Psychology
Dissociative Disorders
Dissociative disorders are mental health conditions characterized by a disconnection between a person's thoughts, identity, consciousness, and memory. This disconnection can manifest as amnesia, identity confusion, or feeling detached from oneself. Dissociative disorders are often linked to trauma and can significantly impact a person's daily functioning. Treatment typically involves therapy to help individuals integrate their dissociated experiences.
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11 Key excerpts on "Dissociative Disorders"
eBook - PDFClinical Assessment Workbook
Balancing Strengths and Differential Diagnosis
- Elizabeth Pomeroy(Author)
- 2014(Publication Date)
- Cengage Learning EMEA(Publisher)
232 Disorders As a psychiatric term, dissociation refers to instances in which the normally integrated aspects of psychological and cognitive functioning (e.g., conscious-ness, memory, identity, perception, and motor control) are disrupted. More concretely, some aspects of an individual’s thoughts, feelings, or behaviors are not under his or her conscious awareness and/or control. It should be noted that dissociative symptoms often precede trauma and may occur in a number of other DSM-5 (APA, 2013) diagnoses, particularly in Acute or Posttraumatic Stress Disorders (ASD/PTSD). In the first and most complicated diagnosis in this section, Dissociative Identity Disorder (DID), there is a “disruption of identity characterized by two or more distinct personality states which may be described in some cultures as an experience of possession” (APA, 2013, p.292). This disturbance in identity manifests as changes in one’s sense of self, characteristic attributes, cognitive constructs, awareness, expected behaviors, and memories. In addition to the di-rect observation of alternate identities, the criterion now allows for self-report. There is an inability to recall personal information (ordinary and/or traumatic events) beyond normal forgetfulness while the client is in at least one of the distinct identities. The identity disturbance is not due to substance use or a general medical condition, and symptoms must cause clinically significant dis-tress and/or psychosocial impairment. Additionally, the disturbance in identity is not understood as a culturally accepted behavior or a religious practice, nor attributable to imaginary play in children (APA, 2013). Individuals impaired from this disorder are often ignorant of, perplexed and/ or embarrassed by their symptoms, often minimizing, concealing, and underreport-ing them.
eBook - ePubCompetency-Based Assessments in Mental Health Practice
Cases and Practical Applications
- Susan W. Gray(Author)
- 2011(Publication Date)
- Wiley(Publisher)
The individual experiences responses ranging from detachment of self or surroundings (depersonalization), an inability to remember after experiencing an emotional trauma (amnesia), confusion about one’s identity (dissociative fugue), to assuming two or more different personality states (dissociative identity disorder). These are controversial disorders and some practitioners do not even believe they exist thus making it hard to estimate the actual prevalence rates (Kihlstrom, 2001). Real or not, the symptoms interfere with a person’s functioning. Prevalence Studies have found that the prevalence rates for a diagnosable dissociative disorder range anywhere from 2% to 3% to approximately 10% of the general population. It is estimated that 73% of persons who have been exposed to a traumatic incident will experience some type of a dissociative state either during the incident or in the following hours, days, or weeks. The dissociative experience can be either acute or chronic. For most people, these experiences will subside on their own and are not diagnosed as a dissociative disorder (Martinez-Taboas & Guillermo, 2000). OVERVIEW OF THE MAJOR CHARACTERISTICS OF THE Dissociative Disorders Dissociation refers to the lack of connection between things usually associated with each other. Dissociated experiences are those that are not integrated into the usual sense of self—resulting in discontinuities of conscious awareness (Simeon, Guralnick, Schmeidler, & Knutelska, 2001). The DSM-IV-TR (American Psychiatric Association, 2000) distinguishes dissociation as a key feature of the Dissociative Disorders. The main symptom cluster for the Dissociative Disorders includes dissociative experiences characterized by a disruption in consciousness, memory, identity, or perception, causing significant distress in a person’s social and/or occupational functioning
