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DSM5 > Dissociative disorders > Flashcards

Dissociative disorders Flashcards

1
Q

when do dissociative disorders typically manifest

A

at any age and typically in the aftermath of trauma

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2
Q

which disorders include dissociative symptoms but are not dissociative disorders

A

PTSD
acute stress disorder

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3
Q

how are dissociative symptoms experienced

A

as unwanted intrusions into awareness/behavior

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4
Q

definition of positive dissociative symptoms

A

loss of continuity in subjective experience

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5
Q

examples of positive dissociative symptoms

A

division of identity
depersonalization
derealization

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6
Q

definition of negative dissociative symptoms

A

inability to access information or control mental functions

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7
Q

example of negative dissociative symptom

A

amnesia

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8
Q

main diagnostic criteria for dissociative identity disorder

A

2+ distinct personality states (or experience of possession)

recurrent gaps in recall inconsistent with normal forgetting

symptoms cause clinically significant distress or impairment and are not attributable to a substance or medical condition

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9
Q

typical manifestation of different identity states in non-possession DID

A

typically minor alterations in identity . Large differences in personality states only in small percentage of patients with disorder

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10
Q

characteristics of disruption in identity (criterion A) for DID

A

-may feel like observer to actions with inability to stop them
-may perceive voices
-may have hallucinations in any sensory modality
-strong emotions/behavior over which the person has no control

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11
Q

how may perception of voices in DID be experienced

A

as individualized thought streams at the same time

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12
Q

lack of sense of agency

A

strong emotions, thoughts, impulses, speech that the person has no control over

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13
Q

common manifestations of dissociative amnesia

A

=gaps in autobiographical history
-forgetting recent events or well learned skills
-finding possession with no recollection of acquiring
-dissociative fugue
-large gaps in ongoing memory

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14
Q

dissociative fugue

A

amnesia for travel

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15
Q

typical comorbidities to DID

A

PTSD, depression, anxiety, substance abuse, personality disorders, and self-injury

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16
Q

features that are sometimes associated with DID

A

nonepileptic seizures
refractory neurological sx (HA, MS sx)

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17
Q

dissociative flashback

A

-sensory reliving of previous event as if it was happening in the present
-often with a change in identity
-partial or lack of contact with reality during flashback
-subsequent amnesia for event

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18
Q

what is the main thing that predisposes to DID

A

trauma, particularly early life trauma

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19
Q

what kind of injury is common in DID

A

non-suicidal self-injury

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20
Q

personality disorder features associated with DID

A

-often avoidant features
-may display bipolar features when decompensated
-obsessional features are common
-subset has narcissistic/antisocial features

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21
Q

how do children with DID typically present differently than adults

A

may present with independently acting imaginary companions or personified mood states rather than identity shifting

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22
Q

how do adolescents with DID typically present

A

with externalizing symptoms, suicidal or self-destructive behavior, or rapid behavioral shifts

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23
Q

how do older persons with DID typically present

A

symptoms that appear as late-life mood disorders, OCD, paranoia, psychosis, and cognitive disorders attributable to dissociative amnesia

24
Q

brain regions implicated in DID

A

orbitofrontal cortex
hippocampus
parahippocampal gyrus
amygdala

25
Q

suicide risk with DID

A

high
greater severity of sx correlates to greater risk

26
Q

what differentiated DID from dissociative amnesia

A

DID requires 2 distinct personality states

27
Q

difference in behavioral shifts in DID as opposed to bipolar

A

DID shifts more rapid than rapid cycling and last minutes too hours but not days

28
Q

difference in manifestation of depersonalization/derealization in DID as opposed to PTSD

A

in PTSD it is r/t specific trauma reminders
It is also in an ongoing fashion in daily life in DID

29
Q

what differentiates dissociative sx in schizophrenia from DID

A

schizophrenia is usually accompanied by delusional ideas for the reason of sx and DID experiences them as ego-alien and frightening

30
Q

hypnotic capacity in DID v. schizophrenia

A

DID has high hypnotic capacity
schizophrenia has low hypnotic capacity

31
Q

what differentiated DID from personality disorders

A

DID has variability in personality styles whereas in personality disorders characteristics are pervasive and sustained

32
Q

localized dissociative amnesia

A

for a specific event

33
Q

general dissociative amnesia

A

involves identity and history

34
Q

difference between wandering r/t seizure disorders and dissociative fugue

A

behavior in fugue is purposeful, complex, and goal-oriented while behavior with seizures is purposely wandering

35
Q

retrospective memory impairments

A

lost memories for traumatic experience as well as everyday life events in which no trauma occured

36
Q

selective amnesia

A

can recall some but not all events during a particular period of time

37
Q

generalized dissociative amnesia

A

complete loss of memory for most/all of an individuals life history

38
Q

length of acute dissociative reactions to stressful events

A

typically last less than a month

39
Q

depersonalization/derealization disorder diagnostic criteria

A

persistent or recurrent sx of depersonalization or derealization, or both

40
Q

depersonalization

A

feeling of unreality or detachment
may feel like an observer to own thoughts, feelings, sensations, actions

41
Q

derealization

A

experiences of unreality in relation to surroundings

42
Q

reality testing during episodes of depersonalization/derealization in depersonalization/derealization disorder

A

typically remains intact

43
Q

mean age of onset for depersonalization/derealization disorder

A

16

44
Q

course of derealization/depersonalization disorder

A

can be discrete episodes, persistent, of initially episodic that turns continuous

45
Q

cognitive disconnection schemata of depersonalization/derealization disorder

A

reflects defectiveness and emotional inhibition w/ themes of abuse, neglect, and deprivation

46
Q

overconnection schemata in depersonalization/derealization disorder

A

involves impaired autonomy with themes of dependency, vulnerability, and incompetence

47
Q

personality disorders commonly comorbid with depersonalization/derealization disorder

A

avoidant
borderline
obsessive-compulsive

48
Q

what characterizes Ganzer syndrome

A

giving approximate answers
clouded consciousness
may have hallucinations, dissociation, somatoform, and conversion sx

49
Q

what is the current standard of care for dissociative amnesia

A

phase-oriented tx

50
Q

what are other therapies for dissociative amnesia besides phase-oriented treatment

A

cogntiive therapy
hypnosis
group therapy

51
Q

stage 1 of phasic trauma treatment

A

stabilization and safety

52
Q

stage 2 of phasic trauma tx

A

intensive processing of traumatic memories and transformation of their meaning

53
Q

stage 3 of phasic trauma treatment

A

fusion, integration, resolution, and recovery

54
Q

what types of therapies are typically not helpful in the treatment of DID

A

self-help and group

55
Q

medication management of DID

A

must target symptoms as opposed to tx disorder itself

56
Q

tx of OCD sx in DID

A

SSRIs

DSM5 (18 decks)

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