Psychology
Dissociative Amnesia
Dissociative amnesia is a psychological condition characterized by memory loss that is not due to a neurological disorder. It is often linked to a traumatic or stressful event, and the memory loss can be selective, affecting specific details or entire periods of time. Individuals with dissociative amnesia may experience gaps in their memory and have difficulty recalling personal information.
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10 Key excerpts on "Dissociative Amnesia"
eBook - PDFResolving Childhood Trauma
A Long-Term Study of Abuse Survivors
- Catherine Cameron(Author)
- 2000(Publication Date)
- SAGE Publications, Inc(Publisher)
Disorders of Memory The DSM-IV describes two major groups of conditions that involve amnesia. They are called amnestic disorders and dissociative disorders. They result from two different forms of trauma—biological or psychoso-cial, respectively. Amnestic disorders arise from biological traumas, such as injuries (e.g., a blow to the skull), chemical addiction (alcoholism), side effects of medication, or brain degeneration and atrophy (e.g., Alz-heimer's disease). Amnestic disorders typically involve some loss of past memories and may also include inability to learn new information and establish new memories. In them, the amnesia may be transient or chronic. Dissociative disorders are more relevant to this study, however. They are caused by severe psychosocial (rather than biological) trauma—that is, from personal or interpersonal experiences. Dissociative Amnesia (for-merly termed psychogenic amnesia, meaning that it is psychologically caused) is an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness (ΑΡΑ, 1994, p. 478). There are many examples of psychosocial trauma that can damage memory: Among them are participating in wartime combat, witnessing the murder of a loved one, and experiencing gang rape, incest, or other threats to one's bodily integrity. These traumas involve emotionally dev-astating events, threat to one's body or life, violence, betrayal, or severe loss. (Environmental disasters such as earthquakes or floods can also damage memory even in the absence of physical injury.) In addition to 99 Amnesia and Posttraumatic Stress causing Dissociative Amnesia, psychosocial trauma can produce dissocia-tive identity disorder (formerly called multiple personality disorder) or fugue states (memory loss combined with sudden, unexpected travel away from one's customary locale, and sometimes even with assumption of a new identity).
- Michael B. First, Allan Tasman(Authors)
- 2013(Publication Date)
- Wiley(Publisher)
DSM-IV-TR Diagnostic Criteria 308.12 Dissociative Amnesia A. The predominant disturbance is one or more episodes of inability to recall important personal information, usu- ally of a traumatic or stressful nature, that is too exten- sive to be explained by ordinary forgetfulness. B. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder, Dissociative Fugue, Posttraumatic Stress Disorder, Acute Stress Disorder, or Somatization Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a neurological or other general medical condition (e.g., Amnestic Disorder Due To Head Trauma). C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Rev. Copyright 2000 American Psychiatric Association. Clinical Guide to the Diagnosis and Treatment of Mental Disorders. Second Edition. M. B. First and A. Tasman Ó 2010 John Wiley & Sons, Ltd. This chapter is based on Chapter 76 (Jose ´ R. Maldonado, David Spiegel) of Psychiatry, Third Edition (3) Type of events forgotten: The memory loss is usually for events of a traumatic or stressful nature. This fact has been noted in the language of the Diagnostic and Statistical Manual of Mental Disorders’, Fourth Edition, Text Revision (DSM-IV-TR), diagnostic criteria. In one study, the majority of cases involved child abuse (60%), but disavowed behaviors such as marital problems, sexual activity, suicide attempts, criminal activity, and the death of a relative have also been reported as precipitants. Dissociative Amnesia most frequently occurs after an episode of trauma, and its onset may be gradual or sudden. Such individuals typically demonstrate not vagueness or spotty memory but rather a complete loss of an episodic memory for a finite period.
