Lecture 7: Dissociative Disorders: Chapter 8 (tot 246) Flashcards
What is the main characteristic of a dissociative disorder?
A person’s consciousness is disturbed
What is the main characteristic of a somatic symptom disorder?
Person complains about physical symptoms that suggest a physical defect or dysfunction.
Sometimes there is no physiological basis found and for others the psychological response is excessive
What are 3 types of dissociative disorders?
- Dissociative amnesia
- Depersonalization/derealization disorder (DDD)
- Dissociative identity disorder (DID)
What is dissociation?
An aspect of emotion, memory or experience is inaccessible consciously
What is dissociation in depersonalization/derealization disorder?
Dissociation is characterized by detachment where the person feels removed from the sense of self and surroundings
What kind of dissociation is there in people with dissociative amnesia and dissociative identity disorder?
Person can’t access important aspects of memory
Give an example of a mild dissociation everyone can experience
Losing track of time while studying
What is pathological dissociation?
An avoidance response that protects a person from consciously experiencing stressful events
What can trigger dissociation?
Naturalistic and experimentally induced sleep disruptions
What are 4 characteristics of depersonalization/derealization disorder?
- Depersonalization: experience of detachment from one’s own mental processes/body
- Derealization: experiences of unreal surroundings
- Persistent or recurrent symptoms
- Symptoms not explained by psychosis or other psychological or medical conditions
When is the onset of DDD and how are the symptoms triggered?
Begins in adolescence and it’s usually triggered by stress
During a lifetime, about …% of people with DDD will experience anxiety disorder or depression
90%
What are 2 defining symptoms of dissociative amnesia?
- Inability to remember important autobiographical information, usually of a traumatic or stressful nature, that is too extensive to be ordinary forgetfulness
- Specify fugue subtype if the amnesia is associated with bewildered or apparently purposeful wandering
How long does dissociative amnesia last and what is the chance of recurrence?
Can last several hours to several years. It disappears as suddenly as it began
Complete recovery of memory and a very small chance of recurrence
What is the fugue subtype of dissociative amnesia?
More extensive memory loss. The person typically disappears from home and work and can wander of in a bewildered manner.
What does psychodynamic theory say suggest about dissociative amnesia? What is some evidence on this view?
Traumatic events are repressed from consciousness
Stress tends to enhance rather than impair encoding memories of negative event, so not repression
What is the usual response of memory when trauma occurs?
Stress enhances memory encoding, especially features of the threat
How can we explain the stress-related memory loss of dissociative amnesia?
Still very debatable
Dissociative amnesia involves unusual responding to stress. High levels of stress hormones could interfere with memory formation
What was the previous name of dissociative identity disorder (DID)?
Multiple personality disorder
What are 3 defining symptoms of dissociative identity disorder (DID)?
- Disruption of identity characterized by 2 or more distinct personality states or an experience of possession
- Recurrent gaps in memory for events or important personal information that are beyond ordinary forgetting
- In children, symptoms aren’t explained by an imaginary playmate or by fantasy play
How do the different personalities interact in DID? How many personalities does a person often have at the start of treatment?
Different personalities are often not aware of each other and have no memory of what happens if they aren’t activated
4 personalities
What is the age of onset of DID and how is it’s recovery?
Onset in childhood, often discovered in adulthood
Recovery is less complete
What is the difference in prevalence in women vs. men for DID?
DID is much more common in women than in men
What are other common comorbid disorders with DID?
PTSD, MDD, somatic symptom disorder, borderline, other personality disorders
What do almost all DID patients report?
Serious childhood abuse
What prevalence percentages fit with DDD, dissociative amnesia and DID?
DDD: 0,8%
Dissociative amnesia: 1,8%
DID: 1,5%
What can explain the increase of prevalence of people with DID in the 1970s?
The diagnostic criteria and growing literature may have increased detection and recognition of symptoms
Some critics think the hightened attention of professionals and media led therapists to suggest strongly to clients they had DID
What are some neurobiological abnormalities in people with DDD?
- Atypical activity in regions integrating information from sensory cortex areas and bodily cues
- Mismatched or unexpected sensory experiences may trigger symptoms of DDD
- Brain regions that are involved in processing body cues related to emotion experience appear to be underactive when viewing emotional stuff
How can DDD symptoms be triggered?
When neural signals from various bodily/sensory cues are mismatched
What are the 2 major theories for the explanation of etiology of DID?
- Posttraumatic model
- Sociocognitive model
How does the posttraumatic model explain DID?
It says some people are particularly likely to use dissociation to cope with trauma and that this dissociation is the reason why people develop alternate personalities after trauma
How does the sociocognitive model explain DID? How do the multiple personalities emerge?
It says that people who have been abused seek explanations for their symptoms of distress.
Alternate personalities appear in suggestions by therapist, exposure to media reports of DID or other cultural influences => DID could be iatrogenic (created within treatment)
What does it mean that DID could be iatrogenic?
It means DID could be created within treatment
Why can we never test the sociocognitive model for DID?
It’s unethical to intentionally reinforce dissociative symptoms
What are 3 major sources of evidence that scientists have gathered for the cognitive model?
- DID symptoms can be role-played: when instructed to generate another personality many participants can pass DID personality tests
- Some therapists reinforce DID symptoms: therapists tend to use hypnosis to urge clients to unbury unremembered experiences or to name alternate personality states. As treatment progresses, they have a lot more personalities than before
- Alternate personalities share memories even when reporting amnesia: implicit memory tests are similar
How is medication as a treatment for dissociative disorders?
Not effective in relieving symptoms
How is psychodynamic therapy used in treatment of DID?
Used to overcome repressions, since DID is believed to arise from traumatic events that the person is trying to block from consciousness
Sometimes using hypnosis to gain access to repressed material
What is age regression?
People going back to traumatic events in childhood to realize that childhood threats are no longer present
What is the effect of hypnosis on dissociative disorders?
It often worsens symptoms
What should be the main goal of treatment of DID?
Convince person that splitting into different personalities is no longer necessary to deal with traumas
Learn person more effective ways to cope with stress and to regulate emotions
Which model can explain the rise of incidents/prevalence of DID?
Sociocognitive model!
Why can mapping out alters be problematic?
Often leading questions are asked. That has a negative effect on treatment
