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44 Cards in this Set
- Front
- Back
- 3rd side (hint)
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How many Dissociative Disorders are there? What are the names of the different Dissociative Disorders? |
There are 4 illnesses classified as Dissociative Disorders 1) Dissociative Amnesia 2) Dissociative Fugue 3) Dissociative Identity Disorder 4) Depersonalization/Derealization Disorder |
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Specify whether each of the Dissociative Disorders are recognized by DSM4, DSM5, neither or both. |
1) Dissociative Amnesia (both DSM4 and DSM5) 2) Dissociative Fugue was its own diagnosis in DSM4. In DSM5 it is classified as a specifier of Dissociative Amnesia. 3) Dissociative Identity Disorder (both DSM4 and DSM5) 4) Depersonalization Disorder in DSM4 was changed to Depersonalization/Derealization Disorder in DSM5 |
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What is the essential feature of Dissociative Amnesia? |
inability to recall important personal information that is too extensive to be explained by normal forgetfullness |
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Dissociative Amnesia usually occurs in (blank) |
those who have experienced 1) trauma 2) extreme stress |
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In order for Dissociative Amnesia to meet criteria, it should not result from what 6 things? |
1) substance abuse 2) medical illness 3) part of the course of DID 4) PTSD 5) acute stress disorder 6) somatic symptom disorder |
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What is the prevalence of Dissociative Amnesia? |
6% of the general population |
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Is Dissociative Amnesia more prevalent in men or women? |
no difference between men and women |
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What are the 10 symptoms that patients with Dissociative Amnesia may present with? Which of these symptoms are noted to occur commonly? |
- somatoform symptoms - conversion symptoms - alterations in consciousness - transient global amnesia - depersonalization - derealization - trance states - spontaneous age regression - depression (common) - suicidality (common) |
"TACS TADS DD" |
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What might you find in the history of a patient with Dissociative Amnesia? |
- prior adult abuse - prior childhood abuse - trauma |
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Describe Transient Global Amnesia: |
sudden onset of - complete anterograde amnesia and learning abilities - pronounced retrograde amnesia - BUT memory for personal identity is preserved |
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Does a person with Transient Global Amnesia have insight to their amnesia? |
Yes. There is - anxious awareness of memory loss - repetetive and often perseverative questioning |
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Describe the typical demographic of a patient that acquired Transient Global Amnesia: |
- over 50 years old - shows risk factors for cerebrovascular disease |
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What is the prognosis of a patient with Dissociative Amnesia? |
Acute Dissociative Amnesia frequently spontaneously resolves once the person is removed to safety from traumatic or overwhelming circumstances But some patients develop chronic amnesia |
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What is the treatment of Dissociative Amnesia? |
- CBT - hypnosis - sodium amobarbital - thiopental |
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Describe Dissociative Fugue |
- Sudden, unexpected - purposeful - travel away from home or one's customary place of daily activities - with inability to recall some or all of one's past - In classic cases, an alter identity is created under whose auspices the patient lives for a period of time. |
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How long to fugue states last? |
hours to days |
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What might the post Dissociative Fugue state look like? |
- perplexity - confusion - trance-like behaviors - depersonalization - derealization - conversion symptoms - amnesia about the event |
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What is the differential diagnosis of Dissociative Fugue? |
- non-purposeful wandering associated with medical illness - complex partial seizures - mania - substance related disorders |
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In order for the criteria for Dissociate Fugue to be met, what has to be ruled out |
- substance abuse - general medical condition |
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What is unique about the prevalence of Dissociative Fugue? |
The prevalence of Dissociative Fugue fluctuates. Dissociative Fugue is more common during - natural disasters - wartime (e.g. military personnel) - times of major social dislocation and violence |
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What is the treatment of Dissociative Fugue?
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- psychodynamic therapy - hypnotherapy - "pharmacologically facilitated interviews" |
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What was the old name of Dissociative Identity Disorder? |
Multiple Personality Disorder |
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Describe Dissociative Identity Disorder: |
- two or more distinct identities or personality states - recurrently take control of the individual's behavior |
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Aside from various identities taking over, DID is also seen with what other psychiatric symptoms?
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- mood swings - depression - suicidal tendency - generalized irritability - impaired impulse control - substance abuse - anxiety - panic - OCD symptoms - OCPD traits |
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In which gender is DID more common? |
Female to male ratio is between - 5 to 1 and - 9 to 1 |
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What is the typical age of onset of DID? |
- late adolescence and - young adult life |
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What might you find in the history of a patient with DID? |
- childhood trauma - maltreatment - physical abuse - sexual abuse |
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What psychiatric disorder is highly co-morbid with DID? What is the percentage of co-morbidity? |
- PTSD - 70% of patients also meet criteria of PTSD |
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What should we be careful to tease out in younger children suspected of having DID? |
normal childhood phenomena, such as: - imaginary companionship - elaborated daydreams |
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What should we be careful to treat is adults suspected of having DID? |
Falsified or Imitative DID |
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What does Falsified or Imitative DID look like? |
- symptom exaggeration - lies - use of symptoms to excuse antisocial behavior - legal problems - pseudologia fantastica |
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What is another word for pseudologia fantastica? |
pathological lying |
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What forms of treatment do we have for DID? |
- psychoanalytic psychotherapy - cognitive therapy - behavioral therapy - hypnotherapy - SSRI's to target associated symptoms |
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Describe Depersonalization |
Depersonalization is a person's persistent of recurrent feeling of - unreality - detachment - estrangement ... from oneself |
"due" |
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Describe Derealization
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- unreality - detachment ... from surroundings |
"du" |
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What are the four components of Depersonalization/Derealization? |
1) bodily changes 2) duality of self as observer and actor 3) being cut off from others 4) being cut off from one's emotions |
4 C's 1) bodily Changes 2) Cast as observer and actor 3) Cut off from emotions 4) Cut off from others |
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In order to meet criteria for Depersonalization/Derealization, what needs to be ruled out? |
Its symptoms should NOT ONLY OCCUR in the context of a psychiatric disorder |
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Are experiences of Depersonalization and Derealization unique to those with the disorder? |
No. Transient experiences of depersonalization and derealization are very common in - normal populations - psychiatric populations - substance abuse populations - certain medical illness populations |
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Patient abusing what substances commonly experience Depersonalization/Derealization? |
- cannabis - LSD - mescaline |
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Patients with what medical illnesses commonly experience Depersonalization/Derealization? |
- seizures - migraines - TBI |
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Depersonalization/Derealization is the (blank) most common psychiatric symptom reported. The first most common psychiatric symptom reported is (blank) The second most common psychiatric symptom reported is (blank) |
Depersonalization/Derealization is the third most common psychiatric symptom reported.
The first most common psychiatric symptom reported is depression. The second most common psychiatric symptom reported is anxiety. |
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What might you find in the history of patients experiencing Depersonalization/Derealization? |
- significant trauma |
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What is the typical time course of Derealization/Depersonalization Disorder? |
may be any of the following: - episodic - relapsing and remitting - chronic refractory course |
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What are the treatments for Derealization/Depersonalization Disorder? |
- SSRI's (fluoxetine) - psychodynamic therapy - CBT - hypno-therapeutic therapy - supportive therapy *These treatments are often NOT effective |
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