eBook - PDFThe Disorders
Specialty Articles from the Encyclopedia of Mental Health
- Howard S. Friedman(Author)
- 2001(Publication Date)
- Academic Press(Publisher)
Diag- nostic criteria are given in Table II. Several subtypes of amnesia are recognized in DSM-IV. In localized amnesia, there is an inability to recall events related to a circumscribed period of time, usually surrounding a disturbing event. In selective amnesia, an individual can recall some, but not all, of the events during a circumscribed period of time. Less common are some other forms. Generalized amnesia is a failure to recall one's whole life. Continuous am- Table II Diagnostic Criteria for Dissociative Amnesia A. The predominant disturbance is one or more episodes of in- ability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be ex- plained by ordinary forgetfulness. B. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder, Dissociative Fugue, Post- traumatic Stress Disorder, Acute Stress Disorder, or Somatiza- tion Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a neu- rological or other general medical condition (e.g., Amnestic Disorder Due to Head Trauma). C. The symptoms cause clinically significant distress or impair- ment in social, occupational, or other important areas of functioning. ,, ,,,-- ,,, Dissociative Disorders 193 nesia involves an ongoing inability to recall events af- ter a particular time, including the present, such that the patient continues to fail to recall events even as they continue to occur. In systematized amnesia, there is a loss of memory for certain categories of informa- tion, such as memories relating to one's family or to a particular person. Until Coons' systematic 1992 study, it had been thought that the onset of amnesia was acute, of sud- den onset, and that the condition resolved rapidly and rarely recurred. It now is clear that some amnesia is chronic--it involves the loss of large blocks of time and does not resolve rapidly.
eBook - PDFDealing with Anxiety and Related Disorders
Understanding, Coping, and Prevention
- Rudy Nydegger(Author)
- 2011(Publication Date)
- Praeger(Publisher)
26 3. Memory loss is usually due to traumatic or stressful events, and one study found that 60 percent of the studied cases involved child abuse. 16 The diagnosis of DA is applied when the predominant disturbance is one or more episodes of inability to recall important personal information, usu- ally of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetting. The symptoms must also cause significant distress and impair normal functioning. 27 Dissociative Amnesia frequently occurs follow- ing an episode of trauma; its onset may be gradual or sudden; it often occurs in the third and fourth decades of life; 28 and it usually involves one episode, al- though multiple episodes are not uncommon. 16 The memory loss is not vague or spotty but is rather a loss of any and all episodic memory for a finite period of time. 8 Although a person has no obvious memory for a particular episode or time period, he does seem to be aware of the world around him at some level. For example, a victim of assault or rape may not remember the event, but she may show other symptoms of trauma and act like a victim in other ways. 8 Further, amnesia victims typically do not have problems that involve their sense of identity. Treatment for DA is often a matter of removing a person from the threat- ening situation and, as a result, may cause a spontaneous remission, which means that the person gets better on his own. 25 Victims of amnesia are often easily hypnotized and respond to techniques such as age regression as well. 29 Some people respond to the screen technique, a type of hypnosis where the person is asked to visualize the event as if it were projected onto a screen. This technique keeps the memory and affective response somewhat isolated 30 Dissociative Disorders 175 and might be used later with flashbacks if necessary.
eBook - PDFThe Popular Policeman and Other Cases
Psychological Perspectives on Legal Evidence
- W. A. Wagenaar, H. F. M. Crombag(Authors)
- 2012(Publication Date)
- Amsterdam University Press(Publisher)
ly of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness’. Furthermore, according to the DSM-IV, it must not be attributable to ‘the direct physiological effects of a substance or a neurological or other general medical condition’. This is why Dissociative Amnesia is often also called ‘psy-chogenic amnesia’.It is also called ‘functional amnesia’(Schacter 1986a) or ‘hysteri-cal amnesia’(Hodges, 1991). But whatever it is called, it needs to be clearly distin-guished from organic amnesia due to substance abuse, closed head injury or some other neurological dysfunction. 2 Apart from being extremely vague, this definition leaves unexplained what dis-sociation is. The term is so commonly used among psychiatrists and psychologists that one gets the impression that everyone knows what it is, and therefore it needs no further explanation. The DSM-IV (p. 477) describes ‘the essential feature of the dissociative disorders’ as ‘a disruption in the usually integrated functions of con-sciousness, memory, identity, or perception of the environment’.To our minds this description is not very informative other than that dissociation may refer to the fact that at times some people may be somewhat confused and less clear-headed about themselves and the world. Dissociation is assumed to be an innate predispo-sition that comes in degrees and serves to cope with trauma (Hacking, 1995, p. 96). In psychoanalytic parlance it is a ‘defence mechanism’, another concept that is not clearly defined and the psychological reality of which is assumed rather than em-pirically demonstrated. There is a self-report questionnaire called the Dissociative Experiences Scale or DES that is purported to measure people’s tendency to dissociate (Carlson et al. , 1993). It consists of 28 statements of experiences that people may have had and that are assumed to be indicative of people’s tendency to dissociate.
