what is the essential feature of dissociative disorders?
a disruption in the usually integrated functions of consciousness, memory, identity, or perception
What is the essential feature of dissociative amnesia?
an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness
What is criterion B for dissociative amnesia?
B. The disturbance does not occur exclusively during the course of DID, dissociative fugue, PTSD, acute stress disorder, or somatization disorder, and is not due to substance/gen med
What is criterion C for dissociative amnesia?
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
What are the five types of memory disturbances described in dissociative amnesia?
What is localized amnesia?
the individual fails to recall events that occurred during a circumscribed period of time, usually the first few hours following a profoundly disturbing event (can't recall anything until two days later, for example)
What is selective amnesia?
the person can recall some, but not all, of the events during a circumscribed period of time (ex. a combat veteran can recall only some parts of a series of violent combat experiences)
What is generalized amnesia?
failure of recall encompasses the person's entire life (rare)
What is continuous amnesia?
the inability to recall events subsequent to a specific time up to and including the present (uncommon)
What is systematized amnesia?
loss of memory for certain categories of information, such as all memories relating to one's family or to a particular person (uncommon)
If dissociative amnesia occurs exclusively during the course of these five disorders, it can not be diagnosed separately.
dissociative identity disorder
acute stress disorder
How can dissociative amnesia be differentiated from depersonalization disorder?
depersonalization is an associated feature of dissociative amnesia, so depersonalization occurring exclusively during dissociative amnesia cannot be diagnosed separately
What is the essential feature of dissociative fugue?
sudden, unexpected travel away from home or one's customary place of daily activities, with inability to recall some or all of one's past
What is criterion B for dissociative fugue?
B. Confusion about personal identity or assumption of a new identity (partial or complete).
What are criteria C and D for dissociative fugue?
C. Does not occur exclusively during course of DID and not due to substance/gen med
D. Causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
True or false:
Dissociative amnesia and depersonalization can be symptoms of dissociative fugue.
If these symptoms occur solely during the course of a dissociative fugue, separate diagnosis would not be warranted.
How can a dissociative fugue be differentiated from a manic episode?
While manic episodes can feature amnesia for some parts of life, the travel is associated with grandiose ideas and other manic symptoms and such individuals often call attention to themselves by inappropriate behavior. Also, assumption of an alternate identity does not occur.
How can dissociative fugue be differentiated from schizophrenia?
While in a fugue, individuals do not appear to have any of the psychopathology associated with schizophrenia (or any other disorder).
What is the essential feature of dissociative identity disorder (DID)?
the presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self)
What is criterion B for DID?
B. At least two of these identities or personality states recurrently take control of the person's behavior.
What is criterion C for DID?
C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
What is criterion D for DID?
D. The disturbance is not due to substance or gen med. In children, the symptoms are not attributable to imaginary playmates or other fantasy play.
The diagnosis of DID takes precedence over what other disorders?
What are factors that help rule out other mental disorders from DID?
presence of clear-cut dissociative symptomatology with sudden shifts in identity states
the persistence and consistency of identity-specific demeanors and behaviors over time
evidence of dissociative behavior that predates clinical presentation
high scores on measures of dissociation and hypnotizability
What are the essential features of depersonalization disorder?
persistent or recurrent episodes of depersonalization characterized by a feeling of detachment or estrangement from one's self
individual may feel like an automaton or like living in a dream or movie
What is criterion B for depersonalization disorder?
B. During the depersonalization experience, reality testing remains intact.
What are criteria C and D for depersonalization disorder?
C. significant distress/impairment
D. Not substance, gen med, and does not occur exclusively during the course of another mental disorder, like schizophrenia, panic disorder, acute stress disorder, or another disoociative disorder.