Dissociative Disorders

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Dissociative Disorders

Disruption/discontinuity of normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior

• Mostly in response to extremely stressful event

Dissociative amnesia

Something happens and you forget your entire past, still have basic functioning skills

• With or without fatigue: the same pieces get played at the wrong time, results in lack of memory of events

Depersonalization/Derealization

Lose sense of “realness of external world

Dissociative Identity Disorder Criterion A

Disruption of identity characterized by 2 or more distinct personality states:

• Marked discontinuity in sense of self and agency

• Alterations in affect, behavior, memory, perception, etc.

• May be observed by others or self

Dissociative Identity Disorder Criterion B

Recurrent gaps in recall of everyday events, important personal information, and/or traumatic events inconsistent with ordinary forgetting

• Gaps in recall are based off what different personalities do

Dissociative Identity Disorder Criterion C

Symptoms cause distress/impairment

Dissociative Identity Disorder Criterion D

Not part of broadly accepted cultural or religious practice

Who gets DID?

• No real research - only case studies

• Gender prevalence: 9:1 female to male, but we don’t really know

• The personalities have different needs

• Large cultural awareness increase in mid 1970’s

• Onset usually in childhood, resulted in childhood trauma, potential manifestation of PTSD

Causes of DID

• One common thread - extremely severe and early childhood abuse

• Dissociation as escape

• More extreme PTSD

Treatment of DID

• No controlled clinical trials

• Personality reintegraton through long-term therapy

• Most treatments similar to PTSD

• Similar to prolonged exposure: visualize and re-live trauma

• Habituate to memories of trauma

• Trauma becomes simply a terrible memory, not a current event

• Often incorporate hypnosis: dissociative from current conscious memory