Chapter 5 Dissociative Disorders

An Overview of Dissociative Disorders 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

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

Depersonalization Disorder: Causes and Treatment 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

Dissociative Amnesia and Dissociative 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

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

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

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

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