DISSOCIATIVE

DISORDERS
Group members:
Ayesha Mohsin
Ayesha Cheema
Aroma Yousaf
Mishal Azam
 DISSOCIATIVE DISORDERS
• Dissociative disorders are characterized by a disruption of and/ or discontinuity in the normal
integration of consciousness, memory, identity, emotion, perception, body representation, motor
control, and behavior.

• The symptoms can potentially disrupt every area of psychological functioning.

• Dissociative disorders occur as an aftermath of a traumatic experience.

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 SYMPTOMS
• The symptoms could be positive or negative;
• Positive symptoms include:
 Depersonalization/derealization
 Fragmentation of identity

• Negative symptoms include:

 Unable to control mental functioning
 Unable to accesses information
 Such as, Amnesia

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DISSOCIATIVE
IDENTITY
DISORDER
AYESHA MOHSIN

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 DISSOCIATIVE IDENTITY DISORDER:

• CRITERION A:
• Disruption of identity characterised by two or more distinct personality
states, could be described in some cultures as an experience of
possession.
• The disruption in identity involves marked discontinuity;
• In sense of self/ agency
• In affect, behaviour, consciousness, memory, perception, cognition, or
sensory-motor functioning.

• CRITERION B:
• Recurrent gaps in the recall of everyday events, important personal
information, and/ or traumatic events that are inconsistent with
ordinary forgetting.

• CRITERION C:
• The symptoms cause clinically significant distress or impairment in
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 SYMPTOMS FOR DID:

• Memory loss (amnesia) of certain time periods, events, people and personal information
• A sense of being detached from yourself and your emotions
• A perception of the people and things around you as distorted and unreal
• A blurred sense of identity
• Significant stress or problems in your relationships, work or other important areas of your life
• Inability to cope well with emotional or professional stress
• Mental health problems, such as depression, anxiety, and suicidal thoughts and behaviors

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 DIFFERENTIAL DIAGNOSIS
• BIPOLAR DISORDER
• PSYCHOTIC DISORDER
• MAJOR DEPRESSIVE DISORDER

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DISSOCIATIVE
AMNESIA
MISHAL AZAM

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 DISSOCIATIVE AMNESIA
• CRITERION A:
An inability to recall important autobiographical information ; usually of a traumatic
or stressful nature, that is inconsistent with ordinary forgetting.
 Involves temporary loss of memory recall caused by disassociation ,
lasts for a period of seconds or years.

• CRITERION B:
Symptoms cause clinically significant distress or impairment in the following;
 Social , occupational and other important areas of functioning.
 Usually occurs in adolescence and adulthood.

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 DISSOCIATIVE AMNESIA
• SYMPTOMS:
• Spacing out.
• Mild depression.
• Inability to feel emotions.
• Identity alteration (switching between states).
• Unable to recall autobiographical memory associated with a traumatic event. It is usually unconscious.
• The inability to recall causes distress.
• The memory dysfunction does not have a physiological cause.
• The memory dysfunction is not a dissociative identity disorder.
• The memory loss is not a result of substance abuse or other substance.
• Individuals may have flashbacks or nightmares.
• Repression of memories can lead to maladaptive behavior. Such as self-harming or harming others.

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 TYPES
A. Localized:
• The person is unable to recall events that took place within a limited period of time (several hours or 1-2 days).
• Survivors of World Trade Centre does not really remember how they got out away from the building.
B. Selective:
• The patients can remember some but not all of the events that took place during a limited period of time.
C. Generalized:
• The person cannot recall anything in his/her entire life.
• Persons with generalized amnesia are usually found by the police or taken by others to a hospital emergency
room.
D. Continuous:
• The amnesia covers the entire period without interruption from the traumatic event from the past to the present.
E. Systematized:
• The amnesia covers only certain categories of information, such as all memories related to certain location or a
particular person.

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 DISSOCIATIVE AMNESIA
• DISSOCIATIVE FUGUE:

• It is stated as ‘bewildered wandering’.

• Formerly a subtype of amnesia that involves a temporary or permanent loss of one`s personal identity or the
development of new identity.
• Often triggers by stressful life event and engages in some form of unexpected travel.
• The person may suddenly find themselves in a place, such as the beach or at work, with no memory of traveling
there.
• The person may also develop a new identity.
• It is rare as low as 0.2% of prevalence in general population.
• More common in adults than in children.

