Dissociative disorders

Describe DepersonalizationDerealization Disorder

A. Persistent/recurrent depersonalization, derealization or both 

• Outside observer of own body or mind 

• Unreality, detachment to surroundings 

B. Reality testing remains intact 

• Rare; onset follows traumatic event

• Cognitive and perceptual deficits occur 

• Mind emptiness 

• Deficits in emotion regulation 

• Dysregulation in the HPA axis

Describe Dissociative Amnesia

• Generalized: Inability to remember anything, including identity

• Localized/selective: Inability to remember specific events (usually traumatic) 

• Usually, adult onset

• Dissociative fugue: memory loss revolves around an unexpected trip(s)

• Intolerable situation left behind 

• Dissociative trance disorder (DTD), a type of DID

Describe  Dissociative Identity Disorder

• Adoption of many identities 

• Several identities (alters) co-exist simultaneously 

• Complete fragmentation of identity 

• Incredibly rare (however – over 1.5 billion tags on TikTok)

Describe Dissociative Identity Disorder Criteria

A. Two+ distinct personality states; discontinuity in sense of self, agency, affect, behaviour, consciousness, memory, perception, cognition, sensorymotor function 

B. Recurrent gaps in memory of everyday events, personal information, traumatic events 

C. Distress or impairment 

D. Not a normal part of accepted cultural or religious practice

What are Dissociative Identity Disorder Characteristics?

• Host identity: asks for treatment 

• Switch: instantaneous transition from one personality 

• 37% report changes in handedness to another

Can dissociative identity disorder be faked?

• Alters may be created upon suggestions from therapist 

• People with fragmented identities may not consciously/voluntarily simulating 

• Changes in hippocampal and medial temporal activity after the switch

DID causes?

• Childhood abuse: physical and sexual 

  • Take on different identities as escape is not possible 

  • Escape sought from physical and emotional pain 

      - DID may be a subtype of PTSD

- Suggestibility personality trait 

- Autohypnotic model: suggestible people may use dissociation as a defense against trauma 

- Less suggestible people may develop PTSD 

- Results of studies inconclusive so far

- Biological Contributions 

- Roles of heredity and environment debated 

- Temporal lobe epileptic seizures associated with dissociative symptoms 

- Sleep deprivation

Whats the treatjment for DID

• Long-term psychotherapy 

  • Reintegrate separate personalities 

  • 22% success rate 

       - Meds don ’t seem to be helpful 

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