Dissociative Disorders

Question 1

Hallmarks of dissociative disorders

Answer 1

Disruption of who you are
Interruption of identity without awareness that it’s happening
Person isn’t consciously aware of what he/she is doing

Question 2

Depersonalization/derealization disorder

Answer 2

Persistent, recurrent episodes of depersonalization, derealization, or both
Person is aware of what is real and what isn’t

Question 3

Depersonalization

Answer 3

Feeling of not being yourself for a period of time

“Observer” of self (out of body)

Question 4

Derealization

Answer 4

Feeling of the world not being real

Dreamlike state

Question 5

Epidemiology of depersonalization/derealization disorder

Answer 5

Episodes are common (about half of people have them at one point or another), but disorder is rare
Sex: equal in male and female
Age of onset: adolescence (time of development of coping mechanisms)
Often associated with PTSD

Question 6

Dissociative amnesia

Answer 6

Inability to recall important personal information, usually of a traumatic nature (similar to repression)
Not due to brain injury

Question 7

Localized amnesia

Answer 7

Forgetting the trauma itself

Question 8

Selective amnesia

Answer 8

Forgetting the details of the trauma

Question 9

Generalized amnesia

Answer 9

Forgetting anything before the trauma took place

Question 10

Systematized amnesia

Answer 10

Forgetting a specific piece of information (ex- having a brother)

Question 11

Continuous amnesia

Answer 11

Forgetting things before and after the trauma

Question 12

Dissociative fugue

Answer 12

Forgetting who you are, moving to a new place, and taking on a new identity

Question 13

Epidemiology of dissociative amnesia

Answer 13

Sex: females 2:1
Age of onset: anytime (consistent with trauma)
Course: usually sudden onset, can last minutes to decades, often reversible

Question 14

Dissociative identity disorder

Answer 14

2 or more distinct personality states (“timeshare” body- many different people inhabit)
When 1 identity has control, the others don’t know what’s happening
Gaps in recall of everyday events/traumas

Question 15

Personalities in dissociative identity disorder

Answer 15

Main personality is host
Secondary personalities are alters
# of alters can range from 2 to hundreds (average is 15)
Alters have ranges in age, gender, and abilities

Question 16

Epidemiology of dissociative identity disorder

Answer 16

Drastic increase in number of cases since release of movie Sybil in 1973
Rates uneven across countries/clinicians (90% of cases are diagnosed by 10% of clinicians)
Sex: equal

Question 17

Typical presentation of dissociative identity disorder

Answer 17

Vague psychological complaints
History of abuse (often child sexual abuse)
Suicide attempts and/or self-mutilation
History of multiple therapists and diagnoses

Question 18

Psychodynamic perspective on dissociative identity disorder

Answer 18

Repression of trauma

Other personalities develop to cope

Question 19

Iatrogenic perspective on dissociative identity disorder

Answer 19

DID is developed in treatment
Suggestibility: trauma is suggested and didn’t actually happen
Reinforcement: people want to please therapist by confirming his/her diagnosis
Role play: therapist teases apart “personalities”

Question 20

Belief that dissociative identity disorder is factitious

Answer 20

People fake having multiple personalities

Minority of psychologists believe this

Question 21

Treatments for dissociative identity disorder

Answer 21

Address underlying trauma
Remove gain of attention
Personality integration: adapt host to take on roles of alters (limited success)
Coping skills training: reduce underlying stress and impairment (ex- journaling between personalities to reduce gaps in memory)

Question 22

Identity disturbance due to prolonged and intense coercive persuasion

Answer 22

Struggling with identity as a result of brainwashing

Question 23

Dissociative trance

Answer 23

Losing oneself in a trance

If part of religious ceremony or meditation, then not a disorder