Disassociative d/o
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| Dissaociative d/o | significant adverse experiences- interruption of consciousness
Unconscious defense mechanism-Protects individual against overwhelming anxiety through emotional separation
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| Dissaociative d/o | Disturbances in integration of consciousness, memory, identify, and perception, Dissociation is unconscious d/t anxiety
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| Prevalence | Unknown: estimated from 5%-20% among psychiatric patients
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| Comorbidity | PTSD, borderline personality disorder (BPD), childhood sexual abuse, attention deficit disorder
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| Depersonalization/derealisation disorder— | This disorder is characterized by feeling that the person is detached from the body- observing themselves at a distance.
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| Dissociative amnesia | –inability to recall important personal information, usually of a traumatic or stressful event. Cannot be explained by normal forgetfulness.
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| Dissociative identity disorder– | the presence of 2 or more distinct personality states that recurrently take control of behavior.
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| Subtype : dissociative fugue- | sudden unexpected travel away from customary locale and inability to recall one’s identity and information about some or all of the past.
Usually precipitated by a traumatic event.
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| Genetics Dissociative identify disorder | more common in first-degree relatives of individuals with this disorder.
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| Cultural considerations- | high level of activity, a trancelike state, and running or fleeing, followed by exhaustion, sleep, and amnesia regarding the episode. If they occur in in corresponding geographical areas –need to be differentiated from dissociative disorders.
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| Psychological factors- | disassociation is a primitive ego defense mechanism. Normal and emotional parts of personality not fully integrated.
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| Note signs of dissociative disorder | Changes in behavior, voice, and dress
referring to self by another name or in third person
Partial memory or memory gaps, Disorientation to time, place, person, Presence of blackouts
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| tools used | Dissociative Experience Scale (DES), Somatoform Questionnaire (SDQ), & the Dissociative Disorders Interview Schedule (DDIS).
Tools are an important part of assessment because the psychiatric interview can often miss dissociative symptoms.
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