ITP Exam 2 Disassociative and Depersonalization

Derealization:

A feeling that the external world is unreal or distorted; an individual feels apart from their environment as if it is distant and lacks emotional coloring and spontaneity.

Dissociative Amnesia:

Inability to recall important personal information, usually of a traumatic or stressful nature.

Depersonalization/Derealization Disorder:

Persistent or recurrent experiences of feeling detached from one's own body or mental processes (depersonalization) and/or feeling that the external world is unreal (derealization).

Identify the DSM V criteria for dissociative identity disorder

• Presence of two or more distinct personality states.
• Reality testing is intact, EXCEPT during a dissociative psychotic episode
• Persistent or recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events (depersonalization/derealization).
• Symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning.
• Not a normal part of a broadly accepted cultural or religious practice.
• Not attributable to the physiological effects of a substance or another medical condition.

Depersonalization co-morbidities

Post-Traumatic Stress Disorder (PTSD)
Borderline Personality Disorder (BPD)
Major Depressive Disorder
Anxiety Disorders

Identify the greatest predictor of the development of dissociative identity disorder

Severe and prolonged childhood trauma, including abuse and neglect predicts worse outcome.

Diagnose dissociative identity disorder based on case presentation

32-year-old woman who reports experiencing distinct identities or personality states that take control of her behavior, along with significant gaps in her memory for personal information and everyday events, a diagnosis of dissociative identity disorder (DID) should be considered. Each identity has its own unique characteristics, and the patient describes feeling like she has different names, ages, and histories for these identities. These symptoms have persisted for several years and are linked to a history of severe trauma, aligning with the diagnostic criteria in the DSM-5 for DID, which emphasizes the presence of two or more distinct personality states and associated memory loss.

Recognize risk factors for dissociative amnesia

History of trauma or abuse.
Severe stress.
Genetic predisposition.
Co-occurring mental health disorders.

Diagnose dissociative amnesia based on case presentation

28-year-old woman who experiences significant gaps in her memory related to a traumatic event, such as a car accident, and is unable to recall important personal information from the period surrounding the incident, a diagnosis of dissociative amnesia should be considered. The memory loss is not attributable to substance use or a medical condition and is specifically linked to the stress of the trauma, indicating a dissociative response. This diagnosis aligns with the criteria outlined in the DSM-5, emphasizing the inability to recall autobiographical information, which causes distress or impairment in functioning.

Diagnose depersonalization/derealization disorder based on case presentation.

25-year-old man who reports persistent feelings of detachment from his own body and surroundings, describing experiences as if he is observing himself from outside, alongside a sense of unreality regarding his environment, a diagnosis of depersonalization/derealization disorder should be considered. These episodes have been recurrent for several months, causing significant distress and impairing his daily functioning. The symptoms are not due to substance use or a medical condition, fitting the criteria outlined in the DSM-5 for this disorder.