Psychogenic amnesia or dissociative amnesia is a memory disorder characterized by sudden retrograde episodic memory loss, said to occur for a period of time ranging from hours to years. More recently, "dissociative amnesia" has been defined as a dissociative disorder "characterized by retrospectively reported memory gaps. These gaps involve an inability to recall personal information, Jun 15, · A personality disorder is a disorder involving a rigid and unhealthy pattern of thinking. Personality disorders are prevalent in the general population and more so in clinical populations. In the pediatric population, all personality disorders can be diagnosed, except antisocial personality disorder, as long as the pathologic behavior has been present for a year or more. The Diagnostic and A disorder in which a person suddenly and unexpectedly leaves home, fails to remember the past, and becomes confused about his or her identity. Dissociative identity disorder. A disorder in which a person fails to remember important personal information and has two or more identities or personality states that control behavior. It is also
Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder
Try out PMC Labs and tell us what you think. Learn More. Some of these diagnoses, particularly dissociative identity disorder, are controversial and have been questioned by many clinicians over the years. Prevalence of dissociative disorders is unknown, but current estimates are higher than previously thought.
This paper reviews clinical, phenomenological, and epidemiological data regarding diagnosis in general, and illustrates possible treatment interventions for dissociative identity disorder, with a focus on psychotherapy interventions and a review of current psychopharmacology recommendations as part of a comprehensive multidisciplinary treatment plan, literature review of effective treatment for dissociative identity disorder.
Dissociative disorders DDs were first recognized as official psychiatric disorders in with the publication of the Diagnostic and Statistical Manual literature review of effective treatment for dissociative identity disorder Mental Disorders, Third Edition DSM III in The existence of dissociative disorders is questioned by many in the field of psychiatry, and the diagnosis is not utilized by some clinicians.
Some research within the past five years indicates that DD consist of psychiatric symptoms that are severe and disabling, resulting in high utilization of community resources. Dissociative symptoms are not merely failures of normal neurocognitive functioning, they are also perceived as disruptive, because there is a loss of needed information or as discontinuity of experience.
Once the individual has learned to dissociate in the context of trauma, he or she may subsequently transfer this response to other situations and it may be repeated thereafter arbitrarily in a wide variety of circumstances. Patients who receive treatment interventions that address their trauma-based dissociative symptoms show improved functioning and reduced symptoms.
She reported being punched, kicked, hit, and whipped with extension cords, literature review of effective treatment for dissociative identity disorder.
She also indicated that he abused alcohol and drugs, and enlisted Ms. B to sell drugs for him at a very early age. Her acute symptoms at the time of admission to the clinic were panic attacks, exaggerated startle response, claustrophobia, literature review of effective treatment for dissociative identity disorder, and self-injurious behavior, which consisted of cutting her abdomen and arms.
After being in weekly psychotherapy with for six months, Ms. B was struggling with what to discuss in the room; she had reported in previous sessions that she used drawing as an outlet to cope with her anxiety and stress so it was recommended she sketch or write her thoughts on paper as a conduit to further discussion and exploration.
After several literature review of effective treatment for dissociative identity disorder, Ms. B suddenly stopped drawing and was very still. B did not respond when her name was called. You can talk to me any time you like.
B: Tom did bad stuff to me. He took me downstairs and showed me lots of guns. B: He touched me down there. You are safe here; no one will hurt you when you are here. Tom was being bad. He hurt you and so did your mom. When dissociation occurs in combination with the following symptoms, the diagnosis of dissociative identity disorder should be considered.
See Table 1 for a list of diagnostic characteristics. Two or more distinct identities or personality states each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self are present. Inability to recall important literature review of effective treatment for dissociative identity disorder information that is too extensive to be explained by ordinary forgetfulness is present.
The disturbance is not due to the direct physiological effects of a substance e. blackouts or chaotic behavior during alcohol intoxication or a general medical condition e. In children, the symptoms are not attributable to imaginary playmates or other fantasy play. Adapted from Spiegel D, Loewenstein RJ, Lewis-Fernandez R, et al. Dissociative disorders in DSM Depress Anxiety. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.
Washington, DC: American Psychiatric Press, Inc. Dissociative identity disorder DID is a controversial diagnosis within the mental health profession. There is an inability to recall important personal information which is too great to be explained by ordinary forgetfulness. It is a complex disorder consisting of posttraumatic, somatoform and depressive symptoms, as well as a variety of dissociative symptoms.
The individual personality states present in DID may be very different from literature review of effective treatment for dissociative identity disorder another. They may have different names, ages, moods, and functions. The primary personality usually has no recall of alternate identities; the alternate identities or personalities may have some awareness of each other. It is common for one alter personality to hold a central role and be aware of and familiar with all of the others, literature review of effective treatment for dissociative identity disorder.
Because dissociation frequently co-occurs with severe anxiety and depressive symptoms, it is understandable that the psychiatrist may be focused on the accompanying pathology and inadvertently omit or fail to consider the diagnosis of DID. The patient experiencing dissociation may be unlikely to report episodes of memory loss unless asked directly during a clinical interview due to embarrassment of the symptoms or the resultant consequences.
According to Coons, 1 altered personality states are less likely to occur while in the room with the psychiatrist, possibly due to decreased level of stress in this setting or alternatively because the psychiatrist is not inquiring about such symptoms. Directed questions may include inquiring about lapses in memory, reports of abnormal behavior by those close to the patient, or finding objects or possessions the patient cannot recall acquiring.