eBook - PDFThe Disorders
Specialty Articles from the Encyclopedia of Mental Health
- Howard S. Friedman(Author)
- 2001(Publication Date)
- Academic Press(Publisher)
Dissociative Disorders Richard P. Kluft Temple University School of Medicine and Harvard Medical School I. Dissociation II. Dissociation as a Response to Trauma III. The Spectrum of Dissociative Symptomatology IV. Depersonalization Disorder V. DissociativeAmnesia VI. Dissociative Fugue VII. Dissociative Identity Disorder VIII. Dissociative Disorder Not Otherwise Specified IX. Dissociative Trance Disorder X. Dissociation and Memory Amnesia An inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. Depersonalization A feeling of detachment or es- trangement from one's self, such as a feeling of detach- ment from one's self, the sensation one is an outside observer of one's body, or a feeling that one is like an automaton or is living in a dream. Derealization An alteration in the perception of one's surroundings so that a sense of the reality of the external world is lost. Dissociation A disruption in the usually integrative functions of consciousness, memory, identity, or per- ception of the environment. Fugue Sudden unexpected travel away from home or one's customary place of work, with inability to re- call one's past. Identity, Personality State, Alter (synonyms) An entity with a relatively persistent and well-founded sense of self and a relatively characteristic and consis- tent pattern of behavior and feelings to given stimuli. Switching Changing from one personality state to another. Trance The capacity to sustain an attentive, recep- tive, and intensely focused concentration with dimin- ished peripheral awareness. The more peripheral awareness fades in relation to focused attention, the deeper the trance. Dissociation and the Dissociative Disorders constitute one of the most compelling and controver- sial fields of study in the mental health sciences. Disso- ciation is a failure or a disruption in the usually integra- tive functions of consciousness, memory, identity, or perception of the environment.
- Michael B. First, Allan Tasman(Authors)
- 2013(Publication Date)
- Wiley(Publisher)
CHAPTER 36 Dissociative Disorders Dissociative phenomena are best understood through the term d esagr egation (disaggregation), originally given by Janet. Events normally experienced as connected to one another on a smooth continuum are isolated from the other mental processes with which they would ordinarily be associated. The Dissociative Disorders are a distur- bance in the organization of identity, memorry, percep- tion, or consciousness. When memories are separated from access to consciousness, the disorder is Dissocia- tive Amnesia. Fragmentation of identity results in Dis- sociative Fugue or Dissociative Identity Disorder (DID; formerly Multiple Personality Disorder). Disintegrated perception is characteristic of Depersonalization Disor- der. Dissociation of aspects of consciousness produces acute stress disorder and various dissociative trance and possession states. Numbing and amnesia are diagnostic components of Posttraumatic Stress Disorder (PTSD). These dissociative and related disorders are more a disturbance in the organization or structure of mental contents than in the contents themselves. Memories in Dissociative Amnesia are not so much distorted or bizarre as they are segregated from one another. The identities lost in Dissociative Fugue or fragmented in DID are two-dimensional aspects of an overall person- ality structure. In this sense, patients with DID suffer not from having more than one personality but rather from having less than one personality. The problem involves information processing: the failure of integration of elements rather than the contents of the fragments. Dissociative amnesia Dissociative Amnesia represents the classical functional disorder of episodic memory. The disorder does not involve procedural memory or problems in memory storage, as in classic organic amnesia (e.g. Wernicke– Korsakoff syndrome).
