Transcript Dissociative Disorders - People Server at UNCW

Chapter 5
Dissociative Disorders
An Overview of Dissociative Disorders
 Overview
 Involve severe alterations or detachments
 Affect identity, memory, and/or consciousness
 Severe form of normal perceptual experiences
 Depersonalization – Distortion in perception of reality
 Derealization – Losing a sense of the external world
 Types of DSM-IV Dissociative Disorders
 Depersonalization Disorder
 Dissociative Amnesia
 Dissociative Fugue
 Dissociative Trance Disorder
 Dissociative Identity Disorder
Depersonalization Disorder: An Overview
 Overview and Defining Features
 Severe and frightening feelings of unreality and
detachment
 These dominate and interfere with life functioning
 Problem involves depersonalization and
derealization
 Facts and Statistics
 High comorbidity with anxiety and mood disorders
 Onset is typically around age 16
 Usually runs a lifelong chronic course
Depersonalization Disorder: Causes and Treatment
 Causes
 Cognitive deficits in attention
 Cognitive deficits in short-term memory
 Cognitive Deficits in spatial reasoning
 Deficits related with tunnel vision and mind
emptiness
 Such persons are easily distracted
 Treatment
 Little is known
Dissociative Amnesia and
Dissociative Fugue: An Overview
 Dissociative Amnesia: Overview and Defining Features
 Several forms of psychogenic memory loss
 Generalized type – Inability to recall anything, including
their identity
 Localized or selective type – Failure to recall specific
(usually traumatic) events
 Dissociative Fugue: Overview and Defining Features
 Related to dissociative amnesia
 Take off to a new place
 Unable to remember the past
 Unable to remember how they arrived at a new location
 Often assume a new identity
Dissociative Amnesia and Fugue:
Causes and Treatment
 Facts and Statistics -- Dissociative Amnesia and Fugue
 Usually begin in adulthood
 Both show rapid onset and dissipation
 Both are mostly seen in females
 Causes
 Little is known
 Trauma and life stress can serve as triggers
 Treatment
 Most get better without treatment
 Most remember what they have forgotten
Dissociative Trance Disorder: An Overview
 Overview and Defining Features
 Symptoms resemble those of other dissociative disorders
 Dissociative symptoms and sudden changes in personality
 Changes are often attributed to possession of a spirit
 Presentation differs in important ways across cultures
 Facts and Statistics
 More common in females
 Causes
 Often attributable to a life stressor or trauma
 Only abnormal if the trance is considered
undesirable/pathological by the culture
 Treatment
 Little is known
Dissociative Identity Disorder (DID): An Overview
 Overview and Defining Features
 Formerly known as multiple personality disorder
 Defining feature – Dissociation of personality
 Adopt several new identities (as many as 100)
 Identities show unique behaviors, voice, and
posture
 Unique Aspects of DID
 Alters – The different identities
 Host – The identity that keeps other identities
together
 Switch – Quick transition from one personality to
another
Dissociative Identity Disorder (DID):
Causes and Treatment
 Facts and Statistics
 Average number of identities is close to 15
 Ratio of females to males is high (9:1)
 Onset is almost always in childhood
 High comorbidity rates, with a lifelong chronic course
 Causes
 Most have histories of horrible, unspeakable, child abuse
 Most are also highly suggestible
 DID – Mechanism to escape from impact of trauma
 Closely related to PTSD
 Treatment
 Focus is on reintegration of identities
 Identify and neutralize cues/triggers that provoke memories
of trauma/dissociation