Chapter 5 D issociative Disorders

1. Chapter 5Dissociative Disorders

2. An Overview of Dissociative Disorders • Overview • Involve severe alterations or detachments • Affect identity, memory, and/or consciousness • Severe form of normal perceptual experiences • Depersonalization – Distortion in perception of reality • Derealization – Losing a sense of the external world • Types of DSM-IV Dissociative Disorders • Depersonalization Disorder • Dissociative Amnesia • Dissociative Fugue • Dissociative Trance Disorder • Dissociative Identity Disorder

3. Depersonalization Disorder: An Overview • Overview and Defining Features • Severe and frightening feelings of unreality and detachment • These dominate and interfere with life functioning • Problem involves depersonalization and derealization • Facts and Statistics • High comorbidity with anxiety and mood disorders • Onset is typically around age 16 • Usually runs a lifelong chronic course

4. Depersonalization Disorder: Causes and Treatment • Causes • Cognitive deficits in attention • Cognitive deficits in short-term memory • Cognitive Deficits in spatial reasoning • Deficits related with tunnel vision and mind emptiness • Such persons are easily distracted • Treatment • Little is known

5. Dissociative Amnesia andDissociative Fugue: An Overview • Dissociative Amnesia: Overview and Defining Features • Several forms of psychogenic memory loss • Generalized type – Inability to recall anything, including their identity • Localized or selective type – Failure to recall specific (usually traumatic) events • Dissociative Fugue: Overview and Defining Features • Related to dissociative amnesia • Take off to a new place • Unable to remember the past • Unable to remember how they arrived at a new location • Often assume a new identity

6. Dissociative Amnesia and Fugue: Causes and Treatment • Facts and Statistics -- Dissociative Amnesia and Fugue • Usually begin in adulthood • Both show rapid onset and dissipation • Both are mostly seen in females • Causes • Little is known • Trauma and life stress can serve as triggers • Treatment • Most get better without treatment • Most remember what they have forgotten

7. Dissociative Trance Disorder: An Overview • Overview and Defining Features • Symptoms resemble those of other dissociative disorders • Dissociative symptoms and sudden changes in personality • Changes are often attributed to possession of a spirit • Presentation differs in important ways across cultures • Facts and Statistics • More common in females • Causes • Often attributable to a life stressor or trauma • Only abnormal if the trance is considered undesirable/pathological by the culture • Treatment • Little is known

8. Dissociative Identity Disorder (DID): An Overview • Overview and Defining Features • Formerly known as multiple personality disorder • Defining feature – Dissociation of personality • Adopt several new identities (as many as 100) • Identities show unique behaviors, voice, and posture • Unique Aspects of DID • Alters – The different identities • Host – The identity that keeps other identities together • Switch – Quick transition from one personality to another

9. Dissociative Identity Disorder (DID): Causes and Treatment • Facts and Statistics • Average number of identities is close to 15 • Ratio of females to males is high (9:1) • Onset is almost always in childhood • High comorbidity rates, with a lifelong chronic course • Causes • Most have histories of horrible, unspeakable, child abuse • Most are also highly suggestible • DID – Mechanism to escape from impact of trauma • Closely related to PTSD • Treatment • Focus is on reintegration of identities • Identify and neutralize cues/triggers that provoke memories of trauma/dissociation