DISSOCIATIVE DISORDERS

DISSOCIATIVE DISORDERS

Is a feeling of detachment from self or surroundings (as if dreaming or in slow motion)

Depersonalization

Derealization

Loss of sense of external world’s reality; things seem to change shape or size; people may seem mechanical or dead.

psychological function of depersonalization and derealization

Both are defense mechanisms in which the mind “dissociates” from reality to cope with stress.

Depersonalization-Derealization Disorder

A dissociative disorder where feelings of unreality are so severe, persistent, and distressing that they impair normal functioning.

• Occurs equally in men and women.

• Average onset: 16 years old.

• Chronic course.

key features of DDD

• Depersonalization: Loss of sense of self (feeling detached from one’s body or mind).

• Derealization: Loss of sense of reality of surroundings (world feels dreamlike, distorted, or unreal).

• Dominant Symptoms: Unreality, detachment, emotional numbing, and perceptual distortions.

• tunnel vision

• mind emptiness

• Reduced emotional responding

• HPA axis dysregulation leads to abnormal stress response and emotional blunting

Dissociative Amnesia

Inability to recall important personal information, usually traumatic or stressful, and too extensive to be ordinary forgetting.

Generalized Amnesia

Forget everything, including identity and life history; can be lifelong or cover a recent period (e.g., past 6 months to 1 year).

Localized/Selective Amnesia (most common)

Forget specific traumatic events during a particular time (e.g., during war or extreme stress).

emotional-related amnesia

The person remembers the event but forgets emotional reactions to it; common in DDD where emotion is blunted.

Dissociative Fugue

Memory loss centers around a sudden, unexpected trip away from home; person may adopt a new identity or become confused about the old one.

• common in adulthood.

characteristics of Dissociative Fugue

• Often escapes an intolerable situation.

• Ends abruptly; person regains memory and returns home.

• Disintegration of identity occurs, not just memory loss.

cultural variants related to dissociative amnesia

• Amok (Southeast Asia): Usually in males; trancelike violent outburst → attack people/animals → followed by amnesia for the episode.

• Running Disorders

• Trance and Possession States

Dissociative Identity Disorder (DID)

A dissociative disorder where a person adopts two or more distinct identities (alters) that coexist simultaneously or alternate control of behavior.

Multiple Personality Disorder.

• Gender ratio: female-to-male = 9:1.

• Onset: almost always in childhood.

• Diagnosis delay: about 7 years.

• Chronic and lifelong without treatment.

• High comorbidity: average of 7+ other diagnoses (anxiety, depression, substance use, personality disorders).

characteristics of DID

• Can have up to 100 identities; average is 15.

• Fragmentation of identity (not full personalities).

• Each identity has its own behaviors, voice tone, gestures, and sometimes physical traits.

• Alters serve a protective function to cope with trauma (violence, abuse).

• Switching is the transition from one identity to another, often sudden and triggered by stress or trauma cues.

Sociocognitive Model

suggests DID symptoms may result from therapist suggestion, cultural expectations, and media influence.

false memory controversy

Some recovered childhood abuse memories may be false, implanted by suggestive therapists.

Elizabeth Loftus (Lost in the Mall Study)

Participants “remembered” fake details.

Bernstein & Loftus

Creating a false memory of getting sick after eating egg salad resulted in long-term food aversion 

Proves false memories can influence behavior

Ceci

Preschoolers asked weekly to recall real vs fake events (e.g., finger in mousetrap) ○

Preschoolers recalled fake events as true some even defended the false memory when corrected.

Clancy

Adult study

People claiming alien abduction with “recovered” memories showed more false recall, higher suggestibility, and depression

Treatment for Dissociative Amnesia and Fugue

Most recover memory naturally; therapy focuses on stressors and strengthening coping.

Treatment for DID

• Goal: Reintegration of identities through long-term psychotherapy.

• Success rates modest (20–25% full integration).

• Based on PTSD treatment methods—identify trauma triggers and relive safely.

• Hypnosis sometimes used to access unconscious memories.

• Antidepressants may help but offer limited benefit.