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Selective amnesia

A person retains memory of some portions of the event but not all details are remembered.

Who is more prone to having dissociative identity disorder?

A person who experienced severe psychological abuse during childhood. A child who endures extreme stress may not be able to integrate all of their experiences into one cohesive identity.

A client tells the nurse a rather confusing story of recent events surrounding her symptoms of amnesia. What is the nurse's best response? A. "You must be very angry that is difficult for you to remember this" B. " You seem to overreact each time you try to talk about this" C. " Let me see if I correctly understand what you are trying to tell me" D. "We will try this again when you can tell the story like it happened"

C: Let me see if I correctly understand what you are trying to tell me Clarification of events the client is describing to the nurse

Dissociative amnesia

Characterized by an inability to remember important personal information usually of a traumatic or stressful nature. This lack of recall includes a loss of information beyond ordinary forgetfulness.

Ralph is a client with dissociative amnesia. The nurse had identified a nursing diagnoses of personal identity disturbance. What is an appropriate expected outcome for this client? A. Client will discuss past experiences that have influenced self concept. B. Client will verbalize understanding of need to integrate personalities C. Client will demonstrate an understanding of the role of each personality D. Client will function independently in all self care activities.

Client will discuss past experiences that have influenced self concept. Provides increased perception and insight into present symptoms and problems

Marked by persistent and repetitious feeling of being detached form one's mental thoughts or body without the presence of disorientation.

Depersonalization. The person with this disorder has a feeling of not recognizing him or herself. They will be unsure about their personal information and identity. The person may sense that their body is imaginary, or in an altered state, or disappearing.

In what type of dissociative episode would a person usually not demonstrate outward indications of a psychological problem and adapt to a new social setting without being noticed.

Dissociative fugue

A woman who claims to be Ryan's biologic sister visits him in his home. She tells him he has family in another location. When she asks Ryan why he doesn't come home, he replies with "I'm sorry, but I don't know who you are." Ryan is demonstrating symptoms of A. derealization B. malingering C. dissociative fugue D. depersonalization

Dissociative fugue: A person with this will have an inability to recall some or all of her past identity and may be accompanied by a sudden and unexpected travel away from home where a new identity is assumed

Dissociative disorders are characterized by

Disturbances in conscious awareness, memory, identity, or view of oneself in relation to the environment.

What type of fugue happens when the person escapes form their identity forgetting things like where they live, but they retain unrelated memories like how to drive a car and read. This type is prevalent in forensic or criminal activities. People will dissociate to avoid legal, financial, or unwanted personal situations

Malingered fugue.

The nurse is addressing past memory deficits with a client who has dissociative disorder. To avoid flooding the client., what is important for the nurse to do? A. Instruct the client to focus on the current stress factors B. Reorient the client to time, place, and person on each contact C. Observe for cues that the client is ready to revisit the traumatic incident D. Include details of the traumatic events surrounding the memory loss in the first session

Observe for cues that the client is ready to revisit the traumatic incident. Flooding the client with details of past traumatic events may cause the clients to regress further into the dissociative state that is serving as protection from the emotional pain.

A client knows that she is married and has three children, but does not remember she recently had a baby who died from sudden infant death syndrome. The nurse would recognize this type of dissociation as:

Selective amnesia: Although she can remember portions of her life, the client does not remember the painful details of her child who died

A patient with dissociative identity disorder will have two or more personalities present in the same person. Which personality is in charge of the person?

The identities alternate in assuming control of the person's behavior. None of the personalities are "in charge", but the client will have one primary personality.

What is a trait of dissociative identity disorder?

The inability to recall important personal information that cannot be explained as simple forgetfulness.

Dissociation

The mechanism that allows our mind to separate certain memories, most often of unpleasant situations or traumatic events from conscious awareness

Derealization

The person perceives the external environment as unreal or changing. He or she may see other people was mechanical but be able to recognize the illogical nature of these feelings

Alice has been admitted to the psychiatric unit with a diagnoses of dissociative identity disorder. The nurse observes that during interaction with other clients Alice is laughing and quite talkative. When the nurse approaches Alice to administer her medications, Alice slumps her shoulders as she looks away with tears in her eyes and says in a childlike voice "Are you going to hurt me". What is the nurses best response in this situation? A. You were laughing a minute ago, What happened to Alice? B. These medications are to help Alice feel better C. Ill come back later when you feel better D. Why do you think I'm going to hurt you

These medications are to help Alice feel better. Focus on the primary personality with reassurance for positive outcome

Localized amnesia

Usually occurs within a few hours following the event or traumatic incident. This acute response is more common in response to events such as war, combat, natural disasters or severe trauma.

Dissociative fugue

demonstrated by the inability to recall some or all of a person's past or identity, accompanied by the sudden unexpected travel of the person away from home or place of employment