Experts in DID believe that a psychiatrist should not make the diagnosis unless the dissociation is observed or a change from one personality to another occurs in the room.
In addition, the altered states should be consistent in their presentation. Signs of a switch to an altered state include trancelike behavior, eye blinking, eye rolling, and changes in posture. Switching is frequently associated with a high level of stress, and may be associated with severe symptoms of depression, extreme anger, or sexual stimulation.
Childhood trauma, and in particular sexual or physical abuse, is nearly always present in individuals with DID. Myrick et al 5 reported that although most studies consist of patients 35 years or older, younger patient populations reported significant dissociative symptoms and destructive behaviors but were less likely to be diagnosed with dissociative disorders.
Although DID may occur in patients under the age of 18 years, it is most commonly diagnosed in patients in their third or fourth decade of life. Early maltreatment experiences can produce various outcomes; this is a multifactorial process, which will be managed differently by individuals based on many elements including but not limited to attachment styles, social supports, and quality and severity of the maltreatment.
The age of the individual at the time of the abuse is also a critical component due to the developmental processes that, under other circumstances, would normally occur at that time.
and should influence which developmental tasks are most disrupted. During infancy and toddler years, literature review of effective treatment for dissociative identity disorder, the major developmental tasks are as follows: Because children at these early stages have such limited coping and self-regulatory capability, they are easily overwhelmed. Core development for preschoolers ages years involves integration of self within social context and norms.
The child begins to develop an understanding of reality and often uses denial as a coping strategy. The capacity for dissociation increases significantly during these years, and this may be related to the introduction of the use of fantasy and imagination. Abuse during this time disrupts self- regulation of emotion as well as early organization of self-perception. One theory is that maltreatment during preschool years is correlated with increased use of denial and dissociation as core coping strategies.
The shot will not hurt. The elementary years involve tasks such as further development of self, including psychological characteristics i. Maltreatment during these years disturbs socialization and causes the individual to experience guilt, shame, and confusion.
Adolescence brings physical growth and change including puberty, which involves major psychological readjustments.
The focus of same-sex friendships converts to opposite-sex exploration of intimacy and mutuality. Maltreatment is complicated by the disruption of the defining of self as well as the increased opportunity for maladaptive coping, such as substance use, sexual acting out, and other risk taking and self-destructive behaviors.
For the psychiatrist, it is important to be cognizant that maltreatment during developmental years is strongly correlated with relationship dysfunction, especially for female victims in the context of incest.
Emotional dysregulation occurs frequently in this subset and may be the precipitant of psychiatric treatment. I feel as though I were looking at the world through a fog so that people and things seem far away or unclear. I act so differently from one situation to another that it is almost as if I were two different people. Information provided in Table 2 delineates the differences between the criteria for DID and the proposed revisions for the upcoming fifth edition of the DSM to be published in May of Proposed criteria for dissociative identity disorder This disruption may be observed by others, or reported by the patient.
Inability to recall important personal information, for everyday events or traumatic events, that is inconsistent with ordinary forgetfulness. Causes clinically significant distress and impairment in social, occupational, or other important areas of functioning.
The disturbance is not a normal part of a broadly accepted cultural or religious practice and is not due to the direct physiological effects of a substance e. blackouts or chaotic behavior during Alcohol intoxication or a general medical condition e.
complex partial seizures. Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play. Specify if A with nonepileptic seizures or other conversion symptoms, B with somatic symptoms that vary across identities excluding those in Specifier A.
These specifiers are under consideration. C was a year-old woman with DID who was status-post motor vehicle accident during childhood wherein she suffered minor literature review of effective treatment for dissociative identity disorder injuries but witnessed the death of both parents.
Subsequently, she spent the remainder of her developmental years in foster homes and reported multiple incidents of sexual abuse during this time. C did not smoke tobacco nor did she drink alcohol or use other substances.
However, she shared that sometimes she knew that she had dissociated into one of the alter personalities who drank, because she found empty beer cans in her home, literature review of effective treatment for dissociative identity disorder.
C often came to sessions with bruises, scrapes, and swollen knuckles, but did not know how or where she incurred the injuries. She also had phone numbers of people that she did not recognize saved in her phone. One of the most important interventions during the treatment was to reframe the DID as a positive, rather than a negative.
Reframing the dissociation helped establish a deeper level of trust in the therapeutic alliance. Expressing empathy, compassion, and nonjudgment was also very important to counter the negative experiences the patient had with past treatment providers.
When treating patients with DID, much time will be spent literature review of effective treatment for dissociative identity disorder different alter personalities and identifying the role each plays in the system.
The Long Haul - Treating Dissociative Disorders
, time: 18:12Psychogenic amnesia - Wikipedia
A disorder in which a person suddenly and unexpectedly leaves home, fails to remember the past, and becomes confused about his or her identity. Dissociative identity disorder. A disorder in which a person fails to remember important personal information and has two or more identities or personality states that control behavior. It is also Psychogenic amnesia or dissociative amnesia is a memory disorder characterized by sudden retrograde episodic memory loss, said to occur for a period of time ranging from hours to years. More recently, "dissociative amnesia" has been defined as a dissociative disorder "characterized by retrospectively reported memory gaps. These gaps involve an inability to recall personal information, Aug 29, · Introduction. This paper presents a comprehensive review of current literature on human trafficking into and within the United States. This review of the literature is part of a larger study funded by the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation, to examine how HHS programs are currently addressing the needs of
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