eBook - PDF- Nancy Ogden, Michael Boyes, Evelyn Field, Ronald Comer, Elizabeth Gould(Authors)
- 2021(Publication Date)
- Wiley(Publisher)
Overlooking this point can lead to knee-jerk mislabels or misdiagnoses. Dissociative Disorders People sometimes experience a major disruption of their memory. They may, for example, lose their ability to remember new information that they just learned or old information they once knew well. When such a change in memory lacks a physical cause, it is called a dissociative disorder. Part of a person’s cognition or experience is no longer consciously accessible, and this aspect of memory seems to be dissociated, or separated, from the rest (Carlson et al., 2018; Wolf et al., 2014; Barlow, 2011). (See photo.) The DSM-5 includes three major Dissociative Disorders: dissociative amnesia, depersonalization/derealization disorder, and dissociative identity disorder. Although Dissociative Disorders are often portrayed in novels, movies, and television shows, they are in fact quite rare (Kate, Hopwood, & Jamieson, 2020; Brand & Frewen, 2017). Dissociative Amnesia People with dissociative amnesia are unable to recall important information, usually of an upsetting nature, about their lives (APA, 2013). The loss of memory is much more exten- sive than normal forgetting and is often triggered by a traumatic event, as in wartime and natural disasters (Staniloiu et al., 2020; Staniloiu & Markowitsch, 2014). In most cases, the forgotten material or events eventually return, often without the help of treatment. The memory loss generally focuses on a particular aspect of a trau- matic experience rather than an entire period of time surrounding the event. For example, a person might not be able to recall the death of a child, but would recall other events that happened during that time. Usually dissociative amnesia is characterized by sudden onset of an episode with an equally rapid disappearance. In a type of amnesia known as fugue, memory loss is extensive.
- Stephen F. Davis, William Buskist, Stephen F. Davis, William F. Buskist(Authors)
- 2007(Publication Date)
- SAGE Publications, Inc(Publisher)
271 81 D ISSOCIATIVE D ISORDERS C OOPER B. H OLMES Emporia State University I n this chapter, the focus is on a group of disorders that generates more controversy than any other diagnostic category, especially two of them: dissociative identity disorder , more commonly known as multiple personal-ity disorder, and dissociative amnesia. Throughout this chapter I use the designations mental health field and mental health professionals rather than psychology and psychologists to reflect the wide diversity of professions involved in the controversy over these diagnoses, for example, psychiatry, social work, counseling, and, of course, psychology. The controversy is principally over the dramatic increase in the frequency of dissociative diag-noses since the 1970s, although some professionals also seriously question the legitimacy of these diagnoses. For example, some research indicates only about one fourth of psychiatrists believe multiple personalities are strongly supported by data. Thigpen and Cleckly (1984)—authors of The Three Faces of Eve (1957)—reported that of many thousands of cases referred to them they found only one genuine multiple personality. Even if one accepts the diag-noses, does the reported increase reflect a genuine rise in the rate of the disorders or is it a result of misdiagnosis? We examine both sides of this controversy subsequently in a separate section. The concept of Dissociative Disorders rests in the word itself. To dissociate is the opposite of associate; therefore, to dissociate is to separate. In this case, the separation refers to a separation within the person’s psychological makeup. A person with this disorder has separated some part of his or her psychological experience(s) from other aspects of psychological functioning. The amount of separated material may vary from relatively restricted to all encompassing.
