Dissociative Disorders

Question 1

Dissociative Disorders

Answer 1

=depersonalization and derealization
=dissociative amnesia
=dissociative identity disorder
-meant to walk to one location, and then end up at another

Question 2

Dissociative Episodes

Answer 2

= loss of awareness for important personal information

=a way of managing stress and anxiety

Question 3

Depersonalization

Answer 3

=sense of self and one’s own reality temporarily lost

• feel like you are watching yourself from outside your body
• can’t form an accurate narrative: memory fragmentation

Question 4

Derealization

Answer 4

=sense of reality of the outside world is temporarily lost

Question 5

Depersonalization/Derealization Disorder

Answer 5

=presence of persistent or recurrent episodes of depersonalization, derealization, or both
=reality testing remains intact during episodes
-date, time, where they are

Question 6

Depersonalization/Derealization Disorder Prevalence

Answer 6

1-2% of US population

Question 7

Depersonalization/Derealization Disorder Treatment

Answer 7

=no clearly effective treatment

Question 8

Dissociative Amnesia and Dissociative Fugue

Answer 8

=inability to recall previously stored personal information
-name, address, occupation, children
=details about a certain event cannot be recalled
-other people know about it, but they don’t
=usually follows a stressor
-not usually traumatic,
-ex: severe occupational stress and a failing marriage
=lasts from a few days to a few years
=person appears otherwise normal
-procedural memory in tact - could still play piano, walk and talk

Question 9

Dissociative Fugue

Answer 9

=dissociative amnesia and leaves home
=behavior otherwise normal - don’t arouse suspicion
-hard to track down
=could be accompanied by taking up a new identity

Question 10

When fugue remits

Answer 10

=sometimes sudden, sometimes takes a lot of prompting

=amnesia remits, but as you remember your old identity, you forget your new identity

Question 11

Dissociative Amnesia and Fugue memory effects

Answer 11

=subtle loss of function in right anterior hemisphere
=episodic and autobiographical memory is impaired
=implicit memory intact
-muscle memory

Question 12

Dissociative Identity Disorder

Answer 12

= used to be known as “multiple personality disorder”
=two or more distinct identities that alternate in taking control of behavior
=for females: average 15 personalities, for males: average 8 personalities

Question 13

Host and Alters

Answer 13

=host: one of the subpersonalities that dominates the person’s functioning and appears more often
=alter identities differ in many ways from host and each other
=transition from one sub personality to the next (“switching”) is usually stable
=sub personalities tend to be fragments of a whole personality

Question 14

Sub personalities tend to be fragments of a whole personality

Answer 14

=they display drastically different characteristics 
=age, race, sex, family history 
=abilities and preference 
-may speak in different accents 
-driving, foreign language, skills

Question 15

Relationships between Alters

Answer 15

=mutually amnesiac: subpersonalities have no awareness of each other
=mutually cognizant: each subpersonality is aware of the next
=one way amnesiac: some personalities aware of others, awareness is not mutual
-most common pattern

Question 16

Lots of Comorbidities with DID

Answer 16

=average of 5

=PTSD, substance abuse disorder, depression, borderline personality disorder

Question 17

Course of DID

Answer 17

= often first diagnosed in late adolescence/ early adulthood
=symptom onset often in childhood
=women receive the diagnosis 3-9 times as often as men

Question 18

Prevalence of DID

Answer 18

=very rare - most therapists never see
=increasing because
-movies and media coverage –> raise public awareness
-improved diagnostic criteria for DID and schizophrenia
-people were receiving schizophrenia diagnoses before who shouldn’t have
=increased attention to history of child abuse
=therapists subtly suggesting multiple personalities

Question 19

How Does DID develop?

Answer 19

=post traumatic theory
-reaction to severe childhood abuse, trauma
=sociocognitive theory
-highly suggestible person learns to adopt different identities as clinicians suggest, legitimize, and reinforce them: leads to an

Question 20

Independence of Personalities

Answer 20

=emotional memories transfer across personalities
=explicit memory does not transfer
=implicit memory transfers
=differences in brain waves across personalities

Question 21

Treatment of DID

Answer 21

=psychodynamic, insight oriented
=therapists bond with host and alters
=recovering memories
-may use psychodynamic therapy, hypnotherapy, medication

Question 22

Therapists bond with host and alters

Answer 22

• try to educate patients, help them recognize the nature of the disorder
• some use hypnosis or video as a means of presenting alters
• some recommend DID support group

Question 23

Final goal of DID treatment

Answer 23

=to merge the different subpersonalities into a single integrated entity
=integration is a continuous process, fusion is the final merging
=many patients distrust this final treatment goal and many subpersonalities see integration as a form of death
=after fusion, farther therapy is needed
-to maintain the complete personality
-to teach social and coping skills to prevent future dissociations