Dissociative Disorders Flashcards
Dissociation
Detachment from immediate surroundings, physical or
emotional reality, your memory, or sense of identity
Core features of dissociative disorders
Disruption in the usually integrated functions of:
- Consciousness
- Memory
- Identity
- Perception
How do dissociative disorders differ from the average person’s dissociative experiences (which are pretty common)?
Differs in:
- Intensity
- Frequency
- Distress/impairment
Symptoms of dissociative disorders
Depersonalization: Detached from self
Derealization: Sense that surroundings aren’t real
Amnesia: For personal info or time
Identity confusion: Confusion and conflict over identity
Identity alteration: Behaviours inconsistent with core identity
Specific dissociative disorders
- Dissociative fugue
- Dissociative amnesia
- Depersonalization disorder
- Dissociative identity disorder
Dissociative fugue
- Sudden, unexpected travel
- Amnesia
- Confused or new identity
Most cases of dissociative fugue
- Short distance
- No new identity
- Brief (Hours or days)
Extreme cases of dissociative fugue
- Travel far
- New identity
- Longer
Dissociative amnesia
Loss of autobiographical memory for events, often due to traumatic event
Lorena Bobbitt
- Cut off her husband’s dick after he raped her but had no memory of doing so
- Could be because the brain isn’t encoding information
- Could be to protect person from traumatic events
Types of amnesia
- Organic amnesia
- Psychogenic amnesia
- Retrograde
- Anterograde
Organic amnesia
Caused by injury to parts of brain related to aspects of memory
Psychogenic amnesia
- Arises in the absence of any brain injury or disease
- Has psychological causes
- Typically not anterograde
Retrograde amnesia
Inability to remember information from the past
Anterograde amnesia
Inability to form new memories (e.g. film Memento)
Depersonalization disorder
- Persistent or recurrent depersonalization
- Aware it is a feeling and not real
- Caused by stress, sleep deprivation, drugs
- Distress/impairment (must experience this in order to be diagnosed)
DID
Two or more distinct personality states (alters) who recurrently take control of behavior
Inter-identity amnesia
Inability to recall important personal information between alters
How alters interact
- Aware or unaware of one another
- Like or dislike one another
- Work together or have conflicting goals
Types of alters
- Host: “true” personality
- Child (most common): May be created during trauma to take on role of victim
- Persecutor: Inflicts self-harm
- Protector: Perform tasks hosts cannot perform
Challenges with DID
- Most controversial disorder
- Lack of research: Mostly from case studies (looks at one person) and you can’t rule out role-playing
- Is it a valid disorder?: 75% of psychologists/psychiatrists say No
- Also meet criteria for other disorders (e.g. depression, PTSD, personality disorders), so could be more extreme forms of them
Posttraumatic model of DID
- Dissociation = pathological reaction to stress
- Trauma memories stored in alter
- Compartmentalization of memories (interidentity amnesia)
- Develops as a protective response to childhood trauma in particular
- May be a form of CPTSD
Weaknesses in posttraumatic model of DID
Not clear why trauma leads to DID rather than depression, PTSD or BPD
If posttraumatic model of DID is correct, what do we expect to see?
Complete interidentiy amnesia
Etiology of DID
- Posttraumatic model
- Sociocognitive model
Sociocognitive model of DID
- DID used to explain life: Identities are somewhat consciously created by individuals
- Media influences
- Therapist is responsible for the symptoms (e.g. using hypnosis, reinforcing behaviours consistent with diagnosis, asking leading questions)
- Dissociation, desire to please & creativity = vulnerability
- Reinforced when they roleplay an alter
- Amnesia as “metaphor”
- Unrelated to childhood trauma