eBook - PDFDealing with Anxiety and Related Disorders
Understanding, Coping, and Prevention
- Rudy Nydegger(Author)
- 2011(Publication Date)
- Praeger(Publisher)
11 Dissociative Disorders Well, another invasion of the body snatchers event happened as usual, and Caroline took over tonight. Which is probably a good idea, because I was in no mood to handle anything. When Caroline and I changed places again tonight, Caroline imagined weaving her memories of the evening in with mine inside of our minds. It looked like she was weaving a ribbon in and out of my mind. —Pilgram’s Journey, Anonymous, 2010 BACKGROUND AND HISTORY All of us can get lost in a good book or a movie, but someone with a Disso- ciative Disorder escapes reality in ways that are involuntary and unhealthy. Dissociative Disorders represent a class of psychiatric disorders that are char- acterized by a loss of control of the integration of identity, memory, and con- sciousness, usually as a result of a traumatic experience or multiple traumatic experiences. The symptoms range from amnesia to multiple identities and serve to repress the troublesome memories. Before the 19th century, people who displayed these types of symptoms were frequently accused of being pos- sessed and were treated accordingly, 1 spawning reports of strange phenomena as well as an intense interest in spiritualism, parapsychology, and hypno- sis. Many hypnotists discovered what appeared to be second personalities in some of their subjects and wondered how two minds could exist within one person. 2 A number of multiple personality cases emerged, which Rieber 3 estimated to be about 100, and, by the late 19th century, it was generally accepted that emotionally traumatic events could cause long-term psycho- logical problems with a variety of symptoms. 4 Between 1880 and 1920, many international medical conferences addressed the issue of dissociation, and it
eBook - PDFAbnormal Psychology
The Science and Treatment of Psychological Disorders
- Ann M. Kring, Sheri L. Johnson(Authors)
- 2019(Publication Date)
- Wiley(Publisher)
In contrast to these common dissociative experiences, Dissociative Disorders are defined by more severe types of dissociation. Depersonalization/derealization involves a form of dissociation involving detachment, in which the person feels removed from the sense of self and surroundings. The person may feel “spaced out,” numb, or as though in a dream (Holmes, Brown, et al., 2005). Dissociative amnesia and dis- sociative identity disorder involve a more dramatic form of dissociation, in which the person cannot access important aspects of memory. In dissociative identity disorder, the gaps in memory are so extensive that the person loses his or her sense of a unified identity. What causes dissociation? Both psychodynamic and behavioral theorists consider patho- logical dissociation to be an avoidance response that protects the person from consciously experiencing stressful events. Consistent with the idea that this is a coping response, people undergoing very intense stressors, such as advanced military survival training, often report brief moments of mild dissociation (Morgan, Hazlett, et al., 2001). In addition to the idea of dissociation as a coping response, sleep disruptions may contribute to dissociation (Giesbrecht, Smeets, et al., 2013). Recent research jointly considers how trauma and sleep could contribute to dissociation. In one study of preschoolers, abuse led to sleep disturbance, and the sleep disturbance then predicted parental report of child dissociation (Hébert, Langevin, et al., 2016). Researchers know less about Dissociative Disorders than about other disorders, and considerable controversy surrounds the risk factors for these disorders, as well as the best treatments. To some, this controversy may seem daunting. We find the process of discovery to be fascinating as researchers strive to untangle this complex puzzle.
eBook - PDF- Gordon L. Flett, Nancy L. Kocovski, Gerald C. Davison, John M. Neale(Authors)
- 2018(Publication Date)
- Wiley(Publisher)
Therapies for Dissociative Disorders Dissociative Disorders suggest, perhaps better than any other disorders, the possible relevance of psychoanalytic theorizing. In three disorders—amnesia, fugue, and DID—people behave in ways that seem to indicate that they cannot access forgot- ten earlier parts of their lives. And since these people may at the same time be unaware of having forgotten something, the hypothesis that they have repressed or dissociated massive por- tions of their lives is compelling (MacGregor, 1996). Consequently, a psychoanalytic approach is perhaps more widespread as a choice of treatment for Dissociative Disorders than for any other psychological problems. The goal of lifting repressions is the order of the day, pursued via the use of basic psychoanalytic techniques. Because Dissociative Disorders are widely believed to arise from traumatic events that the person is trying to block from consciousness, there are links between therapies for these disorders and therapies for PTSD. Indeed, PTSD is the most commonly diagnosed comorbid disorder with DID (Loewen- stein, 1991). It is therefore no surprise that some mental health specialists propose strategies for these problems that are remi- niscent of treatments for PTSD, such as encouraging the clients to think back to the traumatic events that are believed to have triggered the problem and to view them in a context of safety and support and with the expectation that they can come to terms with the horrible things that happened to them. Indeed, in a critical review, Lev-Wiesel (2008) acknowledged that about 80% of adult childhood sexual abuse survivors diagnosed with PTSD actually suffer from Dissociative Disorders. this, and we have previously cautioned about the uncritical acceptance of self-reports. The situation is similar regarding physical or sexual abuse: very high rates have been reported (e.g., Ross et al., 1990), but they have not been corroborated.
