Dissociative Disorders

Question 1

What characterizes dissociative disorders?

Answer 1

Very little scientific evidence. Disorders that are caused by dissociation. Failure of consciousness to integrate cognitions, emotions, motivations (some aspect is inaccessible)

Question 2

What is the prevalence of dissociative disorders?

Answer 2

There are very few cases, prevalence varies from 0.5-2.5% of the population. However there was a spike in the late 20th century. Overall diagnosing DID is very controversial

Question 3

What are the diagnostic criteria for Dissociative Identity Disorder?

Answer 3

There are two or more distinct personality states (alters), the sense of self is disrupted, behaviour and other functioning are affected, recurrent gaps in the recall of everyday events or traumatic events, symptoms cause clinically significant distress or impairment, etc

Question 4

How do the ‘alters’ function?

Answer 4

Alters emerge and take control at different times, usually there is a primary ego state and treatment is sought out by ‘them’, gaps in memory occur for all alters, existence of the alters are long-lasting and cause disruption in life, they can be accompanied by headaches, substance abuse, hallucinations, etc

Question 5

What disorders are comorbid with DID?

Answer 5

Depression, borderline personality disorder, and somatization disorder. Those with DID are often highly hypnotizable

Question 6

How does amnesia manifest in DID?

Answer 6

Gaps in remote memory of personal life events, lapses in dependable memory, discovery of evidence for which they have no memory

Question 7

What is Grade 5 Syndrome?

Answer 7

A clinically identifiable configuration of personality traits associated with high hypnotizability and dissociation

Question 8

What are the features of Grade 5 Syndrome?

Answer 8

High eye-roll sign, readiness to trust, suspension of critical judgement, ease of affiliation with new experiences, telescoped time sense (more experience seems to occupy less time), easy acceptance of logical incongruities, excellent memory, capacity for intense concentration, etc

Question 9

What are the diagnostic criteria for Dissociative Amnesia?

Answer 9

An inability to recall important autobiographical info (usually traumatic or stressful), symptoms cause distress or impairment

Question 10

What is a specifier for Dissociative Amnesia?

Answer 10

Dissociative fugue (apparently purposeful travel or bewildered wandering that is associated with amnesia for identity)

Question 11

What are the different forms that amnesia can take?

Answer 11

Localized (period of time), selective (some of events), generalized (complete loss), systematized (specific category), continuous (new events)

Question 12

What characterizes dissociative fugue?

Answer 12

Extensive memory loss, individuals take on a new name, home, job, personality, etc, fugue is relatively brief and has a full recovery, individual doesn’t remember what happened during the fugue

Question 13

What are the diagnostic criteria for Depersonalization?

Answer 13

Experiences of unreality, detachment, being an outside observer to one’s thoughts, feelings, body, sensations, actions

Question 14

What are the diagnostic criteria for Derealization?

Answer 14

Experiences of unreality or detachment with respect to surroundings

Question 15

What is unique about Depersonalization and Derealization?

Answer 15

There is no disturbance of memory, instead their is a loss of sense of self (triggered by stress)

Question 16

What is unreality/ unfamiliarity?

Answer 16

A subjective state of feeling detached or disconnected from own being

Question 17

What is hypoemotionality?

Answer 17

Feeling detached from own emotions, numbed or blunted

Question 18

When is an Other Specified Dissociative Disorder used?

Answer 18

When symptoms are present but not enough to qualify as a dissociative disorder

Question 19

What are some problems with dissociation?

Answer 19

Confusion about dissociation as a symptom, a process, a pathology, or an ability. Using it as a causal link between abuse and dissociative reactions (but abuse may not be there)

Question 20

Is dissociation a subjective or objective phenomenon?

Answer 20

Dissociation is profoundly subjective and rarely observable. Experience as intrusions into sense of self and disruptions of executive functioning.

Question 21

What are indexical states?

Answer 21

State when experience is believed to be their own (“doesn’t feel like me but must be me”)

Question 22

What are autobiographical states?

Answer 22

State when experience is as their own (“this is me”)

Question 23

What is partial dissociation?

Answer 23

Aware of involuntary, ego-alien intrusions into sense of self. Very distressing. More frequent than full dissociation (suggests current understanding of DID is incorrect)

Question 24

What are the general symptoms of dissociation?

Answer 24

General memory problems, depersonalization, derealization, posttraumatic flashbacks, trance

Question 25

What are some consciously experienced intrusions?

Answer 25

Child voices, two or more voices arguing or commenting, persecutory voices, speech insertion, thought insertion, ‘made’ feelings and emotions, ‘made’ impulses and actions, temporary loss of knowledge or skills, experiences of self-alteration, profound and chronic self-puzzlement

Question 26

What are some fully dissociated intrusions?

Answer 26

Amnesia, time loss, ‘coming to’, fugues, being told of actions by others without memory, finding things among possessions, evidence of recent actions