- Stephen F. Davis, William Buskist, Stephen F. Davis, William F. Buskist(Authors)
- 2007(Publication Date)
- SAGE Publications, Inc(Publisher)
The lost material, usu-ally of some traumatic or very stressful situation, is not forgotten; rather, it is being actively kept out of conscious-ness or awareness in an attempt to protect the person from being psychologically overwhelmed. Different theories characterize this activity differently. For example, psycho-analysis would say the material is being forcefully kept in the unconscious by repression; a behaviorist would say the material is out of awareness—but both agree memory of the event(s) or thoughts is not readily available to the person’s immediate recall. The DSM does not offer separate diagnoses for dif-ferent types of Dissociative Amnesia, but it does describe five types. Localized amnesia refers to not being able to recall something that occurred in a limited time span, usually from a few minutes to a few days at most. Selective amnesia means an inability to recall some details of an event whereas other details are avail-able. Generalized amnesia refers to a global failure of memory for the person’s whole life, whereas continuous amnesia means an inability to recall any material from the time of the traumatic event to the present. Finally, systematized amnesia is the inability to recall a certain category of information, such as military or educational events. Regardless of the type of amnesia, including the generalized type, not all memories are lost. For example, the person can still do basic academic skills, drive, shop, or play cards. The current DSM presents no data on the prevalence of this disorder, but most professionals in the field consider it extremely rare. Dissociative Fugue The word fugue , which is usually associated with musi-cal compositions, comes from Latin and refers to “flight.” It follows that dissociative fugue involves flight as well. A person with this diagnosis combines psychological amne-sia, almost always of the generalized type, with physically leaving, usually after a trauma or severe stress.
eBook - PDF- Richard J. McNally(Author)
- 2005(Publication Date)
- Belknap Press(Publisher)
The two kinds of phenomena are very different. Likewise, the DSM-IV PTSD symptom “inability to recall an important aspect of the trauma” differs from an inability to remember that one has been abused (APA 1994: 428). Furthermore, this symptom is inherently ambigu-ous: it does not distinguish between encoding failure and retrieval failure (amnesia). People may fail to remember aspects of traumatic events merely because their attention was directed elsewhere during the events so they did not encode these aspects. For example, a woman robbed at gunpoint may attend so closely to the assailant’s weapon that she fails to encode and there-fore remember his face. Assuming these aspects have been repressed (or dis-sociated) presupposes that they have been encoded, and this is not necessar-ily the case. Evidence Adduced for Amnesia for Trauma One side of the recovered memory debate argues that there is no convincing evidence that people can banish, and then later retrieve, memories of horriªc experiences. After scrutinizing dozens of studies involving all kinds of docu-mented traumatic events, the psychiatrist Harrison Pope and his colleagues concluded that survivors seldom forget trauma unless they suffer direct physi-cal damage to the brain or experience the traumatic events prior to the offset of childhood amnesia (Pope et al. 1998; Pope, Oliva, and Hudson 1999). The other side of the debate, best represented by Daniel Brown and his col-leagues, proclaims “overwhelming scientiªc support for the existence of re-pressed or dissociated memory” (Brown, Scheºin, and Hammond 1998: 538– 539). Although Pope and Brown agree that most trauma survivors remember their horriªc experiences all too well, Brown claims that a signiªcant minor-ity of survivors have no memory whatsoever for their traumatic experiences, but then later retrieve these memories more or less intact. Strikingly, both sides review the same scientiªc studies, yet arrive at opposite conclusions.
