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This Concept Map, created with IHMC CmapTools, has information related to: Dissociative Disorders, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE AMNESIA -risk fx-childhood/domestic abuse, wars, natural disasters-defense mech -FM>M; 2-7% pop'n -correlate w/ hypnotizability -R/O malingering Other Sx: delirium, dementia -unclear consciousness -disorientation -mental confusion depression, anxiety depersonalization trance states analgesia spon age regression sexual dysfcn self-mutilation aggressive impulses suicidal impulses, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE AMNESIA -risk fx-childhood/domestic abuse, wars, natural disasters-defense mech -FM>M; 2-7% pop'n -correlate w/ hypnotizability -R/O malingering Clinical 2 presentations: 1. abrupt->ER 2. subtle deletion -abrupt, clear-cut onset -abrupt termination -rare recurrence -need processing/integration to avoid recurrence! -can ->suicide, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE AMNESIA -risk fx-childhood/domestic abuse, wars, natural disasters-defense mech -FM>M; 2-7% pop'n -correlate w/ hypnotizability -R/O malingering Can also be Dx'ed w/: -Conversion d/o -Mood d/o -Personality d/o, Dissociative Disorders -most common feature: memory loss DEPERSONALIZATION DISORDER Epidemiolgy-2.4% of pop'n -Sx seen in tumors, epilepsy, LSD -temporal lobe stimulation -risk fx: childhood abuse, witness violence (including domestic) -less severe trauma than other diss d/os. -50% pop'n has had 1(+) episode -preceded by stress -1/3-2/3 of ppl facing life-threatening stimuli, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE AMNESIA -risk fx-childhood/domestic abuse, wars, natural disasters-defense mech -FM>M; 2-7% pop'n -correlate w/ hypnotizability -R/O malingering Memory: -can be short-long term -can be denial->blockage -state-dependent learning -wait til threat neutralized to 'remember' -can be abrupt onset, Dissociative Disorders -most common feature: memory loss Dissociation NL Dissociation: "Hwy hypnosis" "Near death" experiences Reliance on skill interferes w/ fcn ->mental d/o, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE AMNESIA -risk fx-childhood/domestic abuse, wars, natural disasters-defense mech -FM>M; 2-7% pop'n -correlate w/ hypnotizability -R/O malingering Tx: psychotherapy + short-acting barbiturates OR SSRIs, benzodiazepines -not simply "retrieval" -unblocking hypnosis, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE FUGUE -due to ego-threatening fx -like DA -risk fx-during war, crisis -M>FM Tx: (like DA) PsychoTx, Rx, hypnoTx ->uncover, integrate reasons, Dissociative Disorders -most common feature: memory loss DEPERSONALIZATION DISORDER Persistent or recurrent feeling of detachment -outside observer of own mental processes FREE-STANDING Sx INTACT reality testing Distress/impairment NOT schizo, panic, etc., substance, medical NOT voluntary religious/cultural meditation, Dissociative Disorders -most common feature: memory loss Dissociation Correlation w/: Hypnotizability Absorptive ability (imaginal capacity), Dissociative Disorders -most common feature: memory loss DISSOCIATIVE IDENTITY D/O NOS Derealization not acc'd by depersonalization Dissociation due to COERCION while a captive, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE IDENTITY D/O -1-3% pop'n; FM>M; 30yo Dx age -risk: PROLONGED childhood abuse -1st deg relative -onset early adult: Sx to Dx=7 yrs -develops from ɞyo Tx: sim to DA -long-term psychoTx -hypnoTx ->foster integration -higher intelligence -better prognosis -overall good prognosis, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE IDENTITY D/O NOS DISSOCIATIVE TRANCE D/O -single or episodic disturbance indigenous to cultures/locales (amok-Indonesia, possession-India) -not broadly accepted in culture -narrowed awareness of surroundings or stereotyped mvmts beyond control -possession trance-replacement of identity by spirit, deity-involuntary mvmts, amnesia -loss of consciousness, stupor, coma -Ganser syndrome-give approx answers to ?s when not part of DA or fugue, Dissociative Disorders -most common feature: memory loss DEPERSONALIZATION DISORDER Tx: most don't respond well long-term psychoTx SSRIs, benzos, Dissociative Disorders -most common feature: memory loss Dissociation Defense mechanism -rely on dissociation when no other recourse available -high freq ppl abused as kids -may have never developed unitary sense of selves ->confusion, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE IDENTITY D/O -1-3% pop'n; FM>M; 30yo Dx age -risk: PROLONGED childhood abuse -1st deg relative -onset early adult: Sx to Dx=7 yrs -develops from ɞyo 2+ distinct identities -each w/ own pattern of: Perceiving, Relating to, Thinking about self and env 2+ of these identities take CONTROL -recurrent Inability to recall imp't personal info -Almost all have DA NOT substance, medical, imagination (imagination NL in 50% yo), Dissociative Disorders -most common feature: memory loss DEPERSONALIZATION DISORDER Ass'd w/: May feel like automaton/robot -waking dream state Sensory anesthesias Lack of affective/emotional response Can't control actions/speech Sense of derealization Acc'd by dizziness, anxiety, fear, depression Macropsia (world appears big) or micropsia High hypnotizabilty, dissociative capacity, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE IDENTITY D/O -1-3% pop'n; FM>M; 30yo Dx age -risk: PROLONGED childhood abuse -1st deg relative -onset early adult: Sx to Dx=7 yrs -develops from ɞyo Clinical: -highly hypnotizable -high absorptive, dissociative states -can flashback (like PTSD) -often self-mutilation, suicidal -can haer voices WITHIN mind -often w/ somatization -conversion or pain-blocking -pseudo- or hysterical seizures or pregnancies -psychogenic numbing -organic dysfcn -BPD-like: self-mut, impulsive, identity confusion -differences in physio, psych fcn -can have HAs, IBD, asthma, sex dysfcn, Dissociative Disorders -most common feature: memory loss DISSOCIATIVE IDENTITY D/O -1-3% pop'n; FM>M; 30yo Dx age -risk: PROLONGED childhood abuse -1st deg relative -onset early adult: Sx to Dx=7 yrs -develops from ɞyo Comorbidities -anxiety, mood, substance abuse, eating, sleeping, sexual dysfcn, PTSD, BPD, somatiform, Dissociative Disorders -most common feature: memory loss Dissociation False Memory Syndrome -not Dx -can result from implanted memories by therapists DON'T FILL IN THE BLANKS W/ PROJECTED MEMORIES!