wamss notes dissociative disorders

Question 1

dissociative disorders

Answer 1

Dissociative Disorders are characterised by a disruption of and/or discontinuity in the normal integration of
consciousness, memory, identity, emotion, perception, body representation, motor control & behaviour

Question 2

dissociative symptoms are experienced as

Answer 2

a) Positive Symptoms- Unbidden intrusions to awareness or behaviour with accompanying losses of
continuity in subjective experience (depersonalisation, derealisation, fragmentation of identity)
b) Negative Symptoms- inability to access information or to control mental functions that normally are
readily accessible (amnesia)

Question 3

aetiology of dissociative disorders

Answer 3

Stress / trauma / neglect
Often in early childhood
Familial associations

Question 4

dissociative identity disorder

Answer 4

Condition in which 2 or more distinct identities or personality states are present within an individual
Formerly Multiple Personality Disorder

Question 5

criteria for dissociative identity disorder

Answer 5

A. Disruption of identity characterised by 2 or more distinct personality states. Alterations in
affect, behaviour, consciousness, memory, perception, cognition, sensory/motor functioning.
May be observed by self or others
B. Recurrent gaps in recall of everyday events, personal info or traumatic events
C. Causes distress
D-E. Not part of cultural, religious or substance effects

Question 6

pathophysiology of dissociative identity disorder

Answer 6

Creation of an alternative identity as a protective but maladaptive coping mechanism allowing
compartmentalisation of a traumatic experience encased within the alternate personality that
experienced it

Question 7

Tx for dissociative identity disorder

Answer 7

psychotherapy and CBT

Question 8

prognosis for dissociative identity disorder

Answer 8

70% suicide risk

Question 9

dissociative amnesia

Answer 9

Memory disorder characterised by retrograde amnesia occurring in a single episode or episodically through life

Question 10

criteria for dissociative amnesia

Answer 10

A. Inability to recall important autobiographical information, usually of a traumatic or
stressful nature (may be for selective specific events or generalised for life long hx)
B. Causes significant distress
C. Not attributed to a substance or medical condition
D. Not better explained by another mental health condition

Question 11

dissociative fugue

Answer 11

Dissociative Fugue: apparently purposeful travel or bewildered wandering that is associated with amnesia

Question 12

localised amnesia

Answer 12

failure to recall events during a circumscribed period of time, most common, maybe longer than a single traumatic event, months-years with abuse

Question 13

selective amnesia

Answer 13

pt can recall some but not all events in a specific time, may be amnesic to
traumatic events but not other parts

Question 14

generalised amnesia

Answer 14

complete loss of hx from ones life memory. May be loss of knowledge about the world (semantic knowledge), well-learned skills (procedural knowledge). - rare

Question 15

depersonalisation/derealisation disorder

Answer 15

Type of dissociative disorder with persistent or recurrent feelings of depersonalisation (feeling
of being detached from one’s self/an outside observer to ones live) and/or derealisation
(feeling that the world around isn’t really real or detached).

Question 16

criteria for depersonalisation/derealisation disorder

Answer 16

A. The presence of persistent or recurrent episodes of depersonalisation +/- derealisation
1. Depersonalisation: Experiences of unreality, detachment or being an outside
observer with respect to one’s thoughts, feelings, body or actions
2. Derealisation: Experiences of unreality or detachment with respect to surroundings
B. During disassociation reality testing remains intact
C. Cause significant impairment
D. Not attributed to a substance or medical condition
E. Not better explained by another mental disorder

Question 17

depersonalisation

Answer 17

Depersonalisation: Experiences of unreality, detachment or being an outside
observer with respect to one’s thoughts, feelings, body or actions

Question 18

derealisation

Answer 18

2. Derealisation: Experiences of unreality or detachment with respect to surroundings