Ch. 7 - Trauma & Dissociation

What is it?

an emotional/psychological response to a distressing/frightening event that overwhelms a person’s ability to cope (diagnosis split to individuals under and over 6 years)


Post-Traumatic Stress Disorder (PTSD)

→ fear of re-experiencing a traumatic event, where a person may experience nightmares/flashbacks, leading to an avoidance via emotional numbing

  • types (based on diagnosis):

    • acute - first month after trauma

    • chronic - long-term

    • delayed onset - symptoms don’t show until after 6 months

→ in children: memories can be embellished over the years, symptoms may be bed-wetting/separation fears

  • statistics:

    • 50% of acute stress disorder → PTSD

    • limited research on PTSD among indigenous peoples*

    • 8% of the gen. population

    • 29% (SA) / 37% (captivity) / 11% (CAF)

*canada acknowledges this; and has looked into PTSD regarding COVID

  • causes:

    • trauma

    • bio/psycho/social vulnerabilities (temperaments!)

    • lack of social support

    • damaged hippocampus

!!! intensity of stimulus matters (more intense = more trauma)

  • treatments:

    • exposure therapy

    • CBT (cognitive behavioral therapy)

    • EMDR (eye-movement desensitization & reprocessing)

    • SSRIs


***RELATED DISORDERS (not on exam):

  • prolonged grief disorder - adapting to loss is prolonged and intensified with time

  • adjustment disorder - anxious/depressive regarding life stress/changes (could have bio/psychological vulnerabilities)

  • reactive attachment disorder - typically from a child; rarely seeks out caregivers for protection/support

  • disinhibited social engagement disorder - typically from a child; no inhibitions to approaching adults


Dissociative Identity Disorder (DID)

→ formerly known as ‘multiple identities disorder’, has several identities that co-exist simultaneously although partially independent

→ physical transformation occurs during ‘switches’, where amnesia can occur for other identities

!!! FAKED? refer to Hillside Strangler

  • statistics:

    • more than 2, and can have 15 alter personalities

    • high female to male ratio

    • onset in childhood (and lifetime)

    • frequency of switching diminishes with age

    • comorbid

  • causes:

    • childhood abuse (physical/sexual)

      • autohypnotic model - dissociation as defense from trauma

    • biological vulnerability

    • !! real & false memories

      • in children, suggestions → new false memories

      • severity of trauma related to severity of amnesia

  • treatments:

    • long-term psychotherapy (low success rate though)

    • CBT (cognitive behavioral therapy)

    • medication (ineffective)


Depersonalization-Derealization Disorder

→ severe feelings of detachment where one is a observer of their own body/mind which can cause significant distress or impairment

  • rare (follows traumatic event)

  • cognitive/perceptual/emotional regulation deficits occur (where mind is empty)

  • dysregulated HPA axis


Dissociative Amnesia

→ generalized - inability to remember anything, including identity

→ localized/selective - inability to remember specific events

*usually adult onset

→ fugue - memory loss revolving around trips (amok - trance-like)