dissociative disorders Flashcards
Human’s mind capacity to engage in complex mental activity in channels are independent of conscious awareness.
dissociation
Unbidden intrusion to awareness and behavior with accompanying loses of continuity in subjective experience
positive symptoms
inability to access or control mental functions that normally are readily amenable to access or control
negative symptoms
examples of positive symptoms
Fragmentation of identity, depersonalization
& derealization
example of negative symptom
amnesia
fragmented self; a change in personality
fragmentation of identity
detachment to current mind, self or body
depersonalization
unreality or detachment to one’s surroundings
derealization
inability to recall autobiographical information
dissociative amnesia
Disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behavior
dissociative disorders
dissociative disorders included in DSM 5
- Dissociative identity disorder
- Dissociative amnesia
- Depersonalization/ derealization disorder
- Other specified dissociative disorder
- Unspecified dissociative disorder
dissociative disorders included in DSM IV-TR
- Dissociative amnesia
- Dissociative fugue
- Dissociative identity disorder
- Depersonalization disorder
- Dissociative disorder nos
dissociative identity disorder is formerly known as
multiple personality disorder
DID Dramatic dissociative disorder which is characterized
by:
The presence of two or more distinct personality states or in some cultures as an experience of possession and recurrent dissociative amnesia or gaps
In most cases, the one identity that is most
frequently encountered and carries the person’s real name
host identity
these may differ in striking ways involving gender, age,, handwriting, sexual orientation, prescription for eyeglasses, predominant affect, foreign languages spoken, and general knowledge
alter identities
in DID typically manifest as behaviors that appear as if a “spirit,” supernatural being, or outside person has taken control, such that the individual begins speaking or acting in a distinctly different manner
Possession-form identities
Individuals with dissociative identity
disorder experience:
- Recurrent, inexplicable intrusions into their conscious functioning and sense of self
- Alterations of sense of self
- Odd changes of perception
- Strong emotions and impulses
- Intermittent functional neurological symptoms
Diagnostic Criteria of DID
A.) Disruption of identity characterized by two or more distinct personality states
B.) Recurrent gaps in the recall
C.) The symptoms cause clinically significant distress or impairment
D.) The disturbance is not a normal part of a broadly accepted cultural or religious practice
E.) The symptoms are not attributable to the physiological effects of a substance or another medical condition
Associated Features Supporting Diagnosis of DID
- Comorbid depression
- Anxiety
- Substance abuse
- Self-injury/ mutilation/ suicidal behavior
- Non-epileptic seizures
- Often conceal, or not fully aware of
- Disruptions in consciousness
- Amnesia
- Dissociative flashbacks; subsequent amnesia
Prevalence of DID across genders was ____ for males and
____ for females
1.6%; 1.4%
Over ____ of outpatients of DID have attempted suicide
70%
Unable to recall important personal information, usually involving traumatic or stressful experiences
dissociative amnesia
Diagnostic Features of Dissociative Amnesia
- Inability to recall important autobiographical info that:
1) Should be successfully stored in memory
2) Ordinarily would be readily remembered (Criterion A)
Dissociative amnesia differs from the permanent amnesia in neurobiological damage because memory loss is usually ______
reversible
Simple amnesia involves a loss of information from memory, usually as the result of _________ to the brain.
With dissociative amnesia, the memories still exist but are _______ within the person’s mind and cannot be recalled.
disease or injury; deeply buried
Dissociative amnesia most often consists of _________ for a specific event or events; or generalized amnesia for ________
localized or selective amnesia; identity and life history
Apparently purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical info
dissociative fugue
5 types of dissociative amnesia
- Localized amnesia
- Selective amnesia
- Generalized amnesia
- Systematized amnesia
- Continuous amnesia
A failure to recall events during a circumscribed period of time
Localized amnesia
Can recall some, but not all, of the events during a circumscribed period of time
Selective amnesia
A complete loss of memory for one’s life history
Generalized amnesia
The individual loses memory for a specific category of information
Systematized amnesia
An individual forgets each new event as it occurs
Continuous amnesia
extensions to a diagnosis that further clarify the course, severity, or special features of a disorder or illness
specifiers
a feeling of unreality, or detachment from,
or unfamiliarity with, one’s whole self or
from aspects of the self (Criterion A1)
depersonalization
split self, with one part observing and one participating
“Out of body experience”
symptoms of depersonalization
- anomalous body experiences
- emotional or physical numbing
- temporal distortions with anomalous subjective recall
a feeling of unreality, or detachment from, or unfamiliarity with the world (Criterion A2)
derealization
derealization is commonly accompanied by ______
virtual distortions
Associated Features Supporting Diagnosis of Depersonalization/Derealization
- Subjectively altered sense of time
- Difficulty in vividly recalling past memories
- Vague somatic symptoms are common
- Obsessional preoccupation
- Physiological hyporeactivity to emotional stimuli
what are the three most commonly co-occurring personality disorders with depersonalization/derealization?
avoidant, borderline, and obsessive-compulsive
Other Specified Dissociative Disorder
- Chronic and recurrent syndromes of mixed dissociative symptoms
- Identity disturbance due to prolonged and intense coercive persuasion
- Acute dissociative reactions to stressful events
- Dissociative trance
This category includes identity disturbance associated with less-than-marked discontinuities in sense of self and agency, or alterations of identity or episodes of possession in an individual who reports no dissociative amnesia.
Chronic and recurrent syndromes of mixed dissociative symptoms
Individuals who have been subjected to intense coercive persuasion (e.g. brainwashing, thought reform, indoctrination while captive, torture, long-term political imprisonment, recruitment by sects/cults or by terror organizations) may present with prolonged changes in, or conscious questioning of, their identity.
Identity disturbance due to prolonged and intense coercive persuasion
This category is for acute, transient conditions that typically last less than 1 month, and sometimes only a few hours or days. These conditions are characterized by constriction of consciousness; depersonalization; derealization; perceptual disturbances
Acute dissociative reactions to stressful events
Acute narrowing or complete loss of awareness of immediate surroundings that manifests as profound unresponsiveness or insensitivity to environmental stimuli. *unresponsiveness may be accompanied by minor stereotyped behaviors (e.g., finger movements) of which the individual is unaware and/or that he or she cannot control, as well as transient paralysis or loss of consciousness. The dissociative trance is not a normal part of a broadly accepted collective cultural or religious practice
Dissociative trance
Do not meet the full criteria for any of the disorders in the dissociative disorders diagnostic class.
Clinician chooses not to specify the reason that the criteria are not met for a specific dissociative disorder
Unspecified Dissociative Disorder
