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Dissociative disorders

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Important personal information cannot be recalled. Usually related to ... Cult indoctrination. Dissociative trance disorders: Culture-bound. Ganser syndrome ... – PowerPoint PPT presentation

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Title: Dissociative disorders


1
Dissociative disorders
  • Dissociative Amnesia
  • Dissociative Fugue
  • Dissociative Identity Disorder

2
Dissociation
  • Disruption in the usually integrated functions
    of
  • consciousness
  • memory
  • identity
  • perception of the environment (DSM-IV, p.477)

3
Other occurrences of dissociative symptoms
  • Other disorders
  • Acute Stress and Posttraumatic Stress
  • Somatization Disorder
  • Conversion Disorder
  • Cultural expression or activity
  • Religious experiences
  • Dissociation is not inherently pathological

4
Dissociative Amnesia
  • Important personal information cannot be recalled
  • Usually related to trauma or stress
  • Beyond normal forgetting
  • Usually reported as gaps in otherwise intact
    memories of a persons own life

5
What is lost?
  • Victim memories Trauma or stress
  • Perpetrator memories
  • Violence
  • Suicide attempts
  • Self-mutilation

6
Types of Dissociative Amnesia
  • More common
  • Localized amnesia Period of time
  • Selective amnesia Certain events selected from a
    series
  • Less common
  • Generalized amnesia Entire life
  • Continuous amnesia From an event on
  • Systematized amnesia Categorical

7
Dissociative Fugue
  • Sudden relocation (fugue) with amnesia
  • May assume a new identity, and function well.
    May seem more healthy than before the fugue.
  • Upon recovery, may be amnesic for the fugue
    episode

8
Amnesia, fugue, and the law
  • Sometimes claimed as a criminal defense
  • Persists through hypnosis, barbiturate interviews
  • No available test to distinguish it from
    malingering
  • Consider the gain produced by the symptom
  • Crime due to true dissociation is irrational or
    produces no secondary gain

9
Dissociative Identity Disorder
  • Two or more distinct personalities
  • Host and alters
  • Median 10 personalities (women15, men7)
  • Range 2 to gt100
  • Control of behavior rotates among personalities
  • Often cued by stressors, switch in seconds
  • Some personalities appear rarely

10
More DID features
  • At least some of the personalities are unaware of
    the others, and demonstrate amnesia
  • Sometimes the voices of alters are experienced as
    hallucinations
  • Some alters are supportive
  • Others are the voice of the perpetrator

11
Etiological validity of DID
  • 90 of cases are women
  • Memory loss for extended periods of time in
    childhood is common
  • Repeated, severe, usually sexual abuse is common
  • Posttraumatic symptoms are sometimes seen

12
Cultural context of DID
  • Highest rates in U.S.A. and Australia
  • Is child abuse highest here?
  • Is DID a media creation?
  • Is DID iatrogenic?

13
Depersonalization Disorder
  • Repeated or enduring feelings that one is
    detached from ones body or self
  • May feel like an automaton or a detached observer
  • May feel loss of control of actions or speech
  • May coexist with derealization
  • Reality testing remains intact

14
Dissociative Disorder NOS
  • Subclinical DID
  • Derealization without depersonalization
  • Dissociation due to coercion
  • Brainwashing
  • Cult indoctrination
  • Dissociative trance disorders Culture-bound
  • Ganser syndrome
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