Ch. 18 Section 3: Dissociative Disorders Obj: Describe the four dissociative disorders.

Dissociation refers to the separation of certain personality components or mental processes from conscious thought. In some situations, dissociation is normal. Someone may be so engrossed in reading a book or watching a television program, for example, that he is unaware that his name is being called. Someone else may become so involved in watching the road that she misses the sign for her exit on the highway. Perhaps the most common form of normal dissociation is daydreaming, in which the person’s thoughts may be “a million miles away.” in each of these cases, dissociation usually does not indicate a psychological disorder.

However, when dissociation occurs as a way to avoid stressful events or feelings, it is considered to be a sign of a psychological disorder. People with dissociative disorders may lose their memory of a particular event or even forget their identity. It is believed that dissociation occurs when individuals are faced with urges or experiences that are very stressful. By dissociating, they are able to remove themselves from the source of stress and lessen their feelings of anxiety.

There are no current statistics on the prevalence of dissociative disorders. In part, this is because the DSM-IV classifies them somewhat differently than they were classified in the past. However, dissociation is a common psychological symptom.

Types of Dissociative Disorders In the DSM-IV, the dissociative disorders are classified as dissociative amnesia, dissociative fugue, dissociative identity disorder, and depersonalization disorder. These disorders are described next.

Dissociative Amnesia – Formerly called psychogenic amnesia, dissociative amnesia is characterized by a sudden loss of memory, usually following a particularly stressful or traumatic event. A person experiencing dissociative amnesia typically cannot remember any events that occurred for a certain period of time surrounding the traumatic experiences and may be unable to remember his or her name, recognize friends and family, or recall important personal information. Dissociative amnesia may last for just a few hours, or it may persist for years. Memory is likely to return just as suddenly as it was lost, and the amnesia rarely recurs.

Dissociative Fugue – Dissociative fugue – previously called psychogenic fugue – is characterized not only by forgetting personal information and past events but also by suddenly relocating from home or work and taking on a new identity. Like dissociative amnesia, dissociative fugue usually follows a traumatic event that is psychologically very stressful. It is reported most frequently during wartime and natural disasters.

When individuals with dissociative fugue travel away from their home or workplace, they may take on a new name, residence, and occupation. They may become socially active in their new identity and not appear to be ill in any way. When the fugue comes to an end, they no longer remember what happened during the fugue state.

Dissociative Identity Disorder – Formerly called multiple personality disorder, dissociative identity disorder involves the existence of two or more personalities within a single individual. The various personalities may or may not be aware of the others, and at least two of the personalities take turns controlling the individual’s behavior.

Each personality is likely to be different from the others in several ways, including in such observable traits as voice, facial expressions, and handedness, as well as self-perceived age, gender, and physical characteristics. The personalities may even have different allergies and eyeglass prescriptions. They may also behave very differently from one another.

People who are diagnosed with dissociative identity disorder usually were severely abused in childhood. They typically suffered severe physical, sexual, and/or psychological abuse. Less often, dissociative identity disorder is preceded by other types of trauma.

Depersonalization Disorder – Depersonalization refers to feelings of detachment from one’s mental processes or body. People with this disorder describe feeling as though they are outside their bodies, observing themselves at a distance. Depersonalization is a common symptom of other psychological disorders in addition to being a disorder in its own right. After depression and anxiety, it is the most common complaint among psychiatric patients. Like the other dissociative disorders, depersonalization disorder is likely to be preceded by a stressful event.