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PSYCH ROTATION > First Aid: Dissociative Disorders > Flashcards

First Aid: Dissociative Disorders Flashcards

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1
Q

List some examples of dissociative disorders.

A

Dissociative amnesia
Dissociative fugue
Dissociative identity disorder
Depersonalization disorder

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2
Q

True or false: dissociative disorders are NEVER due to an underlying medical condition or substance use.

A

TRUE

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3
Q

Amnesia is a prominent symptom in all dissociation disorders except which?

A

Depersonalization disorder

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4
Q

What specific condition is required for the diagnosis of dissociative amnesia?

A

Amnesia is the ONLY dissociative symptom present

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5
Q

What is the DSM-IV criteria for diagnosis of dissociative amnesia?

A
  • At least 1 episode of inability to recall 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 d/o, medical condition or substance abuse
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6
Q

Are people with dissociative amnesia usually aware of their deficits?

A

YES: they are aware they are having difficulty remembering but are not troubled by it

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7
Q

What types of things do people with dissociative amnesia forget?

A

things like their name but can remember obscure details

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8
Q

In what gender is dissociative amnesia more common?

A

women

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9
Q

In what age group is dissociative amnesia more common?

A

younger adults

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10
Q

What are the common comorbidities with dissociative amnesia?

A
  • MDD

- Anxiety disorders

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11
Q

What is the prognosis for dissociative amnesia?

A
  • Many return to normal abruptly after minutes or days

- Recurrences are uncommon

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12
Q

What is the treatment for dissociative amnesia?

A
  • Help patients retrieve lost memories to prevent future recurrences
  • Subsequent psychotherapy
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13
Q

What drugs may help a patient with dissociative amnesia talk in an interview?

A

Hypnosis or sodium amobarbital or lorazepam

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14
Q

What is the risk in using sodium amobarbital?

A

respiratory depression

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15
Q

What is the word for the strong reaction that patients often get when retrieving traumatic memories?

A

Abreaction

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16
Q

What is the most common dissociative disorder?

A

dissociative amnesia

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17
Q

What is the DSM-IV criteria for diagnosing dissociative fugue?

A
  • Sudden unexpected travel away from home or work plus inability to recall one’s past
  • Confusion about personal identity or assumption of new identity
  • Not due to dissociative identity disorder or the physiological effects of a substance or medical d/o
  • Symptoms cause impairment in social or occupational functioning
18
Q

What is a major difference between dissociative amnesia and dissociative fugue?

A

those with dissociative fugue are not aware that they have forgotten anything

19
Q

What are the major predisposing factors for dissociative fugue?

A
  • Heavy use of alcohol
  • Major depression
  • History of head trauma
  • Epilepsy
20
Q

What is the trigger for dissociative fugue?

A

-Stressful life event (life stressor or personal conflict)

21
Q

How long do fugues usually last?

A

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

22
Q

What usually happens after a fugue?

A

Person will assume his or her old identity without ever remembering the time of the fugue

23
Q

How do you treat dissociative fugue?

A

same as dissociative amnesia

24
Q

What is the DSM-IV criteria for diagnosing dissociative identity disorder (multiple personality disorder)?

A
  • Presence of 2 or more distinct identities
  • At least 2 of the identities recurrently take control of the person’s behavior
  • Inability to recall personal information of when personality when the other is dominant
  • Not due to effects of substance or medical condition
25
Q

Can a pt with dissociative identity disorder remember events that occur when an alternate personality is present?

A

not usually

26
Q

What gender more commonly has dissociative identity disorder?

A

Women (more than 90%)

27
Q

What is a commonality between the pasts of most patients with dissociative identity disorder?

A

Prior trauma (especially childhood physical or sexual abuse)

28
Q

What is the average age of diagnosis for dissociative identity disorder?

A

30

29
Q

What are the common comorbidities of dissociative identity disorder?

A
  • MDD
  • Anxiety disorders
  • Borderline personality disorder
  • Substance abuse
  • Suicide (up to 1/3 of patients commit suicide)
30
Q

What is the prognosis for dissociative identity disorder?

A
  • Usually chronic course with incomplete recovery
  • Worst prognosis of all dissociative disorders
  • Earlier the onset, worse the prognosis
31
Q

What is the treatment for dissociative identity disorder?

A
  • Hypnosis
  • Drug-assisted interviewing
  • Insight-oriented psychotherapy
32
Q

What is the DSM-IV diagnostic criteria for depersonalization disorder?

A
  • Persistent or recurrent experiences of being detached from one’s body or mental process
  • Reality testing remains intact during episode
  • Causes social/occupational impairment, and cannot be accounted for by another mental or physical disorder
33
Q

What is required for diagnosis of depersonalization disorder (as far as timeline)?

A

Episodes are recurrent or persistent

34
Q

Is depersonalization ever normal?

A

yes! during times of stress

35
Q

Are those with depersonalization disorder aware of their symptoms?

A

yes (fear they are going crazy)

36
Q

What are common comorbid feelings in depersonalization disorder?

A

Anxiety
Panic
MDD

37
Q

What is the gender difference in depersonalization disorder?

A

women 2X more common

38
Q

What is the average age of onset in depersonalization disorder?

A

between 15 and 30

39
Q

What is usually the trigger for depersonalization disorder?

A

severe stress

40
Q

What is the prognosis for depersonalization disorder?

A
  • usually chronic (with steady or intermittent course)

- may remit without treatment

PSYCH ROTATION (18 decks)

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