Psychology 2310A/B Lecture Notes - Hypochondriasis, Personality Disorder, Malingering

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Dissociative Disorders
The Dissociation Continuum
Dissociation: a disruption in the usually integrated functions of consciousness, memory,
identity, or perception
Mild dissociation is very common
oE.g., déjà vu, absorption, daydreaming
Continuum of “dissociative ability”
Related to hypnotic susceptibility (some people are more easily hypnotized than others),
Dissociative Experiences Scale (DES)
Can become a defense mechanism  way of coping with stress, trauma, negative
emotions, etc
oSomeone who has been in a bad car accident, if they are high in dissociative
ability, they may be able to forgot the accident even happened or ignore it
Historical rise and fall of interest in dissociation
oLate 1800s – high; early 20th C – low; 1980s, 90s – high
oToday – 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
Changes in DSM-5
Dissociative Identity Disorder
Dissociative Amnesia
oDissociative Fugue no longer a separate diagnosis
oFugue is now a subset of dissociative amnesia
Depersonalization/Derealization Disorder
Dissociative Amnesia
Person is unable to recall important personal information
oTypically people cant remember who they are, their name, where they’re from,
who their family is, etc
Amnesia is usually for autobiographical memory – not general knowledge
oCan typically still name the prime minister of Canada, etc
Usually after a very stressful experience
Information is not permanently lost
oOften remits spontaneously after a few days
oBut can occasionally become chronic or recurrent (especially during times of
Ct. organic amnesia resulting from damage to the brain (hippocampus)
oNo distinction between autobiographical memory and general knowledge
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oPeople with organic amnesia will have difficulty forming new memories after a
certain point
oWith dissociative amnesia, people can form new memories
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 ones past (taking up a
new identity in a different place)
Confusion about personal identity or assumption of a new identity otherwise seems
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
oMan from Canada, showed up in Denver with no memory of his past
oDiagnosed with disassociate fugue
oNever recovered memories from his earlier life
oHad a previous experience with dissociative fugue, for 9 months
Depersonalization Disorder
Not quite as extreme as other dissociative disorders (much more common)
Frequently feeling detached from one’s mental processes or body
Feeling like “in a dream”
Reality testing remains intact
Significant distress or impairment resulting from depersonalization disorder
Numbness, “Derealization” (sense of being in a dream, world doesn’t feel real)
A common experience at mild levels (50%)
Adolescence; life-threatening trauma; life stress
Also common symptom of other disorders – eg, PTSD, depression, panic disorder
oThird most common symptom of all mental disorders (1st and 2nd anxiety and
depression, respectively)
Somatoform Disorders
Soma = body
Physical symptoms not explained by a medical condition
Different froms:
oPsycho physiological conditions (“psychosomatic” illnesses)
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