Dissociative Disorders

Question 1

What is a dissociative disorder?

Answer 1

Loss of memory, identity, or sense of self (one’s sense of self is the normal integration of one’s thoughts, behaviors, perceptions, feelings, and memory into a unique identity)

Question 2

What differentiates an amnestic disorder from a dissociative disorder?

Answer 2

Dissociative disorders are never due to an underlying medical condition or substance use; onset is instead related to a stressful life event or personal problem

Question 3

What is the DSM criteria forDissociative Amnesia?

Answer 3

• At least one episode of inability to recall important personal information, usually involving a traumatic or stressful event
• The amnesia cannot be explained by ordinary forgetfulness
• Symptoms cause significant distress or impairment in daily functioning and cannot be explained by another disorder, medical condition or substance use

Question 4

Dissociative amnesia is more common in ___ than ______ and has increase incidence of comorbid…

Answer 4

• Women than men

* Major depression and anxiety disorders

Question 5

What is the course of dissociative amnesia?

Answer 5

Many patients abruptly return to normal after minutes or days

Question 6

What is the treatment for dissociative amnesia disorder?

Answer 6

• It is important to help patients retrieve lost memories in order to prevent future recurrences
• Hypnosis or administration of sodium amobarbital or lorazepam during the interview helps patients talk more freely
• Subsequent psychotherapy is then recommended

Question 7

What is abreaction?

Answer 7

The strong reaction patients often get when retrieving traumatic memories

Question 8

What is dissociative fugue?

Answer 8

Characterized by sudden, unexpected travel away from home, accompanied by the inability to recall parts of one’s past or identity

Question 9

What are the DSM-IV Criteria for Dissociative Fugue?

Answer 9

• Sudden unexpected travel away from home or work plus inability to recall one’s passt
• Confusion about personal identity or assumption of new identity
• Not due to dissociative identity disorder or the physiological effects of a substance or medical disorder
• Symptoms cause impairment in social or occupational functioning

Question 10

What are some predisposing factors for dissociative fugue?

Answer 10

• Heavy use of alcohol
• Major depression
• History of head trauma
• Epilepsy
• Stressful life event

Question 11

Unlike dissociative amnesia, patients with dissociative fugue are…

Answer 11

unaware that they have forgotten anything

Question 12

Dissociative fugue usually lasts…

Answer 12

A few hours to several days (but may last longer)

Question 13

Treatment of dissociative fugue is similar to that of…

Answer 13

Dissociative amnesia

• Help retrieve lost memories
• Hypnosis or administration of sodium amobarbital or lorazepam
• Subsequent psychotherapy

Question 14

What are the DSM-IV criteria for dissociative identity disorder?

Answer 14

• Prescence of at least 2 or more distinct identities
• At least two of the identities recurrently take control of the person’s behavior
• Inability to recall personal information of one personality when the other is dominant
• Not due to effects of substance or medical condition

Question 15

What is the average age of diagnosis for dissociative identity disorder? Women account for ___% of patients

Answer 15

• Average age of diagnosis is 30

* Women account for 90% of patients

Question 16

Most patients with dissociative identity disorder have experienced…

Answer 16

trauma, especially childhood physical or sexual abuse

Question 17

What is the course of dissociative identity disorder?Which patients have a poorer prognosis?

Answer 17

• Course is usually chronic with incomplete recovery

* Patients with an earlier onset have a poorer prognosis

Question 18

What are the DSM-IV criteria for Depersonalization disorder?

Answer 18

• Persistent or recurrent experiences of being detached from one’s body or mental processes
• Reality testing remains intact during episode
• Causes social/occupational impairment and cannot be accounted for by another mental or physical disorder

Question 19

A diagnosis of depersonalization disorder requires…

Answer 19

that episodes be persistent or recurrent (transient symptoms of depersonalizations are common in normal people during times of stress)

Question 20

What is the course of depersonalization disorder?

Answer 20

Often chronic with either steady or intermittent course, but may remit without treatment

Question 21

How is depersonalization disorder treated?

Answer 21

Anti-anxiety agents or selective serotonin reuptake inhibitors (SSRIs) to treat associated symptoms of anxiety or major depression