Dissociative Disorders (Exam 2) Flashcards Preview

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Flashcards in Dissociative Disorders (Exam 2) Deck (55):
1

What is the definition of dissociation and a continuum of experience?

separation of part of the person's consciousness or identity from the central identity

ex: day dreaming

2

What are the features of dissociative disorders?

-common with extreme anxiety (traumatically induced)
-individual experiences an alteration of experience or identity
-disturbance in memory of events occurring dissociation period

3

What are the adaptive features of dissociative disorders?

-on low end
-extreme end

4

What is the low end of adaptive features of dissociative disorders?

-deal with boredom
-self-stimulation
-fantasy

5

What is on the extreme end features of dissociative disorders?

-escape from reality that is too overwhelming to deal with
-"go off into own world"

6

What is the diagnostic criteria for depersonalization/derealization disorder?

persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental process or body

7

What happens during a depersonalization experience?

reality testing remains intact

8

What does depersonalization cause?

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

9

What are the clinical features of depersonalization disorder?

derealization

10

What happens during derealization?

-whole world seems unreal
-loss of sense of reality
-not "just spacing out"

11

Is derealization distressing to the person?

yes

12

Is derealization common in aspects of dissociative and anxiety disorders?

yes

13

Is derealization a "near death experience"?

no

14

What is the diagnostic criteria for dissociative amnesia?

-one or more episodes of inability to recall important personal info
-not induced organically

15

What is Amnestic Disorder Due to a General Medical Condition called?

Amnesia from a brain injury (organically)

16

What are the clinical features of dissociative amnesia?

- a lot of confabulation
-memory for these periods is accessible under hypnosis (controversial)
-recovery is usually very sudden and natural (spontaneous remission)

17

What is a specifier for dissociative amnesia?

dissociative amnesia with dissociative fugue

18

What is the definition of dissociative amnesia with dissociative fugue?

sudden, unexpected and unexplained travel from one's customary place of work

19

What happens during sudden, unexpected and unexplained travel from one's customary place of work?

-inability to recall one's past
-confusion about personal identity or assuming a new identity
-usually follows some serious pathological stress
-usually lasts a short period of time

20

What is the diagnostic criteria for dissociative identity disorder?

-alter personalities

-switches and changes seen

-2 or more identities/personality states recurrently take control of person's behavior

-inability to recall important personal info that is too extensive to be explained by ordinary forgetfulness

21

What are alter personalities?

-presence of 2 or more distinct identities or personality states
-each has it's own pattern of perceiving, relating to, and thinking about the environment and self

22

What happens during switching?

-changing from one alter to another
-may or may not be consciously done by the individual
-may be triggered by environmental stressor
-can see physical change (ex: posture, facial expressions)

23

What are the symptoms/behaviors associated with DID?

-anxiety
-depressed mood
-severe headaches
-memory disturbance
-loss of time, blackouts
-confusion
-disorientation

24

What do you need to differentiate DID from?

-schizophrenia (different problems w/different treatments)
-bipolar disorder (scattered thoughts of mania)
-depression (w/psychotic features)
-borderline personality disorder
-alcohol and other drug dependence

25

What is the etiology of DID?

childhood trauma

26

What are the general rates of DID with child abuse history?

-98% of DID suffers have been abused
-83% are survivors of child sexual abuse
-67% experienced extreme neglect or abandonment as a child

27

What is often seen a client's history with DID?

-ritualistic abuse
-complex PTSD

28

What is ritualistic abuse?

-brutal form of abuse involving rituals over an extended period of time
-extremely painful, humiliating, and severe

29

What else is ritualistic abuse called?

complex PTSD

30

What are the behavioral theories of DID?

-behavioral position
-behavioral repertoire approach

31

What is the behavioral position for behavioral theories of DID?

-coping behaviors that are avoidance
-negatively reinforced by removing aversive psychological states

32

What is the behavioral repertoire approach for behavioral theories of DID?

DID "alters" (resurgence)

33

What is resurgence for the behavioral repertoire (DID)?

may be person reverting to behavioral repertoires that had reinforcing properties for the individual in past

34

What is the primary goal of DID treatment?

understanding and "integration" into one consistent self

35

What is psychodynamic therapy for DID treatment?

-uncover traumatic experience in childhood
-make it so client can tolerate having these experiences

36

What is behavioral therapy for DID treatment?

integrate behavioral repertoire so that one "self" is experienced across situations

37

What does behavioral therapy for DID treatment allow?

generalization and access to memories in other "states"

38

What is the general rule for DID treatment?

general rule about the person as a whole and being respectful of the individual personalities

39

What is the success of historic attempts to eliminate or destroy specific personalities?

attempts to eliminate or destroy specific personalities in client with DID have, historically, failed

40

What is the main controversy of DID?

-DID of questionable rarity
-may be commonly seen and valid diagnosis
-may not be as common as those people think and may not be a valid diagnosis

41

What is the questionable rarity of the controversy of DID?

-controversy as to whether it is more or less rare than originally thought
-controversy about validity of diagnosis

42

What are the reasons why DID may be commonly seen and a valid diagnosis?

-better criteria available for diagnosing the disorder
-growing belief in authenticity of DID as diagnosis
-incidence of DID may have been under reported

43

What are the reasons why DID may NOT be as common as those people think and may not be a valid diagnosis?

-may be "diagnosis of the year(s)" (zeitgeist issue)
-confirmatory bias
-changing rates (before book of Sybil in 1973, 40,000 after Sybil)

44

What is confirmatory bias? (controversy of DID)

find what you are looking for

45

What are the difficulties of memories and remembering?

people do not remember everything (some events are difficult/painful to recall)

46

What is repressed memory?

-Freudian and psychoanalytic concept
-memory (traumatic) event

47

What are recovered memories?

-possible to have forgotten material and then remember
-may be spontaneous
-may be recovered through therapy

48

Are memories reliable?

no
-subject to manipulation and change

49

What is false memory syndrome?

-high number of vivid but false memories
-often of abusive events during childhood
-experience these as very real (interesting emotions, convinced occurred)

50

What are the criticisms of recovered memories?

-recovered memories are highly detailed (contradicts most research on memory)

-therapists have agendas and look for confirming evidence of abuse histories (clients are encouraged to assume abuse occurred)

51

What are the legal ramifications of recovered abuse memories?

-can arrest alleged abuser/perpetrator
-can take custody from alleged abuser
-can sue alleged abuser for damages

52

Why do people believe/fake false histories?

-client is looking for answer to why they are troubled
-malingering
-factitious disorder

53

What is malingering?

-receiving external support
-Intentional production of false or grossly exaggerated physical or psychological symptoms
-Common with Antisocial Personality Disorder

ex: financial, work related

54

What is a factitious disorder?

-receiving psychological support (secondary gain)
-Munchausen's syndrome
-Intentional production or feigning of physical or psychological signs or symptoms

ex: "sick role"

55

What is factitious disorder imposed on another (aka factitious by proxy aka Munchausen’s by proxy)?

parents or others make up or produce physical illnesses in someone else