Exam 3: Dissociative Disorders Flashcards
Dissociative Amnesia Prevalence (year)
1.8%, f > m
Depersonalization Disorder Prevalence (lifetime)
2%, m = f (over 50% of adults have had an episode)
DID Prevalence (year)
1.5%, m = f
Dissociative Amnesia Symptoms
cannot recall important personal information, usually of a traumatic or stressful nature, too exreme to be attributed to normal forgetfulness, “episodic” memory gaps
Difference between Dissociative Amnesia and other memory loss
DA is sudden vs. gradual of other memory loss, ends abruptly, and recovery can be complete
Dissociative Amnesia: Fugue
very rare; person has amnesia, and will leave and go somewhere else with a completely new identity; length of time varies; heavy alcohol use can contribute
DA Pattern: generalized
loss of memory extends back to times long before the upsetting period; in most extreme cases, person may not remember who they are and fail to recognize family and friends
DA Pattern: localized
most common; person loses all memory of events that took place within a limited period of time, almost always beginning with some very disturbing occurrence
DA pattern: selective
second most common form of dissociative amnesia; remember some, but not all, events that occurred during a period of time
DA patten: continuous
forgetting continues into the present; might forget new and ongoing experiences as well as what happened before and during the trauma
Depersonalization Disorder Symptoms
persistent/recurrent episodes of depersonalization, can feel detached, robotic/mechanical, cannot feel sensory system, have trouble describing symptoms, derealization (external world seems strange and unreal); are aware that they are not actually detached from their body
Depersonalization Disorder Onset and Course
onset is rapid, disappeareance is gradual
mean age: 16
Depersonalization Disorder Triggers
trauma, stress, drugs
Dissociative Identity Disorder Symptoms
lack of unified identity, two or more distinct identities/personalities/alters with a consistent pattern of viewing the self and the world; does not recall important personal information; can be continuous or episodic
DID Onset
seems to begin in childhood, but is not diagnosed until adolescence or early adulthood
DID: Common Alters
child alter, self-mutilating and/or suicidal, helpful (do things the main personality cannot do)
DID: Shift in Alters
Stress or drugs can cause it; facial espression, voice, and demeanor change; disruption in train of thought, rapid eye blinking
DID: Alter Characteristics
sometimes in groups of 2 or 3; if fully developed, can have specific ages, memories, genders, allergy sensitivities, social relationships, etc.; somethimes person is functioning, alters can work well
DID: Alter Awareness
Alters can be mutually amnesic (not aware) or mutually cognizant (aware); some alters are aware of others, but awareness is not mutual
DID Diagnosis History
100 reported cases by 1972
Increase after 1980
Clinicians were reluctant to use this diagnosis; did not appear in DSM until DSM III
DID Comorbidity
Most people have at least 3 other disorders; highly comorbid with PTSD, substance abuse, MDD, and other personality disorders
DID and Trauma
97% of cases are caused by trauma; typically sexual abuse, repeated physical abuse, incest, or other trauma (kidnapping, etc.); other personalities develop to deal with the trauma and used as a defense mechanism
DID + PTSD Associated Features
self-harm, suicidal, aggression, abusive relationships, impulsivity, substance abuse, sexual/eating/sleep disorders, depression and borderline personality disorder
DID Reliability and Validity
equal to or better than diagnoses that are well-accepted
DID Etiology
caused by a major trauma or sexual abuse; only 3% experienced no significant childhood trauma
DID Associated Factors
dissociation prone, highly hypnotizable, harsh abuse in inescapable situation, often have multiple traumas
DID: Psychoanalytic Theory
“post-traumatic” model: 1 part of the mind splits off and becomes dissociated as a defense; trauma is repressed; DID is a lifetime of excessive repression
DID: Learning/Behavioral
dissociation learned through operant conditioning (negative reinforcement for forgetting); social reinforcement: can escape responsibility for actions, a learned social role
DID: Self-Hypnosis
hypnosis can make people forget personal details; kids are more suggestible and suceptible to hypnosis
DID: Cognitive (State-Dependent Memory)
it is easier for anyone to remember something when you are in the same room it occurs/have the same emotiona again/take the same drug; personalities are characterized by mood states, and strong emotions can cause shifts to an alter
DID: Biological
no evidence of inheritable cause, some genetic predisposition to hypnotizability; often had insecure attachment as children; slightly smaller amygdala and hippocampus (similar to PTSD); some research with orbital frontal lobe
Dissociative Amnesia Treatment
patient recovers on their own
Depersonalization Treatment
gradually recover on their own; therapy can be helpful (recognizing symptoms and getting a diagnosis), relieves anxiety and depression to confront stressor; psychodynamic (along with EMDR) and cognitive/behavioral therapies
DID Treatment
do not recover on their own, and often do not reover with treatment; long-term therapy to build trust, psychodynamic therapy, hypnosis, skillbuilding (interpersonal, impulse control); helps client recognize nature of disorder, uncover memory gaps, and integrate alters; no medication
Dissociation
a major disruption in memory
