Dissociative Disorders

Question 1

Define Amnesia

Answer 1

inability to remember events of a specific & significant block of time that has passed

(retrograde, anterograde, or transiet global)

Question 2

Define depersonalization

Answer 2

Feeling detachment or disconnection from one’s body (watching your body from a corner of the room)

(they retain insight and lose affective response)

Question 3

During depersonalization _______ is retained but _______ response is lost

Answer 3

• Insight
• affective

Question 4

Define derealization

Answer 4

A sense that one’s surroundings (or familiar people) are strange or unreal; perceptual distortions

Question 5

Define identity confusion

Answer 5

feelings of uncertainty, puzzlement or conflict about one’s identity

Question 6

Define identity alteration

Answer 6

Behaviors indicating the Assumption of different identities (i.e. DID)

(this is objective, identity confusion is subjective)

Question 7

Retrograde amnesia is _______and Anterograde Amnesia is the ______.

Answer 7

• Loss of prior memories
• Inability to make new memories

(transient global amnesia is both)

Question 8

Define transient global amnesia

Answer 8

Sudden onset of antara grade and retrograde amnesia for recent events preceding symptoms

(often an isolated event)

Question 9

_______ (3 events) may cause transient global amnesia

Answer 9

1. Valsalva maneuver
2. Sexual intercourse
3. Strong emotion

(association with familial predisposition for migraines)

Question 10

Damage to the temporal lobe and hippocampus can cause either retrograde amnesia or anterograde amnesia. Which area, if damaged, will cause anterograde amnesia only?

Answer 10

Basal forebrain

(this structure produces acetylcholine → assist cells and storing new information during learning)

Question 11

What is the function of acetylcholine in the basal forebrain (collection of structures located in the inferior region of the forebrain, near the midsagittal plane)?

Answer 11

Helps cells store new information during learning

Question 12

_______ (2 cognitive functions) remain intact with anterograde amnesia.

Answer 12

1. short-term working memory
2. procedural memories

(personality, intelligence and judment may also be uneffected)

Question 13

Functions of the medial temporal lobe that may be affected by anterograde amnesia

Answer 13

1. Storage and processing of declarative memory (facts)
2. Communicates with neocortex to establish and maintain long-term memories

Question 14

Function of the fornix that may be affected in anterograde amnesia

Answer 14

Carries information from the hippocampus to the limbic system and diencephalon

Question 15

Describe normal dissociation; which is a normal part of consciousness (2)

Answer 15

1. Daydreaming
2. Hypnosis and meditation

Question 16

Normal dissociation allows the mind to _______

Answer 16

process the events of daily life

(maladaptive dissociation interferes with function, is disstressful and may have many severe symptoms)

Question 17

What is the difference between dissociative amnesia and amnesia?

Answer 17

• Amnesia is the inability to remember events around a specific time
• Dissociative Amnesia is the inability to recall personal information (usually surrounding a traumatic event)

Question 18

Duration of dissociative amnesia

Answer 18

Minutes to days (or longer); 80% resolve w/in a week

(rapid onset)

Question 19

Patients with ______ (dissociative disorder) are typically confused and perplexed.

Answer 19

Dissociative Amnesia; may not be able to recall their own name

(anterograde amnesia also presents as disoriented and confused)

Question 20

Define dissociative Amnesia with dissociative fugue

Answer 20

• Apparently purposeful travel or bewildered wandering
• Associated with amnesia for identity/autobiographical information

Question 21

Differential diagnosis of dissociative Amnesia and dissociative fugue (3)

Answer 21

1. Neurological: brain tumor, injury, dementia
2. Substance use: intoxication/blackout
3. Malingering: for secondary gain

Question 22

Dissociative Amnesia treatment

Answer 22

Hypnosis or sodium amobarbital interview → recover memories

(no clear treatment is established; provide safe environment)

Question 23

Dissociative Identity Disorder: Dx criteria (3)

Answer 23

1. Disruption of identity caused by two or more distinct personality states (usually 7)
2. Gaps and recall of everyday events, personal information
3. Inability to recall important personal information (what’s going on in their family or at work)

Question 24

Dissociative disorders: prevalence

Answer 24

typically unknown; about 1.5% for DID in 12-month period

Question 25

Cause of DID

Answer 25

severe sexual & physical childhood abuse

Question 26

Other symptoms complaints not covered in the dx criteria: DID patients

Answer 26

1. headaches
2. amnesia
3. pseudohallucinations (from w/in the mind; they know they are hallucinating)

(70% also have Borderline PD)

Question 27

DID treatment (3)

Answer 27

1. long-term therapy
2. antidepressants (mood & anxiety sx)
3. periodic hospitalization

Question 28

_______ remains in tact in Depersonalization/Derealization Disorder.

Answer 28

reality testing (they are aware of what is going on)

Question 29

Depersonalization/Derealization Disorder: criteria dx

Answer 29

The presence of persistent or recurrent experiences of depersonalization, derealization, or both

(reality testing remains in tact)

Question 30

Depersonalization/Derealization Disorder: age of onset

Answer 30

adolescence - early adulthood

Question 31

Depersonalization/Derealization Disorder: duration of sx

Answer 31

hours - weeks

Question 32

Depersonalization/Derealization Disorder: triggered by (2)

Answer 32

1. substance use
2. stress

Question 33

Depersonalization/Derealization Disorder: treatment (2)

Answer 33

1. Trauma
2. Related Psych disorders