- Alan D. Baddeley, Michael Kopelman, Barbara A. Wilson, Alan D. Baddeley, Michael Kopelman, Barbara A. Wilson(Authors)
- 2004(Publication Date)
- Wiley(Publisher)
Nobody questions the motivation of eyewitnesses or victims whose recall is impaired. Fourth, it should be reiterated that, in English law (and in many other, but not all, ju- risdictions), amnesia per se does not constitute either a barrier to trial or any defence. For amnesia to contribute to the question of responsibility, other issues have to be raised, such as epilepsy or other forms of organic brain disease. Most lawyers are aware of this but, nevertheless, their clients continue to plead amnesia even in instances where recall of what actually happened would be helpful to their cause. Posttraumatic Stress Disorder (PTSD) Posttraumatic stress disorder (PTSD) can occur in association with head injury, road traf- fic accidents, being the victim of a violent crime, or a major disaster (e.g. the sinking of the Herald of Free Enterprise at Zeebrugge, or the King’s Cross fire in the London Underground). As is well known, it is characterized by intrusive thoughts and memories (“flashbacks”) about the traumatic experience, as well as anxiety and avoidance phenom- ena, a startle reaction, and a variety of other cognitive and somatic complaints (Raphael & Middleton, 1988). However, there may be instances of partial memory loss (“fragmentary” memory), distortions, or even frank confabulations. Most commonly, there is disorganization in the retrieval of memory for the trauma, evident as gaps in recall and difficulty in producing a coherent narrative: this disorganization may partially explain the tendency for PTSD patients in psychotherapy to recall progressively additional detail of their traumatic experience as therapy progresses (Harvey & Bryant, 2001; Brewin, 2001). With regard to confabulation, the present author saw a victim of the Herald of Free Enterprise at Zeebrugge, who described trying to rescue a close friend whilst still on board the ship, when other witnesses reported that this close friend had
eBook - PDFPost-Traumatic Syndromes in Childhood and Adolescence
A Handbook of Research and Practice
- Vittoria Ardino(Author)
- 2011(Publication Date)
- Wiley(Publisher)
Still others report continuous, but incom-plete memories. That is, they report always knowing what happened to them, but memories for aspects of the experience – for example, the emotions they felt at the time – are not accessible. There are many other permutations of discon-tinuous and/or incomplete memories that survivors, clinicians, and researchers may or may not label consistently as “forgotten” or “recovered” (e.g., Fivush, 2004). Some people report the experience of being surprised to “discover” they have memories of abuse that in fact they had discussed previously with other people. Schooler (2001) suggests that some people retain memories, but gain a new level of meta-awareness of the memories that is so surprising it leads them to believe they are recovering the memories themselves for the first time. Survivors’ experiences are diverse, and so are the names people use to de-scribe the phenomenon of memory disturbance following trauma. This leads directly to the question: what should we call this phenomenon? As Freyd (1996) noted, “Whatever we call it – repression, dissociation, psychological defense, denial, amnesia, unawareness, or betrayal blindness – the failure to know some 138 Post-Traumatic Syndromes in Childhood and Adolescence significant and negative aspect of reality is an aspect of human experience that remains at once elusive and of central importance” (p. 16). Drawing on Freyd, DePrince, and Gleave’s (2007) recent discussion of terminology, we use the term unawareness to refer to the phenomenon of information inaccessibility. In using this term, we intentionally avoid any inferences about how (i.e., mecha-nism) information becomes inaccessible (e.g., dissociation, everyday forgetting, encoding failures), instead emphasizing why (i.e., motivation) information may become inaccessible. As we move on to discuss the why and how questions, we will structure our discussion around two major approaches to traumatic stress studies.
eBook - PDFHypnosis, Dissociation and Survivors of Child Abuse
Understanding and Treatment
- Marcia Degun-Mather(Author)
- 2006(Publication Date)
- Wiley(Publisher)
2 THE NATURE OF TRAUMA MEMORY WITH PARTICULAR REFERENCE TO EXPERIENCES FOLLOWING CHILDHOOD ABUSE DEFINITION OF TRAUMA Trauma has been defined in DSM-IV (American Psychiatric Association, 1994) as an event which a person experiences or witnesses which involves ‘actual or threatened death or serious injury or a threat to the physical integ-rity of self or others’. The response to the event inevitably has elements of fear, helplessness and horror. Trauma has also been defined by Spiegel (1996) as ‘the experience of being made into an object or thing; the victim of someone else’s rage or nature’s indifference’. It is an overwhelming experience when for a brief period of time the person traumatised loses control of the body, and is helpless. It is outside the range of usual human experience. The immediate reactions to such events may include shock and numbing, fear of dying, anger regarding whoever or whatever caused the event, and even guilt or shame that they (the victim) were not able to do something more to prevent or avert the losses and consequences. Subsequently there are often sleep problems, disruption in the daily routine of work, and loss of appetite. The person may resort to alcohol or drugs to control their emo-tional states. There are three recognised symptom clusters which may emerge and persist after a month or more, and which meet the diagnostic criteria of post-traumatic stress disorder (DSM-IV, 1994) (otherwise referred to as PTSD). THE NATURE OF TRAUMA MEMORY 37 1. Experiencing intrusive mental activity in the form of flashbacks to the event (visual or auditory or even kinaesthetic) and thoughts, memories or daydreams and nightmares, all resulting in preoccupation with the event. 2. Numbing of responsiveness and inability to experience a wide range of emotions (both positive, affectionate etc. and sometimes negative). There is also a sense of detachment from everyday events, and an inability to focus on the present.
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