Dissociative Identity Disorder (DID) Flashcards
What is dissociation?
A) Amnesia: Found myself in a place and I had no idea how I had gotten here.
B) Absorption: Listening to somebody who is talking and realizing after some time that I didn’t hear anything or all of it.
C) Derealization & Depersonalization:
- Derealization: refers to the feeling that the world, objects around you are not real
- Depersonalization: refers to the feeling that you as a person aren’t real
Can dissociation occur in healthy individuals?
Yes, but it depends on the frequency and intensity whether it becomes pathological
What is Dissociative Fugue?
DF is a facet of dissociative amnesia. It is characterized by sudden unplanned trips from the home/workplace without the ability to remember some or all of the individual’s past. Some take on new characteristics or aspects not related to their original identity. After a fugue episode resolves, patients are unable to remember any events of the state. Often caused by shocking/traumatic life events. Thus, they tend to be running away from something which they are unaware.
Why does dissociation occur?
Dissociation occurs as a consequence of experiencing extremely stressful/traumatic events and can be seen as a coping strategy for these experiences. Often adverse life events can be seen as the core for dissociation.
If a person experiences dissociation while sexual abuse, they will dissociate later in life as well, especially when confronted with triggers.
What is the most characteristic aspect in Dissociative Identity Disorder (DID)?
Patients with DID experience the feeling of having multiple identities. They can differ in gender, age, abilities, characteristics, etc..
Explain the Structural Dissociation Model (SDM).
SDM suggests that (repeated) interpersonal childhood abuse interferes with identity development. Thus, a coherent identity can’t develop. Consequently, they develop various “Splits-Off” identities whereas some deal with the experienced trauma.
In context of the Structural Dissociation Model (SDM): What treatment option is suggested?
A treatment is suggested where the identities are mapped and identified + establishing a collaboration of the identities. Final aim is to include the various identities into one.
Explain the Sociocognitive Model (SCM).
The SCM focuses on the aspect of having mood swings and lack of behavioral control (can also be caused due to trauma experiences, but that’s not the point here). It suggests a high influence of social learning and cultural factors such as media influence, therapist cueing, for example. Thus, multiple identities may be just induced by others. Consequently, they state that trauma-focused treatment like it is recommended from the SDM model may even be harmful. SCM recommends to treat the initial symptoms (eg. mood swings, memory problems).
What was found about inter-identity amnesia in DID patients by Huntjents et al. (2003)?
The study showed that DID patients have an objective transfer of semantic (Inhalt + Bedeutung) information/words between the identities, also when trauma-related words were used.
Testing the transfer of emotional valence between the identities, the study showed that evaluative conditioning and affective priming also works in DID patients. Consequently, DID patients can be primed in between their identities the same way as healthy controls.
Does inter-identity amnesia exist?
Objectively no evidence was found for inter-identity amnesia.
Why could Schema Therapy work for DID patients?
- Agrees with the empirical findings on transfer of information
- already used for patients with extreme mood shifts (eg.: bipolar)
- less encouraging of the distinct identity aspect
What is the basic idea if Schema Therapy in DID patients?
Individuals develop so called ‘modes’ during life through various experiences. In DID patients these modes are the subjective experience of switching identities and can be seen as dysfunctional. Schema Therapy focuses on the core and reason of the mode and aims to replace these dysfunctional coping styles with adaptive behavior and more functional modes. The treatment tries not to merge the identities, it strives for more control in the patient.
What is the main problem about hypotheses in previous studies?
Most of the conducted studies don’t have any specific and testable hypotheses with a predefined outcome. That enables researcher to find post-hoc explanations and provoke cherry-picking.
What is the problem about using medicated participants?
The brain scans can differ due to the medication.
What is the problem about studies without any clinical comparison sample such as PTSD patients for example?
Most of DID patients have also PTSD due to childhood abuse for example. As previous studies showed changes in the brain in PTSD patients, it can’t be distinguished what differences are caused by PTSD or DID.
