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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. 90 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