AbPsych Finals Quiz 2

Dissociative Disorders

characterized by an individual becoming split off, or dissociated, from their core sense of self. Memory and identity become disturbed and these disturbances have a psychological rather than physical cause

Dissociation

a split in consciousness, which allows some thoughts and behaviors to occur simultaneously with others

Symptoms of Dissociation

D - Depersonalization

D - Derealization

D - Dissociative amnesia

I - Identity confusion

I - Identity alteration

Depersonalization

a feeling of detachment or estrangement from one's self

Derealization

an alteration in the perception of one's surroundings so that a sense of reality of the external world is lost

Dissociative amnesia

does not refer to permanent memory loss, similar to the erasure of a computer disk, but rather to the hypothetical disconnection of memories from conscious inspection

Identity confusion

thoughts and feelings of uncertainty and conflict a person has related to their identity

Identity alteration

the behavioral acting out of this uncertainty and conflict

Dissociative Disorders List

D - Depersonalization Derealization Disorder

D - Dissociative Amnesia - Dissociative Fugue - Amok

D - Dissociative Identity Disorder (DID)

Dissociative Amnesia or psychogenic amnesia

inability to recall important personal information, usually following an extremely stressful or traumatic experience such as combat, natural disasters, or being the victim of violence.

localized dissociative amnesia

most common, loss of all memory of events occurring within a limited period, for specific event/s

generalized dissociative amnesia

Inability to recall anything, including their identity, identity and life history

Dissociative Fugue

suddenly wandering away from one's own home, experiencing confusion about their identity, and sometimes even adopting a new identity; apparently purposeful travel, last only a few hours or days, but some can last longer.

Dissociative Identity Disorder (DID)

experiencing two or more distinct identities that recurrently take control over one's behavior. People with dissociative identity disorder exhibit two or more separate personalities or identities, each well-defined and distinct from one another.

DID diagnostic criteria

A. Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in

identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception,

cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.

B. Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The disturbance is not a normal part of a broadly accepted cultural or religious practice.Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play.

E. The symptoms are not attributable to the physiological effects of a substance (e.g.,blacl

3 Faces of Eve

Personalities

-Main was Eve White (mild mannered, quiet)

-Eve Black: partier, fun, flirtatious

-Jane: Stable

-Personalities served the purpose of coping mechanisms

-Developed from childhood: trauma of having to kiss dead grandmother

-Therapist with psychodynamic approach: hypnosis, past conflicts

When Rabbit Howls (Truddi Chase)

Truddi Chase began therapy to discover why she suffered from blackouts. What surfaced was terrifying: she was inhabited by 'the Troops'-92 individual personalities. This groundbreaking true story is made all the more extraordinary in that it was written by the Troops themselves. What they reveal is a spellbinding descent into a personal hell-and an ultimate deliverance for the woman they became

Alter (DID)

An alternate identity or personality state within a person with DID, each with its own distinct traits, memories, and behaviors.

Switch (DID)

The process of shifting from one alter to another, often triggered by stress, environment, or internal dynamics.

Child (DID)

An alter that presents as a younger age, often embodying childhood experiences, emotions, or trauma.

Opposite Gender (DID)

An alter whose gender identity differs from the person's assigned or experienced gender in daily life.

Helper (DID)

An alter that supports the system, often offering guidance, stability, or protection to others within the identity structure.

Persecutor (DID)

An alter that may act in hostile or self-destructive ways, often reflecting internalized trauma or negative beliefs.

Trends in DID

Vast majority are women who tend to have a history of severe childhood sexual / physical abuse. Alternate personalities formed during the traumatic experiences to manage experiences psychologically. Hypnotizable - more susceptible.

it involves integration into one functional personality.

Sociocognitive model - not all is trauma; roles that help them psychologically process experiences

Depersonalization/Derealization Disorder

characterized by recurring episodes of depersonalization,

derealization, or both

Depersonalization Signs

may make someone believe their thoughts and feelings are not their own

they may feel robotic as though they lack control over their movements and speech

they may experience a distorted sense of time

in extreme cases, they may sense an "out-of-body" experience in which they see themselves from the vantage point of another person.

Derealization Signs

conceptualized as a sense of "unreality or detachment from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surroundings"

A person who experiences derealization might feel as though he is in a fog or a dream, or that the surrounding world is somehow artificial and unreal

Sleep-Dissociation Model

The theory that a lack of sleep may cause dissociation

(a) how traumatic experiences disrupt the sleep-wake cycle and increase vulnerability to dissociative symptoms, and (b) why dissociation, trauma, fantasy proneness, and cognitive failures overlap.

17

Accordingly, one group of researchers reported

nightmare disorder in _____ out of 30 DID patients

Bipolar Disorder

A mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania.

Manic Episode

a mood disorder marked by a hyperactive, wildly optimistic state

Manic Episode Criteria

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity

or energy, lasting at least 1 week and present for most of the day, nearly every day.

B. During this period three of the following symptoms have persisted representing a noticeable change from usual behavior: inflated self-esteem or grandiosity, decreased need for sleep, more talkative, flight of ideas, distractibility, increased goal-directed activity, or excessive involvement in activities that have a high potential for painful consequences.

C. The episode is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

D. Marked impairment, or necessitates admission, or psychotic features

E. Not due to a substance or GMC

Bipolar I Disorder

a type of bipolar disorder marked by full manic and major depressive episodes

Hypomania

less severe version of a manic episode that does not cause marked impairment in social or occupational functioning

Hypomanic Episode Criteria

A) A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.

B) During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:

1. Inflated self-esteem or grandiosity.

2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).

3. More talkative than usual or pressure to keep talking.

4. Flight of ideas or subjective experience that thoughts are racing.

5. Distractibility

6. Increase in goal-directed activity or psychomotor agitation

7. Excessive involvement in activities that have a high potential for painful consequences

C) The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.

D) The disturbance in mood and the change in functioning are observable by others.

E) The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.

F) The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition

Bipolar II Disorder (BD II)

characterized by single (or recurrent) hypomanic episodes and depressive episodes.

Bipolar Disorder Etiology

Although there have been important advances in research on the etiology, course, and treatment of BD, there remains a need to understand the mechanisms that contribute to episode onset and relapse.

Genetic influences are believed to account for 73-93% of the risk of developing the disorder.

Bipolar Disorder Epidemiology

The lifetime prevalence rate of bipolar spectrum disorders in the general U.S. population is estimated at approximately 4.4%, with BD I constituting about 1% of this rate.

The co-occurrence of BD with other psychiatric disorders is associated with poorer illness course, including higher rates of suicidality.

Cyclothymic Disorder

a mental disorder that involves numerous periods of symptoms of depression and periods of symptoms of hypomania.

Symptoms, however, are not sufficient to be a major depressive episode or a hypomanic episode. Symptoms must last for more than one year in children and two years in adults.

Cyclothymic Disorder Criteria

A) For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.

B) During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time.

C) Criteria for a major depressive, manic, or hypomanic episode have never been met.

D) The symptoms in Criterion A are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

E) The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).

F) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Treatments for Bipolar Disorder

pharmacotherapy

Pharmacotherapy

the application of drugs for the purpose of disease prevention and treatment of suffering

BD - Lithium

SSRIs and SNRIs

have the potential to induce mania or hypomania in patients with BD.