Dissociation Disorders Flashcards
(26 cards)
What is dissociation?
A psychological defense mechanism involving a disruption in memory, identity, perception, or consciousness as a response to overwhelming stress or trauma.
What are dissociative disorders?
Disorders that occur when dissociation becomes severe, persistent, and impairs daily functioning.
What is the spectrum of dissociative experiences?
Ranges from mild experiences, like daydreaming, to severe conditions, such as Dissociative Identity Disorder.
Define derealization.
Feeling that the world is unreal, distant, or distorted.
Define depersonalization.
Feeling detached from oneself, like an outside observer.
What is amnesia in the context of dissociative disorders?
Gaps in memory that cannot be explained by normal forgetfulness.
What is identity confusion?
Uncertainty about personal identity, preferences, and life history.
What is identity alteration?
The presence of different identities or personality states.
What is dissociative amnesia?
Inability to recall important autobiographical information, usually following trauma or stress.
What are the types of dissociative amnesia?
- Localized: Memory loss for a specific traumatic event.
- Selective: Memory loss for certain aspects of a traumatic event.
- Generalized: Complete memory loss of personal identity or life history.
- Dissociative Fugue: Wandering away from home with amnesia for identity.
What is the management for dissociative amnesia?
- Supportive psychotherapy to help recover lost memories.
- Hypnosis or cognitive therapy in resistant cases.
- Avoid benzodiazepines.
Define depersonalization/derealization disorder.
Persistent or recurrent experiences of depersonalization, derealization, or both, while reality testing remains intact.
What are common triggers for depersonalization/derealization disorder?
- Severe stress
- Trauma
- Panic attacks
- Substance use.
What is the management for depersonalization/derealization disorder?
- Cognitive Behavioral Therapy (CBT).
- Grounding techniques.
- SSRIs if anxiety or depression is present.
Define Dissociative Identity Disorder (DID).
Presence of two or more distinct identities (‘alters’), accompanied by memory gaps and identity confusion.
What are signs of switching between identities in DID?
- Sudden change in voice, posture, facial expressions.
- Finding unfamiliar objects or notes.
- Unexplained memory gaps or time loss.
- Reports of ‘hearing voices’ inside the head.
What is the gold standard management for DID?
Phase-oriented therapy
* Stabilization
* Trauma Processing
* Integration & Rehabilitation.
What medications are used as adjunctive treatment for DID?
- SSRIs for depression and anxiety.
- Atypical antipsychotics for severe dissociative symptoms.
- Mood stabilizers for mood dysregulation.
What are other specified & unspecified dissociative disorders?
Dissociative symptoms that do not fully meet criteria for the above conditions, may include possession states or dissociative trance.
What are the primary causes of dissociative disorders?
- Severe childhood trauma
- Neurobiological changes
- High stress, neglect, and abuse.
What is the difference between dissociation and psychosis?
- DID involves internal voices; schizophrenia involves external hallucinations.
- DID has frequent amnesia; schizophrenia has no significant amnesia.
- DID maintains reality testing; schizophrenia has impaired reality testing.
What is the first-line management for dissociative disorders?
- Psychotherapy
- CBT
- Phase-Oriented Therapy for DID.
- Grounding techniques.
What is the role of pharmacological treatment in dissociative disorders?
Symptom-targeted treatment, including SSRIs, atypical antipsychotics, and mood stabilizers.
What are clinical considerations for healthcare settings regarding DID?
- Patients rarely report ‘multiple personalities’.
- They may report memory loss, hearing internal voices, or unexplained behaviors.
