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Transcript
Quick Guide
Dissociative Disorders
Overview of Dissociative Disorders
Dissociative Amnesia. The client cannot remember important information that is
usually of a personal nature. This is usually stress-related.
Dissociative Fugue. The client suddenly travels away from home and cannot
remember important details about the past.
Dissociative Identity Disorder. One or more additional identities intermittently
seize control of the client's behavior.
Depersonalization Disorder. There are episodes of detachment, as if the client is
observing the client's own behavior from outside. In this condition, the client does
not actually have memory loss.
Dissociative Disorder Not Otherwise Specified. Client who have symptoms
suggestive of any of the disorders above, but who do not meet criteria for any one of
them, may be categorized here. Here are some examples:
Derealization without depersonalization. Derealization is a feeling that
the exterior world is unreal or odd.
Brainwashing. People who have been indoctrinated may develop
dissociative states.
Coma or loss of consciousness. These can be dissociative when they are not
due to a general medical condition.
Conditions similar to Dissociative Identify Disorder. Some clients may
not fully meet the criteria for DID. For example, they may not have two fully
formed personality states, or they do not have amnesia as a part of the
syndrome.
Dissociative trance disorder. This proposed diagnostic category covers
certain dissociative conditions not generally encountered in Western
societies. These include amok, koro, latah, pibloktoz, and others. These and
other culture-bound syndromes are briefly discussed in DSM-IV beginning
on page 843.
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Other Causes of Severe Memory Loss
When dissociative symptoms are encountered in the course of other mental
diagnoses, a separate diagnosis of a dissociative disorder is not ordinarily given.
Posttraumatic Stress Disorder. A month or more following a severe trauma, the
client may not remember important aspects of personal history.
Acute Stress Disorder. Immediately following a severe trauma, clients may not
remember important aspects of personal history.
Substance-Induced Disorders. Use of alcohol or other substances may produce
blackouts, in which the client does not recall what happened while intoxicated.
Alternatively, there may be state-dependent learning: Important information learned
while intoxicated is only recalled the next time the client is intoxicated.
Somatization Disorder. Clients who have a long history of many somatic
symptoms that cannot be explained on the basis of known disease mechanisms can
also forget important aspects of personal history.
Sleepwalking Disorder. Sleepwalking resembles the dissociative disorders, in that
there is amnesia for purposeful behavior. But it is classified elsewhere in order to
keep all the sleep disorders together.
Malingering. Some clients consciously deign symptoms of memory loss. Their
object is material gain, such as avoiding punishment or obtaining money or drugs.
91