Week 7 - Dissociative Disorders Flashcards
Dissociative disorders are….
a group of conditions involving disruptions in a person’s normally integrated functions of consciousness, memory, identity, or perception
Dissociation only becomes pathological when
The dissociative symptoms are “perceived as disruptive, invoking a loss of needed information, as producing discontinuity of experience” or as “recurrent, jarring involuntary intrusions into executive functioning and sense of self.”
DSM-5 recognizes several types of pathological dissociation. These include
depersonalization/derealization disorder,
dissociative amnesia,
and dissociative identity disorder.
derealization one’s sense of ________________ is temporarily lost.
the reality of the outside world
depersonalization one’s sense of ______________________ is temporarily lost.
one’s own self and one’s own reality
In contrast to what happens during psychotic states, during depersonalization,….
reality testing remains intact.
depersonalisation disorder the experience of being _____ from…..
detached from (and like an outside observer of) their own bodies and mental processes
DSM-5 Criteria for. . . Depersonalization/Derealization Disorder
A. The presence of persistent or recurrent experiences of depersonalization, derealization, or both:
- Depersonalization: Experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions (e.g., perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or physical numbing).
- Derealization: Experiences of unreality or detachment with respect to surroundings (e.g., individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted).
B. During the depersonalization or derealization experiences, reality testing remains intact
C. clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The disturbance is not attributable to the physiological effects of a substance or another medical condition
E. The disturbance is not better explained by another mental disorder
Retrograde amnesia is….
the partial or total inability to recall or identify previously acquired information or past experiences
anterograde amnesia is…
the partial or total inability to retain new information
If the amnesia is caused by brain pathology, it most often involves….
anterograde amnesia
dissociative amnesia is usually limited to a failure to…
recall previously stored personal information (retrograde amnesia) when that failure cannot be accounted for by ordinary forgetting
DSM-5 Criteria for. . . Dissociative Amnesia
A. An inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. Note: Dissociative amnesia most often consists of localized or selective amnesia for a specific event or events; or generalized amnesia for identity and life history.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The disturbance is not attributable to the physiological effects of a substance (e.g., alcohol or other drug of abuse, a medication) or a neurological or other medical condition (e.g., partial complex seizures, transient global amnesia, sequelae of a closed head injury/traumatic brain injury, other neurological condition).
D. The disturbance is not better explained by dissociative identity disorder, posttraumatic stress disorder, acute stress disorder, somatic symptom disorder, or major or mild neurocognitive disorder.
dissociative fugue
is a defence by actual flight. The person is not only amnesic for some or all aspects of his or her past but also departs from home surroundings. This is accompanied by confusion about personal identity or even the assumption of a new identity (although the identities do not alternate as they do in dissociative identity disorder).
What’s the difference between Dissociative Amnesia and Depersonalization/Derealization Disorder?
Amnesia involves forgetting the self, where depersonalisation is a detachment from self.
According to the DSM-5, Dissociative Identity Disorder entails…
a disruption of identity characterized by two or more distinct personality states as well as recurrent episodes of amnesia
trance is said to occur when
someone experiences a tempo-rary marked alteration in state of consciousness or iden-tity.
A possession trance is similar to a trance except that
the alteration of consciousness or identity is replaced by a new identity that is attributed to the influence of a spirit, deity, or other power.
Host identity
In most cases the one identity that is most frequently encountered and carries the person’s real name is the host identity. Also in most cases, the host is not the original identity, and it may or may not be the best-adjusted identity
The alter identities may differ in striking ways involving
gender, age, handedness, handwriting, sex-ual orientation, prescription for eyeglasses, predominant affect, foreign languages spoken, and general knowledge
The most common comorbid disorders of DID are
Depressive disorders, PTSD, substance-use disor-ders, and borderline personality disorder are the most com-mon comorbid diagnoses (average of 5)
DSM-5 Criteria for. . . Dissociative Identity Disorder
A. Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behav-ior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
B. Recurrent gaps in the recall of everyday events, important personal information, and/ or traumatic events that are inconsistent with ordinary forgetting.
C. The symptoms cause clinically significant distress or impairment
D. The disturbance is not a normal part of a broadly accepted cultural or religious practice.
E. The symptoms are not attributable to the physiological effects of a substance or another medical condition
According to trauma theory, DID starts from….and reflects an attempt to…in the face of…
early childhood traumatization and reflects an attempt to cope with an overwhelming sense of hopelessness and powerlessness in the face of repeated traumatic abuse
the vast majority of patients with DID (over __ percent by some estimates) report memories of severe and horrific childhood abuse.
95
Diathesis-stress model of DID suggests
children who are prone to fantasy and those who are easily hypnotizable may have a diathesis for developing DID (or other dissociative disorders) when severe abuse occurs
sociocognitive theory of DID
According to this theory, DID develops when a highly suggestible person learns to adopt and enact the roles of multiple identities, mostly because clinicians have inadvertently suggested, legitimized, and reinforced them and because these different identities are geared to the individual’s own personal goals.
The theory does not view this as being done intentionally or consciously by the person involved
DID prevalence rates raise from ____ to ____ percent when studying groups with high exposure to trauma or cultural oppression are studied
1.5 to 6
