psych dissociative disorders Flashcards
dissociative disorders def
loss of memory (amnesia), identity, or sense of self
dissoc disorders are often thought to be related to what?
trauma or abuse durin childhood or severe trauma as an adult
what neurotransmitters are involved in dissociative disorders
glutamate and norepi
dissociative disorders include
dissoc amnesia, dissoc fugue, dissic identity disorder, depersonalization disorder, dissoc disorder NOS
dissociative amnesia
amnesia is the only dissoc sx present; patients usually retain new memory formation and can have large periods of time that are forgotten
dissoc amnesia dsm criteria
at least one episode of inability to recall impt personal information, usually involving a traumatic or stressful event; sx cause signif impairment in daily functioning and can not be expained by another disorder
most common dissociative disorder
dissociative amnesia
prognosis of dissociative amnesia
many acute cases abruptly return to normal after minutes to days; recurrences are uncommon
treatment for dissociative amnesia
establish patient’s safety; psychotherapy is the mainstay of treatment; hypnosis or administration of sodium amobarbital or lorazepam during the interview have been used historically and may be useful to help some patients talk more freely
sodium amobarbitol
short acting sedative
dissociative fugue
sudden unexpected travel away from home, accompanied by the inability to recall one’s identity or one’s past
dissoc fugue- are patients aware?
no, they are unaware of their amnesia and new identity and they never recall the period of the fugue; patients show low anxiety despite their confusion
factors that predispose to dissociative fugue
heavy alc use, major depression, history of head trauma, and epilepsy; onset assoc with stressful life event (but that’s not a dsm criteria)
prognosis of fugue
usually lasts a few hours to several days but may last longer; after the episode, the patient will resume identity without remembering the episode
dissociative identity disorder
aka multiple personality disorder; two or more distinct personalities that alternately control their behaviors and thoughts
diagnosis of dissoc identity disorder
presence of two or more distinct identities; at least two of the identities recurrently take control; inability to recall personal info of one personality when the other is dominant
dissoc personality disorder- more common in women or men?
women account for 90 percent
who gets multiple personality disordr?
most patients have experienced prior trauma, esp chilhood physical or sexual abuse;
average age of onset for mult personality disorder
age 6, but avg age of diagnosis Is 30
suicide rate in mult personality disorder
up to 30%
prognosis of mult pers disorder
coruse is usually chronic with incomplete recovery; worst prognosis of all dissoc disorders; patients with an early onset have a poorer prognosis
treatment for mult personality disorder
hypnosis, drug-assisted interviewing, and insight-oriented psychotherapy
depersonalizaiton disorder
persistent or recurrent feelings of detachment from one’s self, environment, or social situation; reality testing remains intact during episode; causes social or occupational impairment
age for depersonalization disorder
more common among adolescents and young adults
treatment for depersonalization disorder
antianxiety agents or SSRIs to treat assoc sx
dissociative disorder NOS
primary dissoc disorders that share the characteristics of disruption in consciousness, memory, identity, or perception but do not meet the criteria of the other specific categories
examples of dissoc disorders NOS
dissoc disorder presentations without two or more states; primary derealization; cultural-bound dissoc trance disorders; loss of consciousness, stupor, or coma not due to med condition; Ganser syndrome (giving approx answers to simple questions)
dissociative amnesia
patients usually report gaps in the recollection of a particular event; the memory forgotten is usually a traumatic one, such as being raped
transient global amnesia versus dissoc fugue
in transient global amnesia, the patiet will have difficulty recalling recent events, while memory for more temporally distant events (like identity) remain intact
abreaction
the strong reaction patients get when retrieving traumatic memories
insight in dissociative amnesia versus dissoc fugue
in dissociative amnesia, the patient knows she has forgotten stuff; not true in fugue
ataque de nervios
trance disorder in Puerto rico that consists of convulsive movements, fainting, crying, and visual problems
