Dissociative Disorders

A 45-year-old man is a chronic alcoholic; his family is concerned because he cannot remember anything anymore. The man denies having any problems, and he suggests that the family is just out to get his head examined, but the family members all agree that the man is often disoriented whether he is drinking or not, and they also say that he seems very apathetic. An interview reveals that while the man's immediate memory does indeed seem to be intact, he quickly forgets new information and he tends to try and cover the loss by filling in the details he cannot remember with fabrications. What is the most likely diagnosis? a. Amnestic disorder b. Mental disorder due to medical condition c. Delirium d. Dementia e. HIV- related psychiatric disorder

a. amnestic disorder

A patient with an amnestic syndrome is approached by a team of physicians, residents, and students. The resident, who has never met the patient, says, "Hello Mr. Smith, do you remember me?" The patient responds with a story about the 2 of them meeting in the hospital cafeteria the day before. What is this syndrome called? a. Retrograde Amnesia b. Anterograde Amnesia c. Confabulation d. Ganser's Syndrome e. Malingering

c. confabulation

A patient known to be a victim of childhood sexual abuse is currently in a volatile relationship. She reports that when she and her boyfriend argue, she feels as though she is standing outside herself watching the scene. What might be the secondary diagnosis? a. Dissociative Disorder NOS b. Dissociative fugue c. Depersonalization/ Derealization Disorder d. Dissociative Identity Disorder e. Dissociative Amnesia

c. depersonalization/derealization disorder

An individual is found wandering and claims that he cannot remember how he got where he is. He appears very confused and states that he's never had anything like this happen to him before. The individual is aware of his personal identity. Barring any physiological explanation for his condition, this individual is most likely suffering from what? a. Dissociative Fugue b. Dissociative Identity Disorder c. Dissociative Amnesia d. Dissociative Disorder NOS e. Depersonalization Disorder

c. dissociative amnesia

A 45-year-old man is known to be an alcoholic. One day he leaves work and travels to another town, where he applies for a job using a different name (although he does not realize he is presenting himself as someone else). He returns home the following day and wonders why his family is concerned, as he claims to have no memory of his adventure. What has the patient likely experienced? a. Dissociative Amnesia b. Dissociative Disorder NOS c. Dissociative Fugue d. Dissociative Identity Disorder e. Depersonalization Disorder

c. dissociative fugue

A middle-aged woman is found wandering around a subway station. Although the woman appears normal and is in no apparent distress, she cannot answer any questions regarding her identity. Physical exam shows no abnormalities and her lab work comes back negative. The police identify her as a missing woman from a town 30 miles away; she recently lost her husband and child in a car accident. What is the most appropriate treatment for this patient? a. Returning the patient to their home to stimulate memories b. Fluoxetine c. Psychotherapy d. Hypnosis e. Lithium

c. psychotherapy

A 45-year-old woman visits a clinic complaining of recurrent periods in which she feels separated from her body. She often feels as though "it's not me doing the moving or the thinking. I'm just a spectator while somebody or something else is making me do things." These episodes cause her considerable worry because she knows that these feelings cannot actually be trusted, that there is no possible way for something outside her to be controlling her behavior. In the absence of any general medical condition or any evidence of substance use, which psychiatric diagnosis might be suggested in this case? a. Dissociated fugue b. Dissociated amnesia c. Dissociative Identity Disorder d. Depersonalization disorder e. Dissociated Disorders NOS

d. depersonalization disorder

A 28-year-old woman begs to make the voices in her head stop arguing. She is very soft-spoken, polite, and well-groomed. She explains that she often becomes confused and finds herself in unfamiliar places. She believes that 1 of the voices might be trying to kill her. She has a history of alcohol abuse, but no drug abuse. She has an extensive medical history of unexplained injuries, stomach problems, and unusual bruising beginning in early childhood. The woman denies being physically or sexually abused as a child, but states that she has weird nightmares about a strange dark figure standing over the bed of a small child; she does not recognize the child or the man. The following week the patient's behavior is very different; she is speaking loudly, acts as if she never has seen you before, refuses to answer most questions, and is very uncooperative. According to the post-traumatic model, what is the most likely etiologic cause for this client's symptoms? a. Genetics b. Witnessing a traumatic event c. High score on hypnotizability d. Severe child abuse e. The therapist planting dissociative suggestions

d. severe child abuse

A 28-year-old woman presents to a psychiatric clinic hearing voices in her head that keep arguing; she believes that one of the voices might be trying to kill her. She is very soft spoken, polite, and well-groomed. She explains that she often becomes confused and finds herself in unfamiliar places. She has a history of alcohol abuse, but no drug abuse. Her medical files show an extensive medical history for unexplained injuries, stomach problems, and unusual bruising beginning in early childhood. The women denies being physically or sexually abused as a child, but states that she has weird nightmares about a strange dark figure standing over the bed of a small child; she does not recognize the child or the man. The following week the woman comes back to the clinic and her behavior appears to be very different from the previous week. She speaks loudly and acts as if she has never seen the psychiatrist before. She is very uncooperative and refuses to answer most questions. What is the most common etiological factor in this patient's condition? a. High score on hypnotizability scales b. Medication Abuse c. Genetics d. Severe child abuse e. Therapist planting dissociative suggestions

d. severe child abuse

During therapy, your client begins to reveal what might be distinct personalities. You know she is an incest survivor. Although you have tentatively diagnosed her with a Post-Traumatic Stress Disorder, you wonder whether a correct diagnosis might be something else. What is another possible diagnosis? a. Dissociative Fugue b. Dissociative Amnesia c. Depersonalization Disorder d. Dissociative Disorder NOS e. Dissociative Identity Disorder

e. dissociative identity disorder

A 37-year-old war veteran comes to the clinic after returning from his last tour in Iraq. During his final days, he witnessed a car bombing that killed 4 of his friends. He feels that he may be experiencing a bout of depression due to the loss of his friends. When probed about the attack, he cannot recall the events that followed the bomb explosion. His memory of that day returns when he "wakes up" in a hospital tent several hours later. He received no injuries from the attacks. After a full work up, including an EEG and other lab work, prove to be negative, a diagnosis of dissociated amnesia is made. What type of amnestic pattern did this man present with? a. Continuous b. Systematized c. Selective d. Generalized e. Localized

e. localized