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Psychology 2310A/B
Rod Martin

Dissociative Disorders The Dissociation Continuum Dissociation – a disruption in the usually integrated functions of consciousness, memory, identity, or perception Mild dissociation is very common - E.g., déjà vu, absorption, daydreaming Continuum of “dissociative ability” Related to hypnotic susceptibility, absorption Dissociative Experiences Scale (DES) Can become a defense mechanism – way of coping with stress, trauma Historical rise and fall of interesthin dissociation Late 1800s – high; early 20 C – low; 1980s, 90s – high Today – low again (over-diagnosis, exaggerated claims, false memory syndrome). Dissociative Disorders in DSM-IV Dissociative Amnesia Dissociative Fugue Dissociative Identity Disorder (DID) (previously Multiple Personality Disorder) Depersonalization Disorder Dissociative Amnesia Person is unable to recall important personal information Amnesia is usually for autobiographical memory – not general knowledge Usually after a very stressful experience Information is not permanently lost Often remits spontaneously after a few days But can occasionally become chronic or recurrent Ct. organic amnesia Types of Amnesia Localized – loss of memory for circumscribed period of time Selective – some but not all events during specific time period Generalized – loss of memory for entire life Continuous – loss of memories subsequent to a specific time up to the present Systematized – specific categories of information (eg, particular person). Dissociative Fugue Sudden, unexpected travel away from home with inability to recall one’s past Confusion about personal identity or assumption of a new identity – otherwise seems normal Can last for hours to months to years Usually associated with life stress Typically spontaneous, rapid recovery Relatively rare (0.2 %) Often comorbid with mood disorders, substance abuse Case of Jeff Ingram – video Depersonalization Disorder Frequently feeling detached from one’s mental processes or body Feeling like “in a dream” Reality testing remains intact Significant distress or impairment Numbness, “derealization” A common experience at mild levels (50%) Adolescence; life-threatening trauma; life stress Also common symptom of other disorders – eg, PTSD, depression, panic disorder Somatoform Disorders Somatoform Disorders Soma = body Physical symptoms not explained by a medical condition Different from: Psychophysiological conditions (“psychosomatic” illnesses) Malingering Factitious Disorders Thorough medical examination essential for diagnosis Medically unexplained syndromes are very common – although rarely diagnosed as somatoform disorders unless evidence of contributing psychological factors Somatoform Disorders in DSM-IV Conversion disorder Somatization disorder Pain disorder Body dysmorphic disorder Hypochondriasis Conversion Disorder Freud – “conversion hysteria” One or more symptoms affecting voluntary motor or sensory function Symptoms mimic a neurological condition E.g., blindness, paralysis, seizures, visceral Failure to conform to physiological patterns Often stress-related “la belle indifférence” – once thought to be a diagnostic sign Lifetime prevalence between 1% and 3% Women > Men Late childhood to early adulthood A case of conversion disorder in a dog (!) Should it be classified as a dissociative disorder? Somatization Disorder Numerous different physical complaints over several years (beginning before age 30) affecting multiple organ areas 4 pain symptoms in different
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