First Aid: Dissociative Disorders Flashcards Preview

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Flashcards in First Aid: Dissociative Disorders Deck (40)
1

List some examples of dissociative disorders.

Dissociative amnesia
Dissociative fugue
Dissociative identity disorder
Depersonalization disorder

2

True or false: dissociative disorders are NEVER due to an underlying medical condition or substance use.

TRUE

3

Amnesia is a prominent symptom in all dissociation disorders except which?

Depersonalization disorder

4

What specific condition is required for the diagnosis of dissociative amnesia?

Amnesia is the ONLY dissociative symptom present

5

What is the DSM-IV criteria for diagnosis of dissociative amnesia?

-At least 1 episode of inability to recall personal information, usually involving a traumatic or stressful event
-The amnesia cannot be explained by ordinary forgetfulness
-Symptoms cause significant distress or impairment in daily functioning and cannot be explained by another d/o, medical condition or substance abuse

6

Are people with dissociative amnesia usually aware of their deficits?

YES: they are aware they are having difficulty remembering but are not troubled by it

7

What types of things do people with dissociative amnesia forget?

things like their name but can remember obscure details

8

In what gender is dissociative amnesia more common?

women

9

In what age group is dissociative amnesia more common?

younger adults

10

What are the common comorbidities with dissociative amnesia?

-MDD
-Anxiety disorders

11

What is the prognosis for dissociative amnesia?

-Many return to normal abruptly after minutes or days
-Recurrences are uncommon

12

What is the treatment for dissociative amnesia?

-Help patients retrieve lost memories to prevent future recurrences
-Subsequent psychotherapy

13

What drugs may help a patient with dissociative amnesia talk in an interview?

Hypnosis or sodium amobarbital or lorazepam

14

What is the risk in using sodium amobarbital?

respiratory depression

15

What is the word for the strong reaction that patients often get when retrieving traumatic memories?

Abreaction

16

What is the most common dissociative disorder?

dissociative amnesia

17

What is the DSM-IV criteria for diagnosing dissociative fugue?

-Sudden unexpected travel away from home or work plus inability to recall one's past
-Confusion about personal identity or assumption of new identity
-Not due to dissociative identity disorder or the physiological effects of a substance or medical d/o
-Symptoms cause impairment in social or occupational functioning

18

What is a major difference between dissociative amnesia and dissociative fugue?

those with dissociative fugue are not aware that they have forgotten anything

19

What are the major predisposing factors for dissociative fugue?

-Heavy use of alcohol
-Major depression
-History of head trauma
-Epilepsy

20

What is the trigger for dissociative fugue?

-Stressful life event (life stressor or personal conflict)

21

How long do fugues usually last?

A few hours to several days (but may last longer)

22

What usually happens after a fugue?

Person will assume his or her old identity without ever remembering the time of the fugue

23

How do you treat dissociative fugue?

same as dissociative amnesia

24

What is the DSM-IV criteria for diagnosing dissociative identity disorder (multiple personality disorder)?

-Presence of 2 or more distinct identities
-At least 2 of the identities recurrently take control of the person's behavior
-Inability to recall personal information of when personality when the other is dominant
-Not due to effects of substance or medical condition

25

Can a pt with dissociative identity disorder remember events that occur when an alternate personality is present?

not usually

26

What gender more commonly has dissociative identity disorder?

Women (more than 90%)

27

What is a commonality between the pasts of most patients with dissociative identity disorder?

Prior trauma (especially childhood physical or sexual abuse)

28

What is the average age of diagnosis for dissociative identity disorder?

30

29

What are the common comorbidities of dissociative identity disorder?

-MDD
-Anxiety disorders
-Borderline personality disorder
-Substance abuse
-Suicide (up to 1/3 of patients commit suicide)

30

What is the prognosis for dissociative identity disorder?

-Usually chronic course with incomplete recovery
-Worst prognosis of all dissociative disorders
-Earlier the onset, worse the prognosis

31

What is the treatment for dissociative identity disorder?

-Hypnosis
-Drug-assisted interviewing
-Insight-oriented psychotherapy

32

What is the DSM-IV diagnostic criteria for depersonalization disorder?

-Persistent or recurrent experiences of being detached from one's body or mental process
-Reality testing remains intact during episode
-Causes social/occupational impairment, and cannot be accounted for by another mental or physical disorder

33

What is required for diagnosis of depersonalization disorder (as far as timeline)?

Episodes are recurrent or persistent

34

Is depersonalization ever normal?

yes! during times of stress

35

Are those with depersonalization disorder aware of their symptoms?

yes (fear they are going crazy)

36

What are common comorbid feelings in depersonalization disorder?

Anxiety
Panic
MDD

37

What is the gender difference in depersonalization disorder?

women 2X more common

38

What is the average age of onset in depersonalization disorder?

between 15 and 30

39

What is usually the trigger for depersonalization disorder?

severe stress

40

What is the prognosis for depersonalization disorder?

-usually chronic (with steady or intermittent course)
-may remit without treatment