PSY 350: Dissociative Disorders

dissociative disorders

a category of disorders in which there is a splitting of functions of personality, memory, or consciousness

dissociative identity disorder

a person’s body is split into two or more distinct personalities (alters)

nonspecific diagnostic criteria of DID

history of abuse, nearly meets criteria for borderline PD, voices in head, blank spells, self-destructive behavior

DID DSM-5

two or more distinct personality states, disrupted sense of self and agency, memory gaps for daily or traumatic events, causes distress or impairment, not due to culture, substance, or medical condition

history of DID

much debate over name and roots, symptoms historically tied to cultural fads (posesstion, satantic rituals)

DSM 2 DID

hysterical dissociative disorder

DSM 3

muliple personality disorder

possible characteristics of DID

dominant host, personalities can interact in diff ways, mutually amnestic, mutually cognizant, one-way amnesic

co-conscious subpersonalities in DID

aware of other personalities

possible characteristics of DID

often represent cultural types (sexually loose, childlike, etc), may differ across many dimensions

mutually amnesic

neither personality knows about the other in DID

mutually cognizant

both personalities are aware of the other

one-way amnesic 

only one personality knows about the other

malingering in DID

the idea that people are deliberately faking

skepticism of DID

culture bound to US (no cases in Japan), concentrated in a small number of therapists, number was relatively small until Sybil

sybil in DID

case caused by severe childhood sexual abuse, had  no symptoms until therapy, therapist suggested, similarly to Hillside Strangler who was suggested an alter “Steve” during hypnosis

sociocog model of DID

MPD is an iatrogenic behavioral syndrome, promoted by suggestion, does not mean people are faking

theoretical perspectives of DID

psychodynamic, diathesis-stress model, learning perspective, self hypnosis

psychodynamic perspective of DID

ego is trying to escape from traumatic experiences, and alters are defense mechanisms to isolate trauma to one identity and protect others

diathesis-stress model of DID

traumatic events trigger underlying vulnerabilities

learning perspective of DID

DID is state-dependent learning, social reinforcement feeds suggestibility, social learning (symptoms often spread within clinical populations)

self-hypnosis in DID

some researches note similarities b/w similarities between this and hypnotic amnesia, have argued that people with DID have developed a mechanism against stress, may develop under treatment hypnosis

treatment for DID

treatments rooted in intensive talk therapy (goal is integration and final fusion of alters), hypnosis and other suggestion techniques are used to elicit alters and lost memories

depersonalization/ derealization disorder

recurrent issues of either instance

depersonalization

feeling of unreality or detachment from oneself, out of body experience

derealization

includes feelings of unreality or detachment from world

dissociative amnesia

memory loss of past events with no identifiable organic origin, typically affects episodic memory, NOT procedural

localized loss

surrounds specific event

selective loss

only selected disturbing details lost

generalized loss

loss of entire life history

continuous loss

loss from an event until the present

systematized loss

tied to specific domains (family)

dissociative fugue

form of amnesia accompanied by flight to a new location and assumption of a new identity

dissociative amnesia

many dissociative amnesia and fugue pts may be malingering to escape responsibility for problems

dissociative amnesia controversy

may be diag before or after “recovery” of suppressed memorues