Dissociative Disorders

Question 1

DSM-5 criteria for DID

Answer 1

• Two or more distinct personality states; marked discontinuity in sense of self; alternations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning.
• Recurring gaps in the recall of events

Question 2

History of DID - dates and # of cases

Answer 2

• Only 77 cases between 1791 and 1962
• 8 DID cases in 1944–70
• 36 from 1970-79
• 100 DID cases “in treatment” in 1982
• 171 outcome analyses in 1984

Question 3

When was the first scholarly monograph devoted to DID?

Answer 3

1986

Question 4

DID hosts come into clinic with what symptoms?

Answer 4

depression, anxiety, headache

Question 5

Describe an alter

Answer 5

• encapsulate memories, affects the host doesn’t want to experience (defense mechanism)
• have specific roles, situations in which they appear

Question 6

what percent of cases have 10 or more alters

Answer 6

50%

Question 7

In which ways do personalities vary

Answer 7

age, ethnic background, ancestry, accents, vocabulary,species, physiology (visual acuity, allergies, handedness)

Question 8

List the percentages of patients experiencing the different signs of multiplicity discovered by Cummings reported by ross

Answer 8

-Sense another person existing inside - 90%
-Hearing voices talking - 87%
-Voices inside talking - 82%
-Another person taking control - 81%
Amnesia for childhood - 81%
-Using ‘we’ during interview = 74%
-Persona inside has different name - 71%
-Blank spells, time distortion, lapses - 68%

Question 9

prevalence of DID in 1994 (us task force)

Answer 9

10%

Question 10

DID prevalence in 1998 (psychiatric hospital)

Answer 10

1%

Question 11

1990 Lifetime prevalence of Dissociative disorders (winnipeg)

Answer 11

11.2 (all disorders)
o	Dissociative amnesia: 7%
o	Depersonalization 2.4%
o	DID: 1.3%
o	Dissociative fugue: 0.2%
o	DD NOS: 0.2%

Question 12

DSM-5: U.S. sample (DID annual) prevalence

Answer 12

together - 1.5%
men: 1.6%
Women: 1.4%

Question 13

We will decide that overall the lifetime prevalence of DID is?

Answer 13

1%

Question 14

Kluft’s 7 signs of DID

Answer 14

• prior treatment failure
• 3 or more prior diagnosis
• Both somatic and psychiatric symptoms
• Fluctuating symptoms/level of functioning
• severe headaches
• Others note observable changes
• First hand schizophrenia symptoms (feelings of imposed ideas, arguing voices in head)

Question 15

psychodynamic view of DID

Answer 15

• No Dissociation; only repression

- Process of removing unacceptable content out of consciousness

Question 16

Trauma-Dissociation Model

Answer 16

• Predisposition for dissociation
• Has trauma exceeding coping capacity
• Removes trauma to non-ego consciousness

Question 17

What percent of DID patients report abuse (Kluft)

Answer 17

98% (children who can’t escape scenario escape inwardly by abandoning ownership of memories)

Question 18

Sociocultural model of DID

Answer 18

Individual unconsciously plays culturally-sanctioned dissociative role (hypnotic state, mediumship, spirit possession)

Question 19

Sources of cultural socialization according to the sociocultural model

Answer 19

• MEdia depictions
• Religious beliefs
• Therapist suggestions/descriptions

Question 20

proponents of trauma-memory debate

Answer 20

Amnesia exists for trauma including:

• Disaster victims
• Combat trauma
• Prisoners, torture victims
• Violent crime victims

Question 21

Opponents of trauma-memory debate

Answer 21

• trauma victims may just be too young to remember
• Few fail to remember trauma, i.e holocaust
• response to trauma is usually PTSD (enhanced memory of event)

Question 22

What are the 2 types of trauma

Answer 22

Type 1; single event = no amnesia

Type 2: Extended events = amnesia

Question 23

Jennifer freyd proposed that types of trauma differ. In what ways?

Answer 23

“terror traumas” enhance memories i.e. combat

“Betrayal traumas” impair memory through dissociation i.e. incest (as she believes herself to be a victim)

Question 24

how many cases of DID did boysen and VanBergen discover while reviewing literature b/w 200-2010?
How many from the west?
How many cases outside of therapy?

Answer 24

1170 new DID cases 82% from West (50% from US., Canada)

79% non-Western cases from Turkey only 3% outside therapy:

Question 25

What were kluft’s treatment steps

Answer 25

1. share diagnosis with patient
2. Make contact with alters - via hypnosis
3. Alters come forward; patients remember and tries to defeat other personalities
4. Alters recieve treatment for concerns
5. Patient encouraged to facilitate inter-alter communication

Question 26

What are the 2 types of alters discussed in class?

Answer 26

1) internal self-helper (in 50-80% of cases)

2) Prosecutor (child/adolescent that torments the host)

Question 27

When do animal alters typically appear

Answer 27

When host is under threat, they play a protective role

Question 28

what does iatrogenisis mean?

Answer 28

“caused by doctor”

Question 29

What is Kihlstrom’s opinion of DID

Answer 29

“DID symptoms are created, legitimized and maintained by social reinforcement”

Question 30

Simulators (pretending to have DID) were similar to DID in what ways?

Answer 30

DES (dissociative experiences scale), implicit memory, ERP

Question 31

What were some problems when we discussed the success of therapy for DID

Answer 31

Evaluation of therapy was unclear, no common protocols, absence of so treatment controls, no alternate approaches were tested

Question 32

in recent (e.g., post 1980) cases of DID, the average number of alters is

Answer 32

7-10.

Question 33

more cases have been diagnosed in the past 20 years than in

Answer 33

all of previously recorded history.