Transcript Dissociative Disorders

Dissociative Disorders
Dissociative Identity Disorder
Dissociative Amnesia
Dissociative Fugue
Depersonalization Disorder
Dissociative Identity Disorder
A. The presence of two or more distinct identities or
personality states
B. At least two of these identities or personality states
recurrently take control of the person’s behavior
C. Inability to recall important personal information that
is too extensive to be explained by ordinary
forgetfulness
D. Not due to a GMC or substance
Dissociative Identity Disorder
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Identities
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At least two of these recurrently take control of a person’s
behavior
Can be categorized into three types:
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Core identity: superego
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1st alternate identity: id
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2nd alternate identity: ego
Dissociative Identity Disorder
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Prevalence
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Up for debate
Rates have increased dramatically over few decades
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First case reported in the 1850’s
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Several cases in 1880’s-1900’s
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By the 1970’s, only about 200 cases in all
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Now, some psychologists claim that up to 1% of the general
population has this disorder
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Individual clinicians are not reporting having dozens to hundreds of
such clients
Dissociative Identity Disorder
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Explanations for increasing prevalence:
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Increased public awareness of the disorder
Changes in the diagnostic criteria for schizophrenia
Therapists may be actively looking for DID
Prevalence, continued…
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Rates very uneven across countries
Rates very uneven across clinicians within countries
The rates of this disorder is very controversial…some
psychologists doubt its existence at all
Dissociative Identity Disorder
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Risk Factors
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Severe child abuse, especially sexual abuse (reported in 95%
of cases
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Remembered or Recovered???
Having generous psychiatric medical coverage
Dissociative Identity Disorder
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Question of Validity
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Studies show differences in psychological test results and
physiological states between “alters”
Alternative theories:
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Could be due to distinct personalities
Could be due to role enactments
Extremely heated controversy over iatrogenesis vs. natural
occurrence (iatrogenesis = “caused by treatment”)
Dissociative Identity Disorder
Can people actually dissociate?
 Have you had a dissociative experience?
 Common dissociative experiences
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Reading a paragraph and then having no recollection of what
you read
Driving somewhere and not knowing how you got there
Talking to someone and not knowing what you’re actually
talking about
Dissociative Identity Disorder
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Perhaps there is an underlying continuum…
Normal
Dissociative
Experiences
Dissociative
Identity
Disorder
Dissociative Amnesia
A.
One or more episodes of inability to recall important
personal information, usually of a traumatic or
stressful nature, that is too extensive to be explained
by ordinary forgetfulness
B.
Not better explained by a another mental disorder and
is not due to a GMC or substance
C.
Symptoms cause clinically significant distress or
impairment in functioning
Dissociative Fugue
A.
Sudden, unexpected travel away from home or one’s
customary place of work, with inability to recall one’s
past
B.
Confusion about personal identity or assumption of a
new identity (partial or complete)
C.
Not better explained by a another mental disorder and
is not due to a GMC or substance
D.
Symptoms cause clinically significant distress or
impairment in functioning
Depersonalization Disorder
A.
Persistent or recurrent experiences of feeling detached
from, and as if one is an outside observer of, one’s
mental processes or body
B.
During the depersonalization experience, reality
testing remains intact
C.
Not better explained by a another mental disorder and
is not due to a GMC or substance
D.
Symptoms cause clinically significant distress or
impairment in functioning