EQ 11-2 DID, Derpersonalization Disorder, Dissociative Amnesia

 Can

people actually dissociate?  Have you had a dissociative experience?  Have you ever…    

…read a paragraph and then having no recollection of what you read? …driven somewhere and not knowing how you got there? …talked to someone and not knowing what you’re actually talking about? …gotten lost in creating a work of art – and felt that you were watching yourself from afar?

Perhaps there is an underlying continuum…

Normal Dissociative Experiences

Dissociative Identity Disorder

Conscious awareness becomes dissociated (separated) from past memories, thoughts, feelings, and identities. Four types:  Dissociative Identity Disorder (DID)  Depersonalization Disorder  Dissociative Amnesia (including the symptom of fugue)

(Formerly “Multiple Personality Disorder”)

DSM Criteria (Summarized) A. At least two identities or personality states. B. These identities/personality states recurrently take control of the person’s behavior. C. Inability to recall memory that is beyond normal levels of forgetfulness. D. Symptoms not due to substance or GMC.

 Explanations   

for increasing prevalence:

Increased public awareness of the disorder Changes in the diagnostic criteria for schizophrenia Therapists may be actively looking for DID

 But…  

Rates very uneven across countries Rates very uneven across clinicians within countries

 The

rates of this disorder is very controversial…some psychologists doubt its existence at all

 Risk 

Severe child abuse, especially sexual abuse (reported in 95% of cases) 



Remembered or Recovered? What might be the problem with this?

Having generous psychiatric medical coverage (?why might this be a risk factor?)

 DID   

Factors

and culture

The United States & Canada have the highest reported cases of Dissociative Disorders Worldwide, they are nearly non-existent Are Dissociative disorders culture-bound?

A recurrent feeling of detachment from one’s own mental process or body. DSM Criteria (summarized) A. Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one’s mental processes or body B. During the depersonalization experience, reality remains intact C. Not better explained by a another mental disorder and is not due to a GMC or substance D. Symptoms cause clinically significant distress or impairment in functioning

Patients suffer a complete loss of personal identity. DSM Criteria (Summarized) A. One or more episodes of an inability to recall important personal information. (Ex: names, sense of time, etc.) B. Sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past. (A FUGUE) C. Disturbance does not occur with an association to Dissociative Identity Disorder. D. Symptoms are maladaptive.

 Biological 

model

Physiological or biochemical basis for disorder 

???

 Psychoanalytic 

model

Disorders are the result of unconscious conflicts 

Conflict rising due to…

 Cognitive-Behavioral 

Disorders are the result of learning maladaptive ways of thinking and behaving 

????

 Diathesis-Stress 

model

model

Biological predisposition to disorder + a stress trigger = psychological disorder 

Yes?