Dissociative Disorders

Q: What core psychological processes are disrupted in dissociative disorders?

A: Consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.

Q: Dissociative symptoms are often linked to what type of experiences?

A: Psychological trauma.

Q: What are “positive” dissociative symptoms?

A: Intrusions like identity division, depersonalization, and derealization.

Q: What are “negative” dissociative symptoms?

A: Inability to access information (e.g., amnesia).

Q: What is the defining feature of DID?

A: Two or more distinct personality states.

Q: In DID, identity disruption involves discontinuity in what two core experiences?

A: Sense of self and sense of agency.

Q: What domains are altered in DID identity disruption?

A: Affect, behavior, consciousness, memory, perception, cognition, sensory-motor functioning.

Q: Can DID symptoms be observed by others or only reported?

A: Both.

Q: What type of memory disturbance is required for DID?

A: Recurrent gaps in recall inconsistent with ordinary forgetting.

Q: What kinds of memory gaps occur in DID?

A: Everyday events, personal information, or traumatic events.

Q: What must DID symptoms cause to meet criteria?

A: Clinically significant distress or impairment.

Q: When would DID NOT be diagnosed due to cultural context?

A: When symptoms are part of accepted cultural/religious practices.

Q: In children, DID symptoms must not be better explained by what?

A: Imaginary playmates or fantasy play.

Q: What must be ruled out medically in DID?

A: Substance effects or medical conditions (e.g., seizures).

Q: What is the core feature of dissociative amnesia (DA)?

A: Inability to recall important autobiographical information.

Q: What type of information is typically forgotten in DA?

A: Traumatic or stressful experiences.

Q: What makes forgetting in DA abnormal?

A: It is inconsistent with ordinary forgetting.

Q: What are the three types of dissociative amnesia?

A: Localized, selective, generalized.

Q: Localized amnesia refers to what?

A: Loss of memory for a specific time period/event.

Q: Selective amnesia refers to what?

A: Forgetting parts of an event.

Q: Generalized amnesia refers to what?

A: Loss of identity and life history.

Q: What must symptoms of dissociative amnesia cause?

A: Distress or impairment.

Q: What must be ruled out before diagnosing dissociative amnesia?

A: Substances and neurological conditions.

Q: Dissociative amnesia must not be better explained by which disorders?

A: DID, PTSD, ASD, somatic symptom disorder, neurocognitive disorders.

Q: What is dissociative fugue?

A: Purposeful travel or wandering with amnesia for identity.

Q: A person suddenly travels to another city and cannot recall who they are—what specifier applies?

A: With dissociative fugue.

Q: What is depersonalization?

A: Feeling detached from oneself (like an outside observer).

Q: What is derealization?

A: Feeling detached from surroundings (world feels unreal).

Q: During depersonalization/derealization, what remains intact?

A: Reality testing.

Q: Why is intact reality testing important diagnostically?

A: It distinguishes from psychotic disorders.

Q: What are common depersonalization experiences?

A: Distorted time, emotional numbing, feeling unreal.

Q: What are common derealization experiences?

A: Dreamlike, foggy, lifeless surroundings.

Q: What must be ruled out medically for depersonalization/derealization disorder?

A: Substances or neurological conditions.

Q: What disorders must be ruled out psychologically for depersonalization/derealization disorder?

A: Schizophrenia, panic disorder, MDD, PTSD, ASD, other dissociative disorders.

Q: A client says “I feel like I’m watching myself in a movie, but I know it’s real”—what disorder?

A: Depersonalization/Derealization Disorder.

Q: What is “mixed dissociative symptoms” in OSDD?

A: Identity disturbance without full discontinuity or amnesia.

Q: What is identity disturbance due to coercive persuasion?

A: Identity changes from brainwashing, captivity, or cult involvement.

Q: What are acute dissociative reactions to stress?

A: Short-term dissociation (<1 month).

Q: What symptoms might occur in acute dissociative reactions?

A: Depersonalization, derealization, microamnesia, altered perception.

Q: What is dissociative trance?

A: Loss of awareness with unresponsiveness to surroundings.

Q: What key feature distinguishes DID from dissociative amnesia?

A: Identity fragmentation (DID) vs. memory loss only (amnesia).

Q: What distinguishes depersonalization from psychosis?

A: Insight (reality testing intact).

Q: What symptom overlaps between PTSD and dissociative disorders?

A: Dissociation (e.g., amnesia, depersonalization).

Q: What type of amnesia is most common in dissociative amnesia?

A: Localized or selective.

Q: Are individuals always aware of their amnesia?

A: No, many are initially unaware.

Q: What often triggers dissociative symptom flare-ups?

A: Stress.

Q: A client has identity shifts + memory gaps—diagnosis?

A: Dissociative Identity Disorder.

Q: A client forgets trauma but has no identity disturbance—diagnosis?

A: Dissociative Amnesia.

Q: A client feels unreal but knows it’s not real—diagnosis?

A: Depersonalization/Derealization Disorder.