Lecture 11

Question 1

What are some Dissociative disorders?

Answer 1

• Depersonalization-derealization disorder
• Dissociative amnesia
• Dissociative identity disorder

Question 2

What are Dissociative Experiences?

Answer 2

• Dissociation is characterized by a disruption of usually integrated functions of memory, consciousness, identity, or perception of the environment.
• Both retrospective and prospective studies reveal that dissociation is one of the consequences of developmental trauma.
• Fogginess, sleep and concentration difficulties.
• Disconnected from feelings and people.
• Lapses of memory and lost time.

Question 3

What is depersonalization?

Answer 3

a feeling that your body doesn’t quite belong to you or is disconnected from you. Being outside observer with respect to one’s thoughts, feelings, sensations, body or actions

Question 4

What is Derealization?

Answer 4

a feeling that you are disconnected from the world around you or “spaced out” Individuals or objects are experienced as unreal, dreamlike, foggy, lifeless or visually distorted.

Question 5

What are some features of derealization or depersonalization?

Answer 5

• Persistent or recurrent experiences
• During the depersonalization or derealization experience, reality testing remains intact
• The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

Question 6

What is Dissociative Amnesia?

Answer 6

• Generalized type – Inability to recall anything, including their identity
• Localized or selective type – Failure to recall specific (usually traumatic) events
• May involve dissociative fugue
• DF-Sudden unexpected travel away from one’s home or
  place of work with inability to recall one’s past
• Assume new identity
• May involve new name, job, personality characteristics
• More often of brief duration
• Remits spontaneously
• Unable to remember how or why one has ended up in a new place

Question 7

What are some features of dissociative amnesia?

Answer 7

• An inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting
• The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
• The disturbance is not attributable to the physiological effect of a substance (e.g., alcohol or other drug of abuse), a neurological or other medical condition, or a different psychological disorder

Question 8

What is Dissociative Identity
Disorder?

Answer 8

• The individual experiences two or more distinct identities or personality states, each with its own pattern of perceiving, relating to, and thinking about the self and the world.
• The disruption in identity involves a change in sense of self, loss of personal agency, and alterations in effect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor function.
• Frequent gaps in memories of personal history, including the distant and recent past as well as everyday events.
• These gaps are not consistent with the expected normal forgetfulness.
• Significant distress and impairment in the level of functioning because of the symptoms.
• The disturbance cannot be attributed to the physiological effects of a substance or another medical condition.

Question 9

What are the unique aspects of DID?

Answer 9

• Alters—different identities or personalities
• Host—the identity that keeps other identities together
• Switch—quick transition from one personality to another

Question 10

What are the statistics of DID?

Answer 10

• Ratio of females to males is high(9:1)
• Onset is almost always in childhood or adolescence
• High comorbidity rates and lifelong chronic course
• More common than previously thought :3% to 6%

Question 11

What are some features of DID?

Answer 11

• Disruption of identity characterized by two or more distinct personality states; the disruption or marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning
• Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting
• The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
• The disturbance is not a normal part of broadly accepted cultural or religious practice, and is not attributable to the physiological effects of a substance or another medical condition.

Question 12

What are some causes of DID?

Answer 12

• Typically linked to a history of severe, chronic
  trauma, often abuse in childhood
• Closely related to PTSD, possibly an extreme subtype
• Mechanism to escape from the impact of trauma
• Biological vulnerability possible

Question 13

What are the treatments for DID?

Answer 13

• Focus is on reintegration of identities
• Identify and neutralize cues/triggers that provoke memories of trauma/dissociation
• Patient may have to relive and confront the early trauma
• Some achieve through hypnosis