Dissociative disorders lecture

Understanding Dissociative Disorders

Overview of Dissociative Disorders

  • Key Concepts: Symptoms can overlap between different diagnoses, particularly in stress-related disorders such as Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD).

    • Important to recognize that trauma is a critical component connecting these disorders.

Dissociation Explained

  • Definition: Dissociation involves losing touch with immediate surroundings, characterized by a disconnect in thoughts, feelings, memories, behaviors, and even a sense of identity.

  • Significance: Dissociation is more prominent in dissociative disorders than in ASD or PTSD, affecting various aspects of daily life beyond just traumatic memories.

  • Common Experience: Example given of driving on auto-pilot, where an individual may not remember the journey itself—this reflects how dissociative symptoms manifest….

    • Automated Behavior: Lower centers of consciousness may drive, while the conscious mind is preoccupied with other thoughts.

Types of Dissociative Disorders

  1. Dissociative Amnesia

    • Characteristics: Inability to recall personal information, including name or life events; memory loss typically involves episodic long-term memory.

    • Cause: Differentiates from retrograde amnesia, which is physically induced (e.g., head injury), as dissociative amnesia's cause is psychological, connected to traumatic experiences (e.g., abuse).

    • Memory Loss: Can vary from brief segments to total loss of personal life history.

    • Relation to Dissociative Fugue: Sometimes occurs alongside dissociative fugue, where an individual suddenly travels away from home and cannot recall the trip or personal identity (Latin 'fuga' meaning flight).

      • Emotional Trauma Trigger: Commonly occurs following emotional trauma (e.g., disasters, wars).

  2. Dissociative Identity Disorder (DID)

    • Current Terminology: Formerly known as multiple personality disorder, it is essential to use the correct terminology in the professional field.

    • Core Concept: Involves the presence of two or more distinct identities or personality states within one individual.

    • Core Personality: The default personality which is usually unaware of other identities, often experiences memory blackouts and confusion.

    • Public Awareness: Became well-known in the 1980s; the phenomenon was sensationalized, causing an increase in diagnoses.

      • Controversy exists regarding the validity and rate of diagnosis, with some professionals questioning its existence.

      • Researchers suggest DID may occur alongside other disorders (like Borderline Personality Disorder) and may exhibit variations in brain functioning associated with dissociative symptoms.

    • Cultural Context: Dissociative symptoms may manifest in various cultural contexts, as exemplified by trancelike states in Southeast Asia.

Theoretical Models of DID

  1. Post-Traumatic Model

    • Explains that dissociation is a response to trauma but recognizes that not all trauma results in dissociation.

    • Symptoms help regulate fear responses, identified via therapeutic practices.

  2. Socio-Cognitive Model

    • Suggests that DID symptoms could be shaped or influenced by therapists unintentionally through media portrayals and sociocultural expectations.

    • Professionals must be cognizant of factors like client suggestibility, fantasy proneness, cognitive distortions, and coexisting disorders.

  3. Psychodynamic Theory

    • Focuses on repression of unacceptable thoughts/behaviors as a defense mechanism contributing to psychological disorders.

    • Emphasizes the role of motivated forgetting in dissociative disorders.

  4. Cognitive and Behavioral Models

    • Suggests that avoidance of distressing thoughts or memories reinforces non-thinking habits.

    • Individuals with dissociative disorders may excel at this form of thought avoidance, potentially leading to stronger memory formation capabilities.

    • Positive reinforcement can occur through therapist attention to reports of identity shifts, further entrenching these behaviors.

Biological Contributions

  • Research indicates individuals with depersonalization/derealization disorder may show reduced brain activity in areas responsible for body awareness;

    • Associated factors include lower amygdala activity and heightened activation in medial prefrontal areas, suggesting emotional over-modulation that contributes to dissociation.

DSM-5 Classification

  • Dissociative Disorders Listed:

    • Dissociative Identity Disorder (DID)

    • Dissociative Amnesia

    • Depersonalization/Derealization Disorder

    • Other Specified Dissociative Disorder

    • Unspecified Dissociative Disorder

  • Note on Recognition: Challenges remain in identifying these disorders due to their complex nature and historical controversies.

Future Topics of Discussion

  • Next Sections: Upcoming discussion on eating disorders and sexual dysfunction disorders.

  • Additional Segment: Mention of a segment about addictive disorders introduced in a previous class, emphasizing the connection to psychoactive drugs and their potential for addiction, indicating a broad nature of psychological inquiries.