eBook - PDF- V. Durand, David Barlow, Stefan Hofmann, , V. Durand, David Barlow, Stefan Hofmann(Authors)
- 2018(Publication Date)
- Cengage Learning EMEA(Publisher)
• The disturbance is not attributable to the physiological effects of a substance (e.g., alcohol or other drug of abuse), a neurological or other medical condition, or a different psychological disorder. From American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. DISORDER CRITERIA SUMMARY Dissociative Amnesia DSM 5 An amnesia sufferer who had been searching for his identity for more than a month was back in Washington state with his fiancée on Tuesday, but he still doesn’t remember his past life or what happened, his mother said. Jeffrey Alan Ingram, 40, was diagnosed in Denver with dissociative fugue, a type of amnesia. He has had similar bouts of amnesia in the past, likely triggered by stress, once disappearing for nine months. When he went missing this time, on September 6, he had been on his way to Canada to visit a friend who was dying of cancer, said his fiancée, Penny Hansen. “I think that the stress, the sadness, the grief of facing a best friend dying was enough, and leaving me was enough to send him into an amnesia state,” Hansen told KCNC-TV. When Ingram found himself in Denver on September 10, he didn’t know who he was. He said he walked around for about six hours asking people for help, then ended up at a hospital, where police spokeswoman Jeffrey... ● A Troubled Trip Far more common than general amnesia is localized or selective amnesia, a failure to recall specific events, usu- ally traumatic, that occur during a specific period. Dissoci- ative amnesia is common during war (Cardeña & Gleaves, 2003; Spiegel et al., 2013). An interesting case of a woman whose father deserted her when she was young and who then was forced to have an abortion at the age of 14 is described by Sackeim and Devanand (1991). Years later, she came for treatment for frequent headaches.
eBook - PDFAbnormal Psychology
An Integrative Approach
- David Barlow, V. Durand, Stefan Hofmann, , David Barlow, V. Durand, Stefan Hofmann(Authors)
- 2017(Publication Date)
- Cengage Learning EMEA(Publisher)
The behavior and emotions that make up dissociative disor-ders seem related to otherwise normal tendencies present in all of us to some extent. It is quite common for otherwise normal individuals to escape in some way from emotional or physical pain (Butler, Duran, Jasiukaitis, Koopman, & Spiegel, 1996; Spiegel et al., 2013). Noyes and Kletti (1977) surveyed more than 100 survi-vors of various life-threatening situations and found that most had experienced some type of dissociation, such as feelings of unreal-ity, a blunting of emotional and physical pain, and even separation from their bodies. Dissociative amnesia and fugue states are clearly reactions to severe life stress. But the life stress or trauma is in Copyright 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-208 208 CHAPTER 6 SOMATIC SYMPTOM AND RELATED DISORDERS AND Dissociative Disorders lobe epileptic seizure especially can be associated with dissociative symptoms (Bob, 2003). Patients with dissociative experiences who have seizure disorders are clearly different from those who do not (Ross, 1997). The seizure patients develop dissociative symptoms in adulthood that are not associated with trauma, in clear con-trast to DID patients without seizure disorders. This is an area for future study (Hara et al., 2015). Head injury and resulting brain damage may induce amnesia or other types of dissociative experience. But these conditions are usually easily diagnosed because they are generalized and irrevers-ible and are associated with an identifiable head trauma (Butler et al., 1996). Finally, strong evidence exists that sleep deprivation produces dissociative symptoms such as marked hallucinatory activity (Giesbrecht et al., 2007; van der Kloet, Giesbrecht, Lynn, Merckelbach, & de Zutter, 2012). In fact, the symptoms of individu-als with DID seem to worsen when they feel tired.
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