Dissociative Disorders Flashcards
What are the 5 DSM V classifications of dissociative disorders?
- Dissociative identity disorder
- dissociative amnesia (with or without dissociative fugue)
- depersonalization/ derealization
- other specified dissociative disorder
- unspecified dissociative disorder
Which of the DSM V classifications are actually dissociative disorders?
- DID
- dissociative amnesia
- depersonalization, derealization
What is dissociation, according to Pierre Janet?
It was an idea that he brought up, parallel to Freud’s defence mechanisms
What is the problem with dissociative disorders?
They are only a description of clinical evidence, but there are no physiological markers
In short, what is dissociation?
A failure of consciousness to integrate cognition, emotions and motivation
- the result is that some aspect of cognition is unable to be consciously accessible
What is the prevalence of dissociative disorders?
About as high as schizophrenia (about 1% of the population)
What happened from 1960 to 1980?
Reported cases of DID climbed from 2 cases per decade (1960) to 20,000 cases from 1980-2000
What are the diagnostic criteria specific to DID?
- discontinuity in sense of self and sense of agency; alterations in affect, behaviour, consciousness, memory, perception, cognition and/or sensorimotor functioning
- recurrent gaps in recall inconsistent with ordinary forgetting
- symptoms cause distress or impairment in social functioning
- disturbance is not a broadly accepted cultural or religious practise
- symptoms cannot be attributed to physiological effects of a substance or other medical condition
What are the two symptoms the DSM describes that are specific to DID (exam question)?
- discontinuity in sense of self and sense of agency; alterations in affect, behaviour, consciousness, memory, perception, cognition and/or sensorimotor functioning
- recurrent gaps in recall inconsistent with ordinary forgetting
In what three ways does DID amnesia manifest?
- gaps in memory
- lapses in dependable memory (such as reading)
- discovery of evidence for which they have no memory
What is a dissociative fugue?
Purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical information
- example: going to a new country and calling themselves a different name, with no memory of previous life
What is the problem with dissociative fugue?
There is only anecdotal evidence to support this
What is DID linked to?
Higher levels of hypnotizability and dissociativity
What are the diagnostic criteria for dissociative amnesia?
- inability to recall important autobiographical information, inconsistent with ordinary forgetting
- often selective amnesia of a specific event, or generalized amnesia for life history - distress/social impairment
- disturbance is not caused by a substance
- disturbance is not better explained than DID, PTDS, acute stress disorder, somatic symptom disorder, or neurocognitive disorders
What are the symptoms specific to dissociative amnesia (exam question)?
- inability to recall important autobiographical information, inconsistent with ordinary forgetting
- often selective amnesia of a specific event, or generalized amnesia for life history - disturbance is not better explained than DID, PTDS, acute stress disorder, somatic symptom disorder, or neurocognitive disorders
What is the difference between amnesia from PTSD, and amnesia from dissociation?
In PTSD, amnesic memories are eventually remembered
What are the different kinds of amnesia (5 in total)?
- localized: failure to recall during a period of time
- selective: failure to recall some of the events
- generalized: complete loss of memory of one’s life
- systematized failure to recall a specific category of information
- continuous: failure to recall each new event as it occurs
What are the diagnostic criteria for depersonalization/derealization?
- the persistent or recurrent experiences of depersonalization or derealization
- during depersonalization and/or derealization, reality testing remains intact (i.e. you remain a critical agent of reality) - no disturbance of memory, often triggered by stress
- causes distress
What are the symptoms specific to depersonalization/derealization (exam question)?
- the persistent or recurrent experiences of depersonalization or derealization
- during depersonalization and/or derealization, reality testing remains intact (i.e. you remain a critical agent of reality) - no disturbance of memory, often triggered by stress
Describe other specified dissociative disorder (exam question)?
Used when some symptoms are present, but not enough to qualify as a true dissociative disorder
What is unspecified dissociative disorder (exam question)?
When the dissociative symptoms are present, but there is no known cause
What are some major problems with dissociation?
- dissociation is used to describe a symptom, a pathology, or an ability (it becomes a circular description)
- we can’t decide the line between normal and pathology
- imagination better explains dissociation than trauma
- should only be used as a descriptor (to index a person’s subjective experience)
How was hypnosis used with dissociative disorders?
Hypnosis was the road to uncover the traumas of the alters
Describe how DID gained popularity?
Because in the late 80s and 90s, the belief that Satan was back caused many religious figures to explain mental illness (and specifically DID) as possession; the response of the psychologists was to give it a clinical label instead
