Dissociative Disorders

Question 1

Dissociative Identity Disorder Diagnostic Criteria

Answer 1

A. Discruption of identity characterized by ≥2 distinct personality states, which may be described in some cultures as an experience of possession. Disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behaviour, consciousness, memory, perception, cognition, and/or sensory-motor functioning. Can be subjective or observed by others.
B. Recurrent gaps in recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
C. Causes clinically significant distress/functional impairment
D. Not part of a broadly accepted cultural or religious practice.
E. Not attributable to substances or another medical condition.

Question 2

Differentiation of DID from PTSD

Answer 2

• Majority of individuals with DID have symptoms that meet criteria for comorbid PTSD
• Dissociative amnesia in pure PTSD is specific to the traumatic event, and more recurrent/episodic in DID

Question 3

Dissociative Amnesia Diagnostic Criteria

Answer 3

A. Inability to recall important autobiographical information, usually of traumatic or stressful nature, that is inconsistent with ordinary forgetting.
Note: DA most often consists of localized or selective amnesia for a specific event/events; or generalize amnesia for identiy and life history.
B. Causes clinically significant distress/functional impairment
C. Not attributable to substances, another medical condition
D. Not better explained by DID, PTSD, acute stress disorder, SSD, neurocognitive

Question 4

Diagnostic Amnesia Specifiers

Answer 4

Specify if:
* With dissociative fugue: Apprently purposeful travel or bewildered wandering that is associated with amnesia for identity or other important autobiographical information.

Question 5

Differentiation of DA from PTSD

Answer 5

• If amnesia extends significantly beyond a trauma event, and the individual meets criteria for PTSD, an additional DA diagnosis may be warranted.

Question 6

Depersonalization/Derealization Disorder Diagnostic Criteria

Answer 6

A. The presence of persistent or recurrent experiences of depersonalization, realization, or both:
1. Depersonalization: Experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions (e.g., perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or physical numbing)
2. Derealization: Experiences of unreality or detachment WRT one’s surroundings (e.g., individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually disorted)

B. During the depersonalization or derealization experiences, reality testing remains intact.
C. Causes clinically significant distress/functional impairment
D. Not attributable to substances or another medical condition
E. Not better explained by another mental disorder