Dissociative disorders

Dissociative Disorders

Presenter:Aachal Taywade

Assistant Professor,Amity University Mumbai.

What are dissociative disorders?Disruption in the usually

integrated functions of consciousness, memory, identity, or perception.

Major dissociative disordersDISSOCIATIVE AMNESIA Inability to remember significant events- everything of traumatic nature.

DISSOCIATIVE FUGUE Sudden, unexpected travel away from home or workplace.

DISSOCIATIVE IDENTITY DISORDERS Presence of 2 or more personalities.

DEPERSONALIZATION DISORDER Sense of being cut off or detached from one’s self.

DISSOCIATIVE DISORDER NOT OTHERWISE SPECIFIED Dissociative symptoms, not meet criteria of any specific disorder.

Dissociative amnesia

.. Dissociative amnesia

Most common dissociative disorder.Selective but extensive memory

loss that occurs without any indications of injury or other organic changes. Inability to recall important information, specially of stressful content, that can not be attributed to ordinary forgetfulness.

DSM criteriaa) The predominant disturbance is one or more

episodes of inability to recall important personal information, usually of a traumatic stressful nature, that is too extensive to be explained by ordinary forgetfulness.

b) The disturbance does not occur exclusively during the course of dissociative identity disorder, dissociative fugue, post traumatic stress disorder, acute stress disorder, or somatization disorder & is not due to direct physiological effects of a substance or other medical condition.

c) The symptoms cause clinically significant disturbance or impairment in social, occupational, or other important areas of functioning.

Types of dissociative amnesia:

Localized Events of a particular time.

Selective Recall some but not all events of a particular time.

Generalized Entire life.

Continuous Events subsequent to a specific time, upto & including the present.

systematized Certain categories of information.

Dissociative fugue

Dissociative fugueUnexpected travel away from home & customary

workplace, the assumption of a new identity, & inability to recall the previous identity.

They set up a new life in some distant place as a seemingly different person.

Precipitated by intolerable stressors.After “waking up” the person has no memory of

events during fugue.Patients may appear normal during fugue, they are

brought to experts due to amnesia of recent event or lack of awareness of personal identity.

DSM criteriaa) The predominant disturbance is sudden,

unexpected travel away from home or one’s customary place of work, with inability to recall one’s past.

b) Confusion about personal identity or assumption of new identity.

c) The disturbance does not occur exclusively during the course of dissociative identity disorder & is not due to direct physiological influence of substance or general medical condition.

d) The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

Dissociative identity disorder

Dissociative identity disorder

Formerly known as multiple personality disorder.

Most dramatic & very famous in literature.

Individual assumes alternate personalities.

Each personality has its own set of memories & typical behavior.

DSM criteriaa) The presence of 2 or more distinct identities or

personality states(each with its own relatively enduring pattern of perceiving, relating to, & thinking about the environment & the self.)

b) At least 2 of these identities or personality states recurrently take control of person’s behavior.

c) Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

d) The disturbance is not due to direct physical effects of a substance or general medical condition.

NOTE:- In children, symptoms are not attributed to imaginary playmates or other fantasy.

Depersonalization disorder

Change of self perception. Temporary loss or change in one’s sense of reality.

Individual feels of not being in complete control of his actions. He says: “ I feel as if I’m in dream.” “I feel I’m doing this mechanically.”

DSM criteriaPersistent experience of feeling detached from, & as

if one is outside observer of one’s mental processes or body.

Reality testing remains intact during experience of depersonalization.

It causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The experience does not occur exclusively during the course of other mental disorder, such as schizophrenia, panic disorder, or other dissociative disorder & is not due to effect of substance or general medical condition.

Dissociative disorder N.O.S.

…Dissociative disorder N.O.S.

In this disorder, predominant feature is of dissociative disorder but does not meet the criteria of any specific one.

Some examples are :- - clinical presentations similar to dissociative

identity disorder that fails to meet full criteria of it.

- dissociative trance disorder . - ganser syndrome

Causes of dissociative disordersTrauma : most often form in children

subjected to chronic physical, sexual or emotional abuse or, a home environment that is otherwise frightening or highly unpredictable.

Treatment to dissociative disordersCreative art therapy. Cognitive therapy. Medication.  antidepressants,anti-anxiety medications or

tranquilizers.

References • Sarason , I.G. & Sarason, B. R.

(1993). Abnormal Psychology; The Problem of Maladaptive . Behaviour. New Jersey: Prentice Hall.

• DSM IV (TR), Diagnostic Statistical Manual of Mental Disorder DSM-IV TR, American Psychological Association; Jaypee publication.