1. Chapter 5 Dissociative Disorders

2. 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

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
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 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

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