Term
| What are dissociative disorders? |
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Definition
| Dissociative disorders involve similar alterations or detachments in consciousness, memory, identity or perception from the environment. They occur when the normal processes regulating awareness and the multi-channel capacities of the mind apparently become disorganised, leading to various anomalies of consciousness and personal identity. |
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Term
| Key dissociative disorders |
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Definition
- Dissociative amnesia
- Dissociative fugue disorder
- Depersonalisation/derealisation disorder
- Dissociative identity disorder |
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Term
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Definition
Dissociative amnesia (previously known as psychogenic amnesia) is the inability to recall important personal information, generally of a traumatic or stressful nature. This differs from normal forgetfulness as it is significantly more extensive. Dissociative amnesia commonly presents itself as reported gaps in recall for aspects of a person's life (e.g. suicide attempt, details of war experiences). In some cases the gaps in recall can be selective; someone may remember the event but not the effect of the experience. The experience is usually localised and relates to a specific event (rather than generalised amnesia where someone may be unable to remember anything). In the case of dissociative amnesia the gaps in memory are reversible and are not organic in origin.
Amnesic episodes usually last between a few days and a few years. Although many people experience only one such episode, some people have multiple episodes in their lifetimes
Thus, the only type of memory that is affected is episodic (pertaining to events experienced) or autobio- graphical memory (pertaining to personal events experi- enced). |
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Term
| - Dissociative fugue disorder |
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Definition
Dissociative fugue (formally known as psychogenic fugue) occurs when a person not only goes into an amnesiac state but also leaves his or her home surroundings and becomes confused about his or her identity, sometimes assuming a new one. Someone experiencing dissociative fugue may either not think about their past or can create a false past. Although not as common, someone may also experience confusion regarding their personal identity and in rare cases may assume a new identity.
During a fugue individuals do not experience psychopathy. The fugue state may last anywhere from a few hours to a number of days. Once a person returns to the pre-fugue state they may have no memory of the events that occurred during the fugue. This disorder has a prevalence of around 0.2% (but this may increase during highly stressful events). |
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Term
| - Depersonalisation/derealisation disorder |
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Definition
Depersonalisation/derealisation disorder occurs in people who experience persistent and recurrent episodes of derealisation (losing one's sense of reality) and depersonalisation (losing one's own sense of self and one's own reality). These feelings can be quite severe and frightening. Feelings of being an outside observer of one's mental processes or body are common. This disorder can cause marked distress and impairment.
Although presenting with similar symptoms, depersonalisation/derealisation is not diagnosed if it occurs during schizophrenia, panic disorder, acute stress disorder or any other dissociative disorder. The prevalence of this disorder is not known.
Two of the more common kinds of dissociative symptoms are derealization and depersonalization.
As many as 50 to 74 percent of us have such experiences in mild form at least once in our lives, usually during or after periods of severe stress, sleep depri- vation, or sensory deprivation
Occasional depersonalization/derealization symptoms are also sometimes reported by people with schizophrenia, borderline personality disorder, panic dis- order, acute stress disorder, and posttraumatic stress disor- der (Hunter et al., 2003) |
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Term
| - Dissociative identity disorder |
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Definition
An individual with dissociative identity disorder (DID; previously known as 'multiple personality disorder') manifests at least two or more distinct identities or personality states that alternate in some way in taking control of behaviour. There is usually one primary identity with secondary identities displaying contrasting characteristics. Each personality state may be experienced as if it has its own distinct personal history. Alternate identities ('alters') take control in sequence. Someone experiencing DID may report frequent gaps in their memory of their personal history.
Switching is the process of changing from one alter to another. Switches are commonly triggered by flashback memories of prior trauma or stressful events. Sufferers do not exert any voluntary control over the switching of alters.
There are many controversies about DID, including whether it is real or faked, how it develops, whether memories of childhood abuse are real, and, if the memories are real, whether the abuse played a causal role. The two prevailing theories of dissociative identity disorder, the dissociation-trauma model and the sociocognitive model, are discussed in the following section. |
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Term
| There are two contrasting theoretical approaches to understanding DID and the emergence of alters. |
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Definition
1) Dissociation-trauma model of DID
2) Sociocognitive model of DID |
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Term
| 1) Dissociation-trauma model of DID |
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Definition
A major risk factor for developing DID is severe trauma in early childhood. This can be either physical, sexual or witness trauma. In this theory, it is proposed that the child copes with the trauma by dissociating and imagining a new identity. These dissociative experiences then form the beginning of one or more new identity. These identities may then reappear as 'alters' when the person is subjected to stressors in adulthood. Select the following heading to read about the argument for this model.
DID patients exhibit unique symptoms, such as dissociative amnesia, dissociative fugue, and depersonalisation, which cannot be explained by therapist-induction alone. |
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Term
| 2) Sociocognitive model of DID |
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Definition
In this model, the experiences and displays of multiple role enactments presented by people experiencing DID are considered to have been created, legitimised and maintained by social reinforcement. Roles are not products of conscious deception; rather, they flow spontaneously such that the role and self are indistinguishable. Select the following heading to read about the argument for this model.
