Week 8: Trauma-Related Disorders - Dissociative Disorders

What are types of non-clinical dissociations?

-Meditations

-Hypnosis

-Concentration

-Absorption

What are types of clinical dissociations?

-Dissociative disorders

-Disconnection between thoughts, identity, consciousness, and memory

-Sense of detachment from emotions

-Lack of self-identity

-Significant memory loss

What is “dissociation” in the context of disorders?

“Splitting” of consciousness or the separation of mental processes–such as perception, memory, and self-awareness–that are normally integrated

What is dissociative amnesia?

• An inability to recall important autobiographical information that…

  • Should be successfully stored in memory

  • Ordinarily would be readily remembered

  • Comes with or without dissociative fugue

What is a dissociative fugue specifier?

unplanned travel or wandering; confusion around personal identity or the assumption of a new identity (partial or full)

What is depersonalization-derealization disorder?

• Depersonalization:

  • Detached from one’s own thoughts, feelings, and/or behaviors

  • Out-of-body experiences

  • Examples: panic attacks

• Derealization:

  • Detached from one’s surroundings

  • Things are experienced as unreal, dreamlike, etc.

What are the diagnostic criteria for dissociative identity disorder (multiple personality disorder)?

-Two or more distinct identities or personality states (called alters) each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self

-Amnesia occurs

What is the average number of alters?

10

What are the common fragmented identities in persons with DID?

-Child (one who experiences trauma)

-Protector

-Persecutor

-Opposite sex role

What are the etiological factors for DID?

-Environmental factors: abuse (physical and sexual) and inconsistent parenting (disorganized attachment style)

-Post-traumatic model: learning in one state is best recalled in that same state

-Socio-cognitive model: consequence of social learning and expectancies (media, therapist cuing, etc.); fantasy proneness; suggestibility

-Disruption of the sleep-wake cycle

Are biological factors recognized as an etiological factor in DID?

no, there is no evidence for a genetic component

What is suggestibility?

the tendency to incorporate misleading information into memory

What is sleep loss associated with?

-dissociative-like experiences

-executive functioning problems

True or False: Sleep, memory, and dissociation are interrelated; a sleep hygiene intervention reduces dissociative symptoms.

true

What is confirmation basis?

-People tend to seek information that is consistent with their view of the world

-People also discount information inconsistent with their world view

What is iatrogenesis?

the creation of a disorder by an attempt to treat it

What are some epidemiological factors of dissociative disorders?

-DID is unrelated to schizophrenia

-Low rates of dissociative disorders

-More commonly diagnosed in women

-Only seems to develop in adults

-Large increase in cases since the 80’s

What are some issues in DID prevalence?

-Malingering

• -Faking symptoms for some sort of secondary gain

• -People may fake DID to claim they aren’t responsible for a crime

What is the treatment for DID?

-Antidepressants and anti-anxiety medications reduce distress but not symptoms

-Fuse individual identities into 1

What are the stages that DID is done through?

stabilization, treatment of traumatic memories, and personality integration

Is DID treatment evidence-based?

no, it’s not