Dissociative Disorders

Question 1

Dissociative Disorders

Answer 1

• DID
• Dissociative Amnesia
• Depersonalization/Derealization Disorder
• Other specified Dissociative Disorder
• Unspecified Dissociative Disorder

Question 2

Dissociative Identity Disorder

Answer 2

• Disruption of identity characterized by two or more distinct personality states
• Recurrent amnesia (sometimes alters don’t know about each other)
• Causes distress/impairment
• Not a normal part of broadly accepted cultural or religious practice (e.g., speaking in tongues)
• Not due to a substance

Question 3

Dissociative Amnesia

Answer 3

• Inability to recall important autobiographical info, usually of a traumatic or stressful nature (localized or generalized)
• Causes distress/impairment
• Not due to a substance or medical condition
• Not better explained by DID, PTSD, acute stress disorder, somatic symptom disorder, or dementia
  Note: just autobiographical or semantic memory lost; memories thought to be there and can be retrieved through therapy

Question 4

Dissociative Amnesia specifier

Answer 4

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

Question 5

Depersonalization/Derealization Disorder

Answer 5

• Persistent or recurrent depersonalization, derealization, or both
• —depersonalization: unreality, detachment, or being an outside observer with respect to one’s experiences
• —derealization: unreality or detachment with respect to surroundings
• Reality testing remains intact (person still able to tell you who they are, where they are, what day of the week it is, etc.)
• Not attributable to substance or medical condition
• Not better explained by other MD

Question 6

Cognitive View

Answer 6

• Both conscious and unconscious/automatic processes
• Normal for there to be some lack of awareness of some processes (e.g., procedural memory, implicit memory)
• Also, high levels of stress changes how memories are encoded; stress can cause damage to hippocampus, which is involved with episodic memory formation

Question 7

Psychogenic Amnesia

Answer 7

• Memory loss without brain injury, insult, or disease
• Usually an identifiable stressor associated with onset
• Subtypes:
• —- localized/selective - loss of brief amounts of time/specific events
• —- generalized: temporary loss of memory for entire life
• Onset and recovery usually sudden

Question 8

Dissociative Fugue

Answer 8

• Loss of memory, loss of identity, physical relocation
• Often related to trauma, depression, or legal problems
• Three types:
  1) Classic: amnesia for personal history, change in identity, relocation
  2) Loss of personal history, but no new identity
  3) Revert to earlier period with amnesia for the time between that period and the present
• Procedural memory spared
• There are legitimate cases, but difficult to verify
• Now listed as a specifier

Question 9

Research on DID

Answer 9

• Theory that it’s a case of severe PTSD, usually due to very severe and/or chronic abuse in early childhood
• Some psychophysiological support, but experimental research remains rare
• Prevalence rates fluctuate over time: increase after Sybil, etc.
• Arguable that DID is driven by social phenomena, or social pressures (but increased awareness and refinement of criteria can increase diagnosis of legitimate cases)

Question 10

Sociocognitive Model of DID

Answer 10

• DID the result of psychotherapy (i.e., iatrogenic) and media’s representation of DID
• Presumes that some cases actually come to believe that the disorder they have been faking is real
• Are documented cases of faked DID
• Are documented cases of iatrogenic DID symptoms
• Does not prove there are no genuine cases

Question 11

Gleaves et al. article

Answer 11

• Gee et al: claim that a physician or therapist can cause symptoms of DID (iatrogenic model)
• Gleaves et al: argue against this and believe that symptoms of DID have existed since childhood
• Gleaves did study and found that participants exhibited features of DID well before diagnosis or therapy
• Gee et al. misinterpreted the data

Question 12

Lynn et al. article

Answer 12

Posttraumatic model of dissociation: dissociation associated with intense stressors, trouble processing emotionally laden info, and an avoidant info-processing style

• Sociocognitive model: proposes that DID is a consequence of social learning and expectancies, therapist cues, media influences, etc.
• New model proposed: Hypothesis that dissociative disorders can be triggered by a) a labile sleep-wake cycle that impairs cognitive functioning, combined with b) highly suggestive psychotherapeutic techniques