Flashcards in Dissociative Disorders (Exam 2) Deck (55):
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
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
What are the adaptive features of dissociative disorders?
-on low end
What is the low end of adaptive features of dissociative disorders?
-deal with boredom
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"
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
What happens during a depersonalization experience?
reality testing remains intact
What does depersonalization cause?
clinically significant distress or impairment in social, occupational, or other important areas of functioning
What are the clinical features of depersonalization disorder?
What happens during derealization?
-whole world seems unreal
-loss of sense of reality
-not "just spacing out"
Is derealization distressing to the person?
Is derealization common in aspects of dissociative and anxiety disorders?
Is derealization a "near death experience"?
What is the diagnostic criteria for dissociative amnesia?
-one or more episodes of inability to recall important personal info
-not induced organically
What is Amnestic Disorder Due to a General Medical Condition called?
Amnesia from a brain injury (organically)
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)
What is a specifier for dissociative amnesia?
dissociative amnesia with dissociative fugue
What is the definition of dissociative amnesia with dissociative fugue?
sudden, unexpected and unexplained travel from one's customary place of work
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
What is the diagnostic criteria for dissociative identity disorder?
-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
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
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)
What are the symptoms/behaviors associated with DID?
-loss of time, blackouts
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
What is the etiology of DID?
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
What is often seen a client's history with DID?
What is ritualistic abuse?
-brutal form of abuse involving rituals over an extended period of time
-extremely painful, humiliating, and severe
What else is ritualistic abuse called?
What are the behavioral theories of DID?
-behavioral repertoire approach
What is the behavioral position for behavioral theories of DID?
-coping behaviors that are avoidance
-negatively reinforced by removing aversive psychological states
What is the behavioral repertoire approach for behavioral theories of DID?
DID "alters" (resurgence)
What is resurgence for the behavioral repertoire (DID)?
may be person reverting to behavioral repertoires that had reinforcing properties for the individual in past
What is the primary goal of DID treatment?
understanding and "integration" into one consistent self
What is psychodynamic therapy for DID treatment?
-uncover traumatic experience in childhood
-make it so client can tolerate having these experiences
What is behavioral therapy for DID treatment?
integrate behavioral repertoire so that one "self" is experienced across situations
What does behavioral therapy for DID treatment allow?
generalization and access to memories in other "states"
What is the general rule for DID treatment?
general rule about the person as a whole and being respectful of the individual personalities
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
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
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
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
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)
-changing rates (before book of Sybil in 1973, 40,000 after Sybil)
What is confirmatory bias? (controversy of DID)
find what you are looking for
What are the difficulties of memories and remembering?
people do not remember everything (some events are difficult/painful to recall)
What is repressed memory?
-Freudian and psychoanalytic concept
-memory (traumatic) event
What are recovered memories?
-possible to have forgotten material and then remember
-may be spontaneous
-may be recovered through therapy
Are memories reliable?
-subject to manipulation and change
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)
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)
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
Why do people believe/fake false histories?
-client is looking for answer to why they are troubled
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
What is a factitious disorder?
-receiving psychological support (secondary gain)
-Intentional production or feigning of physical or psychological signs or symptoms
ex: "sick role"