Dissociative Disorders Flashcards
The inability to recall important autobiographical nature that is usually traumatic in nature or hard to forget. Can be associated with dissociative fugue.
Dissociative Amnesia
What is localized amnesia?
Failing to recall event in a circumscribed time.
What is selective amnesia?
Recall some but not all of the events in a circumscribed time.
What is generalized amnesia?
Complete loss of memory for one’s personal identity. Can happen with both factual memory or procedural (well-learned) memory.
What is systemized amnesia?
Just forgetting one category of knowledge. AKA forgetting your entire family.
What is continuous amnesia?
Loss of memory as each new event occurs. Cannot make memories throughout the day.
If a patient has experienced dissociative amnesia once before in their lifetime… will they get it again?
Yes. Dissociative amnesia tends to reoccur in many patients.
Is generalized amnesia sudden or gradual? What are some of the characteristics that patient displays?
Sudden onset.
Patient may be unaware of amnesia. Not in any distress.
As amnesia remits … underlying PTSD may surface.
What are some of your differential diagnoses when you see somebody with dissociative amnesia?
Delirium and dementia Memory loss 2ndary to trauma. seizure disorder Transient global amnesia Dissociative identity disorder PTSD substance use disorder Malingering
What is depersonalization d/o?
Lasting or recurring feeling of being detached from one’s body.
Being an observer to one’s thoughts, feelings, and sensations.
What is derealization d/o?
Experiencing unreality or detachment from your surroundings.
People/objects are experienced as unreal, foggy, magical, lifeless, or visually distorted.
Microscopia / Macroscopia associated
What are the characteristic features of Depersonalization/Derealization d/o?
Patients are extremely distressed / think they’re going crazy.
Can be sudden or gradual. Can last hours to days.
When do people usually get depersonalization/derealization d/o?
Mean age of onset = 16 y/o
What is a risk factor for depersonalization / derealization d/o?
Emotional abuse / neglect.
What is dissociative identity disorder?
Disruption of identity often by two or more distinct personality states.
Sometimes described as possession.
Marked discontinuity between sense of self with alterations in cognition, behavior, affect, memory and perception.
Are patients aware that they’ve switched personalities? What happens when patients switch personalities?
Patients are often unaware that they’ve switched personalities. They will find clues from their other personalities around the house.
Recurrent amnesia / gaps in memory occur when personalities are switching.
How is possession different from DID?
Possession is usually manifest as some spirit taking over. It is not dissociative identity disorder but more cultural.
Possessions are accepted by the culture around them and are not distressed.
What are patients with Dissociative Identity Disorder often misdiagnosed with?
Schizophrenia or with a personality disorder.
They may also have a co-morbid PTSD.
What are the risk factors for dissociative identity disorder?
Trauma that is physical or sexual in nature.
What is the differential diagnosis for dissociative identity disorder?
Dissociative amnesia Major depressive disorder bipolar disorder psychotic disorder borderline personality d/o malingering complex partial seizures
What is identity due to prolonged and intense coercive persuasion?
Brainwashing, cult, sects, and thought reform.
Over long periods of time of brainwashing you may dissociate from your old identity and assume a new one.
What is acute dissociative reaction?
Lasting less than a month under intense stress.
What is dissociative trance?
Complete loss of awareness of environment with stereotyped behavior and loss of consciousness.
*You need to be in a trance to fugue.
What is a minor trance state?
Hypnosis
