Dissociative Disorders

Question 1

Criteria A of dissociative identity disorder? (core)

Answer 1

Disruption of identity characterized by 2 or more distinct personality states. Involves marked discontinuity in sense of self and sense of agency, acompanied by related alterations in affect, behaviour, conciousness, memory, perception, cognition and or sensory- motor functioning.

Question 2

Criteria B of dissociative identity disorder? (recall)

Answer 2

Recurrent gaps in recall of everday events, personal info, and or traumatic events that are inconsistent with ordinary forgetting

Question 3

Which condition is described by an inability to recall important autobiographical info, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting.

Answer 3

Dissociative amnesia

Question 4

Nature of amnesia in dissociative amnesia in terms of specific events and life history?

Answer 4

Specific events: localized or selective

Identity and life history:Generalized amnesia

Question 5

Name specifier dissociative amnesia

Answer 5

With dissociative fugue: apparently purposeful travel/bewildered wandering that is associated with amnesia for identity or for other important autobiographical information

Question 6

Name 4 presentations that fall under other specified dissociative disorder

Answer 6

• Chronic and recurrent syndromes of mixed dissociative symptoms
• identity disturbance due to prolonged and intense coercive persuasion
• acute dissociative reactions to stressful events: < 1 month
• dissociative trance

Question 7

Name differences primary vs secondary vs tertiary dissociation

Answer 7

• Hyperarousal, hyper emotional vs hypoemotional vs dissociative identity
• flashbacks, reliving experiences, intrusion, autonomic hyperarousal vs distancing, emotional numbing , derealisation, depersonalisation, amnesia vs identity confusion + alteration, conversion
• limbic area activated vs cortical vs different areas
• seen in PTSD vs PTSD with dissociative symptoms, depersonalisation / derealisation disorder, dissociative amnesia vs dissociative amnesia with dissociative fugue, did

Question 8

Name 7 differentials dissociative disorders

Answer 8

• PTSD, PTSD with dissociative symptoms
• somatic symptom and related disorders: “somatoform dissociation”
• bipolar disorder = comorbid
• depressive + anxiety disorders = comorbid
• psychotic disorders
• eating disorders
• substance related disorders

Question 9

Management dissociative disorders?

Answer 9

1. Psychotherapy first line.
   → first phase: stabilisation
   → 2: memory work (confront trauma)
   → 3: integration
2. Medication for comorbidities eg anxiety

Question 10

Name 5 dissociative disorders

Answer 10

• Did
• dissociative amnesia
• depersonalisation/ derealisation disorder
• other specified dissociative disorder, reason
• unspecified dissociative disorder