has studies on DID Patients and memory tasks shown that patients are role-playing their personalities?

A

One of the defining features of DID is the patient’s inability to remember info or experiences witnessed by one personality when another personality is currently in control.
- Implicit memory tasks (word, “lullaby” task) shows that different personalities share implicit memory (patients were acting out the fact that personalities don’t share memory)
- Personalities might even share explicit memory, but it is possible that patient inhibits it, or lies about it as well

45
Q

Treatment of Dissociative Disorders

A
46
Q

What psychotherapeutic approach is mainly used in order to treat Dissociative Disorders?

A

Psychodynamic treatment. Goal is to overcome repression

47
Q

What other method has been used by therapists in the past to treat Dissociative Disorders?

A

Hypnosis.
- Reason why: Therapists used it to gain access to repressed material of traumatic events in childhood (this method, of gaining access to traumatic events of childhood is called age regression
- Goal: Make people realize that childhood threats are no longer present, and that they shouldn’t govern one’s life

48
Q

What was a problem with hypnosis?

A

It increased or induced DID symptoms. Because of this, hypnosis became less popular

49
Q

What are some general principles clinicians agree on when treating DID?

A
  • Empathic, gentle stance
  • Clinician must convince the person that splitting into different personalities isn’t necessary to deal with trauma
  • Clinician must teach the person effective ways to cope with stress and regulate emotions
  • Psychoeducation on Dissociation:
    ~ Why does it occur
    ~ What are the triggers
  • Hospitalization to help them avoid self-harm and offer more treatment

Clinical and Neuropsychology - 1 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions