PSY350 Module 6: Dissociative Disorders

*6.1. Clinical Presentation*

*6.1. Clinical Presentation*

*6.2. Epidemiology*

*6.2. Epidemiology*

*6.3. Comorbidity*

*6.3. Comorbidity*

*6.4. Etiology*

*6.4. Etiology*

*6.5. Treatment*

*6.5. Treatment*

*Review Assignment*

*Review Assignment*

integration

the ongoing process of merging subpersonalities into one personality

Dissociative Identity Disorder (DID)

the presence of two or more distinct personality states or expressions. - aka multiple personality disorder

What is dissociative disorder commorbid with? What are depressive disorders commonly found in combination with?

DID ~ PTSD depressive disorders ~ dissociative disorders

stats on DID and dissociative amnesia

DID: 1.5%, = between sexes, generally come up in late adolescence and early adulthood dissociative amnesia: females 2x as likely to be diagnosed

primary personality

While personalities can present at any time, there is generally a dominant personality that is present the majority of the time. From there, an individual may have several subpersonalities.

Describe treatment options for dissociative amnesia.

While there is no evidenced-based treatment for dissociative amnesia, both hypnosis and phasic therapy have been shown to produce some positive effects in patients with dissociative amnesia.

depersonalization

a feeling of unreality or detachment from ONESELF. Individuals describe this feeling as an out-of-body experience where you are an observer of your thoughts, feelings, and physical being.

dissociative disorders

a group of disorders characterized by symptoms of disruption in consciousness, memory, identity, emotion, perception, motor control, or behavior

What was Sybil? And what aspect of etioligy is it part of?

A documentation of a woman's 16 subpersonailities --> mass media also influences the way clinicians get info about dissociative symptoms. - Sociocultural

How many main types of dissociative disorders are there? A. 3 B. 4 C. 5 D. 2

A. 3

Many dissociative disorders have been found to have a high comorbidity with ___ and ___ disorders. A. PTSD; depressive B. PTSD; anxiety C. Acute stress disorder; depressive D. Acute stress disorder; anxiety

A. PTSD; depressive

What is another name for Dissociative Identity Disorder? A. Depersonalization disorder B. Multiple personality disorder C. Derealization disorder D. Dissociative amnesia disorder

B. Multiple personality disorder

What is the most extreme type of dissociative amnesia? A. Selective amnesia B. Generalized amnesia C. Localized amnesia D. Dissociative fugue

D. Dissociative fugue

How might a clinician be influenced following exposure to a media source discussing dissociative disorders? A. Engage in dissociative behaviors themselves B. Develop a memory retrieval deficit C. Use the media portrayal as a model for their patients' cases D. Use questions or techniques that evoke dissociative types of problems in patients

D. Use questions or techniques that evoke dissociative types of problems in patients

Describe how dissociative amnesia presents.

Dissociative amnesia disorder is identified by the inability to recall important autobiographical information. This type of amnesia is different from what one would consider permanent amnesia in that the information was successfully stored in memory; however, the individual cannot retrieve it. Additionally, individuals experiencing permanent amnesia often have a neurobiological cause, whereas dissociative amnesia does not (APA, 2013).

Describe the comorbidity of dissociative disorders.

Given that a traumatic experience often precipitates dissociative disorders, there is a high comorbidity between dissociative disorders and PTSD. Similarly, depressive disorders are also commonly found in combination with dissociative disorders, likely due to the impact the disorders have on social and emotional functioning. In individuals with dissociative amnesia, a wide range of emotions related to their inability to recall memories during the episode often present once the amnesia episode is in remission (APA, 2013). These emotions frequently contribute to the development of a depressive episode.

localized vs selective vs generalized amnesia

L = the most common type, is the inability to recall events during a specific period, can be short from months or years S = a component of localized amnesia where the person can recall some, but not all, of the details during a specific period G = a complete loss of memory of their entire life history, including their own identity

Describe the sociocultural causes of dissociative disorders.

The sociocultural model of dissociative disorders has been primarily influenced by Lilienfeld and colleagues (1999) who argue that the influence of mass media and its publications of dissociative disorders, provide a model for individuals to not only learn about dissociative disorders but also engage in similar dissociative behaviors. This theory has been supported by the significant increase in DID cases after the publication of Sybil, a documentation of a woman's 16 subpersonalities (Goff & Simms, 1993). These mass media productions are not just suggestive to patients. It has been suggested that mass media also influences the way clinicians gather information regarding dissociative symptoms of patients. For example, therapists may unconsciously use questions or techniques in session that evoke dissociative types of problems in their patients following exposure to a media source discussing dissociative disorders.

What is hypnosis and what disorder is it for?

Through hypnosis, the clinician can help the individual contain, modulate, and reduce the intensity of the amnesia symptoms, thus allowing them to process the traumatic or unpleasant events underlying the amnesia episode - dissociative amnesia

There is a large population of individuals with dissociative amnesia that require additional treatment. a) True b) False

b) False Many individuals regain memory without the need for treatment; however, there is a small population that does require additional treatment.

dissociative fugue

considered to be the most extreme type of dissociative amnesia

final fusion

difficult to obtain; once all subpersonalities are fused and the individual identifies themselves as one unified self

dissociative amnesia disorder

identified by the inability to recall important autobiographical information

derealization

include feelings of unreality or detachment from the WORLD—whether it be individuals, objects, or their surroundings. For example, an individual may feel as though they are unfamiliar with their surroundings, even though they are in a place they have been to many times before.

fusion

occurs when two or more alternate identities join together --> complete loss of separateness - it can take a while

What do psychodynamic theorists believe DID results from?

repeated exposure to traumatic experiences, such as childhood abuse, neglect, or abandonment