Chapter 6 Dissociative Disorders

Front 1

What is dissociation

Back 1

Is a destruction of Consciousness, memory, Identity, or perception.

--When is it normal?

Daydreaming, sleep-deprived or under stress.

Front 2

When dose dissociation become concern

Back 2

The concern is when the dissociation Is frequent, disruptive, and causes impaired functioning.

Front 3

Pathological dissociation

Back 3

- trance state / time lost

- altered sense of self

- out-of-body sensation

- sense of oneself is not real

- memory loss

•When dissociative experiences become chronic and defining features of people's lives, they may be diagnosed as a dissociative disorder.

Front 4

Dissociative disorders

Back 4

Dissociative identity disorder, dissociative amnesia, depersonalization derealization disorder

Front 5

DSM-5 criteria for dissociative identity disorder

Back 5

A. Disruption of identity characterized by two or more distinct personality states, which may be described and some cultures as experience of possession. The distribution and identity involves marked discontinuity and sense of self and sense of agency, accompanied by related alterations in affect Tama Behavior, Consciousness, memory, perception, cognition, and or sensory motor functioning.

B. Gaps in recall and inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

C. Associated significant distress or impairment.

E. Not due to the direct physiological ex of a substance or a general medical condition.

D.Not part of accepted cultural or religious practice.E. Not due to the direct physiological ex of a substance or a general medical condition.--- and children the symptoms are not attributed two imaginary Playmates or other fantasy play.

--- and children the symptoms are not attributed two imaginary Playmates or other fantasy play.

Front 6

Dissociative identity disorder

Back 6

Recent studies suggest that an average of 8 to 15 separate identities. Usually one personality is the identity held the majority of the time / host.

Altars may be created by people under conditions of extreme stress. There is a high,l incidence reports of physical and or sexual abuse in early childhood by adults diagnosed with DID.

329 times more frequent in females than in males.

There is some evidence that dissociation in families

Front 7

DSM criteria DID insufficient / sufficient

Back 7

-Generally abstract criteria and lack of concrete clinical symptoms, sharply reduced their utility for the average clinician.

- Arguments for a set of frequently appearing dissociative signs and symptoms.

-- others have argued that the current criteria are significant.

---There is a third argument that dissociative disorder should be reconceptualized as trauma-based disorders, there by emphasizing association with overwhelming and traumatic circumstances.

• experiments in 2006 study assessing the prevalence of DSM-5 dissociative disorders in the inner city Outpatient Psychiatric population they found that 29% of the people they interviewed qualified, they met the criteria, for any of the dissociative disorders. Five patients met criteria for DID specifically. They also found that only four out of the 80s to patients interviewed had been diagnosed with a dissociative disorder.

Front 8

Controversy of DID

Back 8

- there are questions about the validity of the diagnosis.

- many individuals discovered that they have separate identities while in treatment.

- some theorists argue that is not possible to repress awareness of identities or past traumatic events and then discover these in treatment. They assert that IDI is created by therapist to suggest the experience of alternate personalities to the client over the course of treatment., this is the social cognitive perspective.

Front 9

Repressed memories/ trauma Theory perspective

Back 9

Others argue that is possible in probable that someone would develop a separate identity under extreme stress will or traumatic circumstances this is trauma Theory perspective

Front 10

Treatment

Back 10

Phase oriented treatment most often psychodynamic.

1. Establishing safety, stabilizing, and symptom reduction: Studies have shown that 67% of dissociative disorders patients report a history of repeated suicide attempts and 42% report a history of self-harm.

2. Confronting, working through, and interrogating traumatic memories.

3. Identity interrogation and Rehabilitation.

Front 11

DSM-5 diagnostic criteria for dissociative amnesia

Back 11

1. An inability to recall important audio biographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting.

2. Dissociative Amnesia most often consists of localized or selective amnesia for a specific event or events. Or organized amnesia for identity and life history.

3. The symptoms caused clinically significant distress or impairment and social, occupational, or other important areas of functioning.

4. The disturbance is not attributable do the direct physiological effects of a substance example alcohol drugs.

5. The disturbance is not better explained by dissociative identity disorder, post-traumatic stress disorder, acute stress disorder, somatic symptom disorder or major or mild neurological disorder.

- specifyer: What's the associative Fugue: apparently purposeful travel or bewilderment wandering that is associated with an amnesia for identity or four other important autobiographical information.

Front 12

Differences between psychogenic inorganic amnesia

Back 12

Psychogenic anesthesia:

- caused by psychological factors.

- seldom involves alterohrade amnesia ( inability to learn new information acquired since onset of amnesia)

- can involve retrograde amnesia ( inability to remember events from the past)

- retrograde amnesia often only for personal information, not for general information.

Organic amnesia:

- Pause by biological factors such as a disease, drugs, and blows to the Head.

- Austin and balls anterograde amnesia.

- can involve retrograde amnesia

- retrograde amnesia usually for both personal and general information.

Front 13

Depersonalization/ derealization disorder

Back 13

- people with this disorder have frequent episodes in which they experience depersonalization. Detach from their own mental processes or body, as if they are outside of themselves.

- individuals may also experience derealisation. Where their surroundings or others do not feel real ( dream like, foggy. )Or are detached.

- occasionally experiences of depersonalization /derealization are common, especially when people are very stressed or sleep deprived.

- depersonalization /derealization this order is only diagnosed when episodes are so frequent and distressing that they interfere with an individual's ability to function.