Dissociative Disorders Lecture Flashcards

Overview of Dissociation and Dissociative Disorders

• Definition of Dissociation: Dissociative disorders are characterized by a disturbance of, or an alteration in, the usually integrated functions of consciousness, memory, and identity.
• Core Classification: The three primary types of dissociative disorders include:
  • Dissociative Amnesia.
  • Depersonalization-Derealization Disorder.
  • Dissociative Identity Disorder (DID).

Dissociative Amnesia

• General Definition: Dissociative amnesia is an inability to recall important personal information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting.
• Determining Origin: The lack of memories is not caused by organic problems, such as neurological damage, head injury, traumatic brain injury, or toxicity.
• Types of Dissociative Amnesia:
  • Localized Amnesia: A failure to remember events that occurred during a specific, circumscribed time frame.
  • Selective Amnesia: A failure to remember some, but not all, events that occurred during a specific time frame.
  • Generalized Amnesia: A failure to remember one's entire life history. This form is considered very rare and is often associated with dissociative fugue.
• Diagnostic Criteria for Dissociative Amnesia:
  • Criterion A: An inability to recall important autobiographical information, usually related to trauma or stress, which cannot be explained by ordinary forgetfulness.
  • Criterion B: The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Criterion C: The disturbance is not attributable to the physiological effects of a substance (e.g., alcohol, drugs of abuse, or medication) or a neurological or medical condition (e.g., head injury or traumatic brain injury).
  • Criterion D: The disturbance is not better explained by other disorders, including:
    • Dissociative Identity Disorder (DID).
    • Posttraumatic Stress Disorder (PTSD).
    • Acute Stress Disorder.
    • Somatic Symptom Disorder.
    • Major or mild neurocognitive disorder.

Depersonalization-Derealization Disorder

• Core Distinctions:
  • Depersonalization: A disturbance in the perception of oneself. It involves experiences of unreality, detachment, or feeling like an outside observer of one's own thoughts, feelings, sensations, body, or actions.
    • Examples include perceptual alterations, a distorted sense of time, or an unreal/absent self.
    • Case Example: In the "Bahjat" case, the individual perceives their hand as looking longer than the other.
  • Derealization: An alteration in the perception of the external environment. This involves experiences of unreality or detachment with respect to surroundings. Individuals or objects may be experienced as unreal or dreamlike.
• Diagnostic Criteria for Depersonalization-Derealization Disorder:
  • Criterion A: The presence of persistent or recurrent depersonalization, derealization, or both.
  • Criterion B: The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Criterion C: The disturbance is not attributable to the physiological effects of a substance (e.g., drug of abuse or medication) or another medical condition (e.g., seizures).
  • Criterion D: The disturbance is not better explained by another mental disorder, such as:
    • Schizophrenia.
    • Panic disorder.
    • Major Depressive Disorder (MDD).
    • Acute Stress Disorder.
    • Posttraumatic Stress Disorder (PTSD).
    • Another dissociative disorder.

Dissociative Identity Disorder (DID)

• Historical Context: Dissociative Identity Disorder was formerly known as Multiple Personality Disorder.
• Core Characteristic: This disorder is characterized by the existence of two or more distinct personalities within a single individual.
• Diagnostic Criteria for Dissociative Identity Disorder:
  • Criterion A: Disruption of identity characterized by two or more distinct personality states. This disruption involves related alterations in:
    • Affect.
    • Behavior.
    • Consciousness.
    • Memory.
    • Perception.
    • Cognition.
    • Sensory-motor functioning.
    • Note: These signs may be observed by others or reported by the individual themselves.
  • Criterion B: Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
  • Criterion C: The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Criterion D: The symptoms are not attributable to the physiological effects of a substance.