Rather than being a genuine diagnosis, DID is an example of therapist-induced 'recovered memories' of childhood trauma. Worse still, DID is also an example of therapist persuasion, whereby patients are covertly persuaded to act out particular symptoms that did not previously exist, such as multiple identities. |
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Term
| Implicit Memory/Perception |
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Definition
| all people routinely show indirect evidence of remembering things they cannot consciously recall (implicit memory) and respond to sights or sounds as if they had perceived them even though they cannot report that they have seen or heard them (implicit perception; |
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Term
| Retrograde amnesia by contrast, anterograde amnesia |
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Definition
| Retrograde amnesia is the partial or total inability to recall or identify previously acquired information or past experi- ences; by contrast, anterograde amnesia is the partial or total inability to retain new information |
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Term
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Definition
dentity that is most frequently encountered and carries the person’s real name is the host identity. Also in most cases, the host is not the orig- inal identity, and it may or may not be the best-adjusted identity. The alter identities may differ in striking ways involving gender, age, handedness, handwriting, sexual orientation, prescription for eyeglasses, predominant affect, foreign languages spoken, and general knowl- edge.
Additional symptoms of DID include depression, self-injurious behavior, frequent suicidal ideation and attempts, erratic behavior, headaches, hallucinations, posttraumatic symp- toms, and other amnesic and fugue symptoms |
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Term
Dissociation:
only occurs in people with a dissociative disorder.
is a sign that something is seriously wrong.
is extremely common and not necessarily pathological.
is extremely rare and not necessarily pathological. |
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Definition
| is extremely common and not necessarily pathological. |
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Term
The disorder involving the experience of sudden loss of the sense of self is:
depersonalization/derealization disorder.
psychogenic amnesia.
disidentity disorder.
derealization disorder. |
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Definition
| depersonalization/derealization disorder. |
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Term
Gerard became amnesic, wandered away from home and assumed a completely new identity as a shoe salesman. He suffers from:
dissociative fugue.
dissociative identity disorder.
malingering identity disorder.
depersonalization. |
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Definition
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Term
When a person experiences dissociative amnesia, one main type of memory is usually affected. Which?
Semantic memory (pertaining to language and concepts).
Procedural memory (how to do things).
Perceptual memory (the representation of things in images).
Episodic memory (the events we have experienced). |
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Definition
| Episodic memory (the events we have experienced). |
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Term
Dissociative identity disorder was formerly known as:
psychogenic amnesia.
multiple personality disorder.
conversion hysteria.
neurasthenia. |
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Definition
| multiple personality disorder. |
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Term
In the individual with DID, 'switches' between identities:
usually take several days.
produce gaps in memory.
occur symmetrically, such that all identities share equal control.
are controlled by the host identity. |
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Definition
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Term
What is one reason why the prevalence of DID has been increasing?
Children in today's society are far more likely to experience severe trauma than they were in the past.
DID has only recently received full acceptance from the psychiatric community and thus professionals are now using this diagnosis.
As of 1980 most insurance companies had to accept DID as a billable diagnosis.
It may be that the prevalence of DID has not changed at all, but that clinicians may unknowingly encourage the emergence of new identities. |
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Definition
| It may be that the prevalence of DID has not changed at all, but that clinicians may unknowingly encourage the emergence of new identities. |
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Term
There is debate as to the relationship between DID and abuse because:
few of those who develop DID have a history of abuse.
there is little evidence of a link between trauma and psychopathology.
other factors correlated with abuse may be the true causal factors in DID.
most reports of abuse are faked. |
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Definition
| other factors correlated with abuse may be the true causal factors in DID. |
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Term
According to sociocognitive theory:
the mind separates due to some traumatic experience and is never fully integrated, resulting in the multiple identities observed in DID.
the alters in DID develop as a means of escaping from some form of trauma.
DID has a factitious origin.
DID may develop when a suggestive patient is treated by an overzealous clinician. |
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Definition
| DID may develop when a suggestive patient is treated by an overzealous clinician. |
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Term
| What is dissociative fugue and its key features? Under what circumstances is this disorder likely to develop? |
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Definition
| Dissociative fugue has been described as a walking amnesia. In the DSM, dissociative fugue is diagnosed as a subcategory under Dissociative Amnesia. The key features include an inability to recall important autobiographical information that is inconsistent with ordinary forgetting; the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms are not attributable to substance use or an underlying neurological medical condition. In terms of the fugue sub-category, the individual engages in travel that is associated with amnesia. In this form of amnesia, an individual not only forgets his or her history, but he or she also leaves. The individual with dissociative fugue may actually leave his or her home and begin a new life elsewhere with a new identity. Such an extreme means of dealing with anxiety is most commonly seen when faced with a situation that both intolerable and inescapable. |
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