Dissociative Disorders

The most puzzling of the disorders. Part of the person’s personality is separated form the rest. This usually involves memory loss, and a complete, albeit temporary, change in identity. Rarely several distinct personalities can been seen in one person.

Dissociative Identity Disorder (Multiple Personality)

Key features: A person has several personalities that emerge at different times. EXTREMELY RARE! But the number of cases is on the rise. In true DID the personalities are distinct people, with their own names, identities, mannerisms, speaking voices, and even IQs!

May be seen through:

  • Various personalities don’t know they inhabit the same body.
  • Sometimes they know of the other people and make disparaging comments about them.
  • They usually are very different as if the various aspects of the person are represented by various personalities.
  • Almost always one of the personalities is a child.

DSM Criteria:

A. The presence of two or more distinct identities or personality states

B. At least two of these identities or personality states recurrently take control of the person’s behavior

C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness

D. Not due to a GMC or substance

Origins?

  • Childhood abuse – child copes with the abuse by assigning it to another person and thus dissociates themselves. 3/4ths of all MI cases have child abuse.
  • Prevalence of child personalities in DID seem to support this.
  • Some believe this is not real and it is an elaborate role play – but the various personalities have different blood pressure readings, different responses to medication, different allergies, different vision problems and different handedness, and maybe even brainwave patters.

Dissociative Amnesia

Key features– loss of memory for past events without a biological reason. Can be a defense mechanism. Is usual selective. Total amnesia is very rare.

  1. One or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness
  1. Not better explained by a another mental disorder and is not due to a GMC or substance
  1. Symptoms cause clinically significant distress or impairment in functioning

Dissociative Fugue

Extreme and rare, involves flight from home and the assumption of a new identity, with amnesia for past identity and events.

  1. Sudden, unexpected travel away from home or one’s customary place of work, with inability to recall one’s past
  2. Confusion about personal identity or assumption of a new identity (partial or complete)
  3. Not better explained by a another mental disorder and is not due to a GMC or substance
  4. Symptoms cause clinically significant distress or impairment in functioning

Depersonalization Disorder

Key features: Much more common, the person suddenly feels changed or different in a strange way. Common during adolescence and early childhood as our sense of self changes rapidly.

This may be seen by people feeling:

  • They have let their bodies
  • Actions are suddenly mechanical or dreamlike
  • A sense of losing control over one’s behavior
  1. Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one’s mental processes or body
  2. During the depersonalization experience, reality testing remains intact
  3. Not better explained by a another mental disorder and is not due to a GMC or substance
  4. Symptoms cause clinically significant distress or impairment in functioning

Causes

1. Biological factors: LSD elicits Dissociative experiences.

2. Psychological factors: Seem to involve an unconscious process. The loss of memory is real.

3. Social Factors: Trauma