Dissociative Disorders

Question 1

Removal from conscious awareness of painful feelings, memories, thoughts, or aspects of identity

Answer 1

Dissociation

Question 2

Mainly characterized by disturbance in identity, memories, thoughts, or aspects of identity

Answer 2

Dissociative Disorders

Question 3

Precipitated by extreme stress or trauma

Answer 3

Dissociative Disorders

Question 4

Types of Dissociative Disorders

Answer 4

-Dissociative Amnesia
-Dissociative Fugue
- Dissociative Identity Disorder

Question 5

loss of memory or inability to recall important personal information

Answer 5

Amnesia

Question 6

Inability to form new memories after onset of amnesia

Answer 6

Anterograde

Question 7

Inability to recall memories before amnesia

Answer 7

Retrograde

Question 8

Characteristics of Dissociative Amnesia

Answer 8

-One or more episodes of the inability to recall important personal information that is beyond ordinary forgetfulness
-Lost information is usually stressful or traumatic in nature
-(+) wandering, disorientation, confusion
-Psychosocial stressors: threat of physical injury or death

Question 9

(+) wandering, disorientation, confusion

Answer 9

Dissociative Amnesia

Question 10

What’s the Psychosocial Stressors of Dissociative Amnesia?

Answer 10

Threat of physical injury or death

Question 11

Nursing Diagnosis of Dissociative Amnesia

Answer 11

-Impaired Memory
- Ineffective Coping

Question 12

Goals for Dissociative Amnesia

Answer 12

-Help the person to remember forgotten or traumatic events in a controlled way & to accept & integrate them
-Resolve distressing situations
-Strengthen coping skills

Question 13

Interventions for Dissociative Amnesia

Answer 13

-Involvement of family member/significant other to remember what happened
-Trauma work (CISM)
-Hypnosis

Question 14

Characteristics of Dissociative Fugue

Answer 14

-Sudden, unexpected travel away from home or some other location with the assumption of a new identity or a confusion about one’s identity
-(+) amnesia
-Unable to recall events during fugue state

Question 15

(+) Amnesia

Answer 15

Dissociative Fugue

Question 16

Psychosocial stressors of Dissociative Fugue

Answer 16

-Marital quarrels
-Personal rejections
- Military conflict
- Natural disasters
- Financial difficulty
- suicidal ideation

Question 17

Nursing Diagnosis of Dissociative Fugue

Answer 17

-Risk for Injury
- Impaired Memory
- Ineffective Coping

Question 18

Interventions for Dissociative Fugue

Answer 18

Fugue states usually end rather abruptly on their own

Supportive psychotherapy- to help person identify & resolve stressors leading to fugue state and to learn better coping skills, so that fugue does not happen again.

Question 19

Existence of two or more personalities that take control of the person’s behavior

Answer 19

Dissociative Identity Disorder (D.I.D)

Question 20

Has a Host & Alters

Answer 20

Dissociative Identity Disorder (D.I.D)

Question 21

Original Personality

Answer 21

Host

Question 22

Dissociative Personality/-ies

Answer 22

Alters

Question 23

Precipitated by abuse (Sexual)

Answer 23

Dissociative Identity Disorder (D.I.D)

Question 24

Initially, unaware of the existence of alters

Answer 24

Host

Question 25

Experiences amnesia while alters takes over

Answer 25

Host

Question 26

Has an awareness of the existence of alters

Answer 26

Alters

Question 27

Each has its own name, behavior traits, memories, emotional characteristics, and social relations

Answer 27

Alters

Question 28

Represents fragments of the host's sense of identity with different identity states remembering distinct information

Answer 28

Alters

Question 29

Management-Milieu

Answer 29

Psychotherapy -Long- term, intensive, out- patient -Directed toward uncovering the underlying psychological conflicts, helping him or her gain insight into these conflicts, and striving to synthesize the various identities into one integrated personality.

Question 30

Part of psychotherapy that involves mental re-experience of trauma/abuse that caused the illness

Answer 30

Abreaction

Question 31

Part of Psychotherapy that blending of all personalities into one

Answer 31

Integration

Question 32

Used to look into each personalities

Answer 32

Hypnosis

Question 33

Part of Psychotherapy that recommends when an aggressive or suicidal alter is in a dominant role

Answer 33

Hospital admission

Question 34

Psychopharmacology Management of Dissociative Identity Disorder (D.I.D)

Answer 34

-Anxiolytics, as ordered - Anti-depressants, as ordered

Question 35

This drug is used if client becomes hostile

Answer 35

Anxiolytics

Question 36

This drug is used to control anxiety

Answer 36

Anti-depressants

Question 37

Nursing Management of Dissociative Identity Disorder (D.I.D)

Answer 37

-Establish trust and rapport - Facilitate physiologic and neurology work ups to rule out organic causes - Assist in slowly helping patients deal with anxiety and conflicts in their lives and improve coping skills -Treat an adult patients as an adult even if an alter is a child - Be consistent with approach to develop a caring and supportive environment -If patient has suicidal tendencies, facilitate initiation of no-harm contract - If patient becomes aggressive, deal with aggression while observing the principle of least restrictive treatment.

Question 38

Dealing with Aggressive Patients

Answer 38

-Ensure scene safety, when in doubt do not act alone - Attempt verbal de-escalation (use a calm, firm voice) - Direct the patient to take a voluntary time-out in a quiet area - Inform the patient aggressive behavior is not acceptable -Offer PRN medications to help the patient return to a calm state (e.g., Lorazepam) - Provide a "show of force/strength" (gather 4-6 team members to remain in sights with patient interactions

Question 39

Involves debriefing

Answer 39

Dealing with aggressive patients