Dissociative Disorders

Dissociative Disorders
By: Mena Shawky

Schizophrenia is not Dissociative Disorders
• Dissociative • Schizophrenia ‫الفُصام‬

Disorders • Impaired Reality testing
• ‫االضطرابات االنشقاقية‬ • Skhizein = to split
Phren = mind
Definition
• What is Dissociation?
• The separation/ disconnection of thoughts, feelings, memory, perception and even
identity from the normal stream of consciousness and memory
• Is there Normal dissociation?
• Yes,
• We all experience mild forms of normal dissociation
• For example: daydreaming, highway hypnosis or “getting lost” in a book or movie
• all of which involve “losing touch” with awareness of one’s immediate surroundings.
Dissociative symptoms as described in
DSM-5
Dissociative symptoms are experienced as
a) unbidden intrusions into awareness and
behavior, with accompanying losses of continuity in subjective experience (i.e., "positive"
dissociative symptoms such as fragmentation of identity, depersonalization, and derealization)
and/or
b) inability to access information or to control mental functions that normally
are readily amenable to access or control (i.e., "negative" dissociative symptoms such
as amnesia).
The dissociative disorders are frequently found in the
aftermath of trauma
Etiological Factors:
• Bio Psycho Social model
• Mainly Dissociation arises as a defense mechanism against trauma
produced unconsciously for helping victims to remove themselves from
trauma
• With some evidence on the effect of trauma on the chemical environment

of the brain
Clinical Types OF
Dissociative
Personality Disorders
Other Specified Dissociative Disorder
according to DSM-5
• This category applies to presentations in which symptoms characteristic of a dissociative
disorder that cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning predominate but do not meet the full criteria for any of
the disorders in the dissociative disorders diagnostic class. The other specified dissociative
disorder category is used in situations in which the clinician chooses to communicate
the specific reason that the presentation does not meet the criteria for any specific dissociative
disorder. This is done by recording “other specified dissociative disorder” followed
by the specific reason (e.g., “dissociative trance”).
identity disturbance due to prolonged and
intense coercive persuasion
Individuals
who have been subjected to intense coercive persuasion (e.g.,
indoctrination while captive, torture, long-term political imprisonment,
recruitment by sects/cults or by terror organizations) may present with
prolonged
changes in, or conscious questioning of, their identity.
Acute dissociative reactions to stressful
events
This category is for acute, transient
conditions that typically last less than 1 month, and sometimes only a few hours
or days. These conditions are characterized by constriction of consciousness;
depersonalization;
derealization; perceptual disturbances (e.g., time slowing, macropsia);
micro-amnesias; transient stupor; and/or alterations in sensory-motor
functioning (e.g.,
analgesia, paralysis).
Dissociative trance
This condition is characterized by an acute narrowing or complete
loss of awareness of immediate surroundings that manifests as profound unresponsiveness
or insensitivity to environmental stimuli. The unresponsiveness may be
accompanied by minor stereotyped behaviors (e.g., finger movements) of which the
individual
is unaware and/or that he or she cannot control, as well as transient paralysis
or loss of consciousness. The dissociative trance is not a normal part of a broadly accepted
collective cultural or religious practice.
1) Depersonalization/ Derealization
Prevalance
• In general, approximately one-half of all adults
have experienced at least one lifetime episode of depersonalization/derealization.
However,
• symptomatology that meets full criteria for depersonalization/derealization disorder
is markedly less common than transient symptoms.
Lifetime prevalence in U.S. and non-U.S. countries is approximately 2% (range of 0.8% to
2.8%). The gender ratio for the
disorder is 1:1.
2) Dissociative Amnesia
Prevalence
The 12-month prevalence for dissociative
amnesia among adults in a small U.S.
community study was 1.8%
(1.0% for males; 2.6% for females).
3) Dissociative Identity Disorder (DID)
Prevalence
The 12-month prevalence of dissociative identity
disorder among adults in a small U.S. community study
was 1.5%. The prevalence across genders in that study
was 1.6% for
males and 1.4% for females.
Comorbidity
• PTSD
• Depressive disorders
• Personality disorders especially avoidant and borderline
• Conversion syndrome (Functional neurological symptom disorder)
• OCD
• Sleep disorders
Treatment
• Treatment typically involves psychotherapy.
• Therapy can help people gain control over the dissociative process and
symptoms. The goal of therapy is to help integrate the different elements
of identity. Therapy may be intense and difficult as it involves
remembering and coping with past traumatic experiences.
• Cognitive behavioral therapy and dialectical behavioral therapy are two
commonly used types of therapy. Hypnosis has also been found to be
helpful in treatment of dissociative identity disorder.
• There are no medications to directly treat the symptoms of dissociative
identity disorder. However, medication may be helpful in treating related
conditions or symptoms, such as the use of antidepressants and anxiolytics
Thank you

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Dissociative Disorders

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Dissociative Disorders

By: Mena Shawky

• Dissociative • Schizophrenia ‫الفُصام‬

• With some evidence on the effect of trauma on the chemical environment

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