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 DISSOCIATIVE FUGUE
• SYMPTOMS:
• Most commonly found in those who have dissociative personality disorder.
• Person will mentally and physically try to escape from the distress.
• The travel occurs usually lasts for as little as a few hours or as long as weeks or months.
• When the fugue state is over, people usually cannot remember what happened during the period of fugue.
• This state can end suddenly or more gradually, with persisting confusion about identity.
• CAUSES:
• Can be due to highly stressful event, natural disasters and wars, as well as severe marital or financial distress.
• Alcohol abuse, depression, and a history of child abuse.
• There may also be a genetic link, sometimes having family members with the same condition.

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 DIFFERENTIAL DIAGNOSIS
 Dissociative Identity Disorder:
 Post Traumatic Stress Disorder:
 Neurocognitive Disorder:
 Factitious Disorder
 Seizure Disorder

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Depersonalization/
Derealization
Disorder
AYESHA CHEEMA

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Depersonalization/ Derealization Disorder

The client has persistent or recurrent feelings of detachment from ones mental or bodily processes or from ones
surroundings.
Diagnostic Criteria:
a. The client has persistent or recurrent feelings/experiences of depersonalization, derealization or both.

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 D e pe rso na l i zati on : i t i s d e s c r i b e d a s a fe e l i n g o f b e i n g d i s c o n n e c te d o r d e ta c h e d f ro m o n e ’s s e l f.
• C l i e n t o f t e n r e p o r t s a l o s s o f c o n t ro l o v e r t h e i r t h o u g h t s o r a c t i o n s .

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D e re a l i zati on : i t i s d e s c r i b e d a s d e ta c h m e nt f ro m o n e ’s s u r ro u n d i n g s .
• C l i e n t m ay r e p o r t p e r c e i v i n g t h e w o r l d a ro u n d t h e m a s fo g g y, d r e a m - l i ke .

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b. During experience, reality testing remains intact.
c. Diagnosis is only given when feelings of unreality and detachment cause distress or impairment in social, occupational
functions of daily life.

d. The experiences are not attributed due to,

• Physiological effects of a substance (i.e. drugs or medication)
• Another medical condition (i.e. seizures)

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 Differential diagnosis

• Illness anxiety disorder

• Obsessive compulsive disorder
• Psychotic disorders

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ETIOLOGY, ASSESSMENTS AND INTERVENTION:

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Dissociative identity disorder

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 Etiology
• The contribution of genetic factor is now being
systematically assessed but preliminary studies
have not found evidence of significant genetic
contribution.
• Researchers believe that the main cause of
Dissociative Identity Disorder is physical or
sexual abuse when the individual was a child.
There is a strong association between childhood
trauma (especially sexual abuse) and the
formation of DID (Murray, 1994)
• They create the alters to distance themselves
from the pain and trauma.

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Assessment mental

MMPI Dissociative Experiences Scale (DES II) Mental State Examination (MSE)

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Interventions

Hypnosis Psychotherapy

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Dissociative amnesia

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 Etiology
• Dissociative amnesia has been linked to
overwhelming stress, which may be
caused by traumatic events such as war,
abuse, accidents, or disasters. The person
may have suffered the trauma or just
witnessed it.
• It can be genetic as people with this
disorder usually had close family members
who have had similar conditions.

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Assessment

• DES (Dissociative Experience Scale)

• SDQ-20 (Somatoform Dissociation Questionnaire): The Somatoform Dissociation Questionnaire
(SDQ-20) is a scale of good psychometric quality, which measures somatoform
dissociation. The symptoms pertain to negative and positive dissociative phenomena.

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Intervention

• Psychotherapy
• CBT (cognitive
Behavior therapy

Cognitive art therapy Family therapy

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Depersonalization/Derealization disorder

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 Etiology
• A history of neglect, or physical or
emotional abuse can lead to
depersonalization/Derealization
disorder.
• Triggers may include significant
stress, cannabis or hallucinogen
use.
• Neurochemical and hormonal
changes in individuals with
depersonalization disorder is
common.
• The disorder is typically associated
with cognitive disruptions in early
perceptual processes.

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Assessment

• Dissociative Experience Scale (DES)

• Shutdown Dissociation scale: The Shut-D is a brief structured
interview for assessing the vulnerability to dissociate as a
consequence of exposure to traumatic stressors. The scale
demonstrates high-quality psychometric properties and may be
useful for researchers and clinicians in assessing shutdown
dissociation as well as in predicting the risk of dissociative
responding.

Steinberg depersonalization test

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Intervention

Psychodynamic Psychotherapy Grounding therapy Cognitive Behavior Therapy

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