PSYCH 333 1nd Edition Lecture 13 Outline of Last Lecture I. DSM-5 Definition of TraumaII. Post-traumatic Stress Disorder (PTSD)III. Associated FeaturesIV. Acute Stress DisorderV. Predisposing FactorsVI. Neurobiological FactorsVII. Biological TreatmentsVIII. Psychological FactorsIX. Psychological TreatmentsX. Treatment Efficacy XI. Complex PTSDXII. Post-traumatic Growth Outline of Current Lecture II. What is DissociationIII. Dissociative AmnesiaIV. Theories of Dissociative AmnesiaV. Depersonalization/Derealization DisorderVI. Theories of Depersonalization/Derealization DisorderVII. TreatmentsVIII. Dissociative Identity DisorderIX. Controversial DiagnosisX. Theories of DIDXI. Treatments for DIDCurrent Lecture- What is Dissociation:o Disruptions in consciousness, memory, or identity.o Usually an inability to access some part of conscious experience.- Dissociative Amnesia:o Inability to remember important personal information, usually of a traumatic or stressful nature.o Not due to normal forgetting.o Not due to effects of a substance, medical condition, or other psychological disorder (such as PTSD).These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.o Subtypes. With dissociative fugue.- They don’t only forget but they also aimlessly wander without knowing how they got there.o Associated features. Alteration in explicit memories, not implicit memory. Localized amnesia more common than generalized amnesia. Couse is episodic. History of trauma/abuse. High suggestibility/hypnotizability. Self-injury, suicidality, and risk-taking.- Theories of Dissociative Amnesia:o Psychodynamic/psychoanalytic. Extreme form of repression.o Cognitive theory. Stress usually leads to strong memories. May only be emotionally relevant information – not neutral.o Neurobiological. Stress hormones and hippocampus functioning.- Depersonalization/Derealization Disorder:o Disruption of perception of self and/or surroundings.o Depersonalization – feeling outside of oneself.o Derealization – feeling as though surrounds are unreal.o Reality testing remains intact.o Not due to substances, medical condition, or a psychological disorder.o Associated features. Difficulty describing symptoms. Belief that one is “going crazy” or has brain damage. Altered sense of time. Physiological hypo-arousal to emotional stimuli. Typical age of onset: adolescence. Course is chronic. Comorbid with personality disorders, depression, and anxiety.- Theories of Depersonalization/Derealization:o Psychodynamic. Inability to integrate ego states/objects.o Extreme coping strategy. Reduced ANS reactivity when dissociating.o Cognitive. Memory fragmentation leads to feelings of “unrealness.” Inability to integrate sensory information.- Treatments:o “Grounding” techniques. Body awareness. Distress tolerance skills. Mindfulness.o Memory aids.o Psychodynamics/psychoanalytic therapy. Gain insight into conflicts.o Treatment of trauma.o Hypnosis (controversial).- Dissociative Identity Disorder:o Formally known as Multiple Personality disorder.o Disruption in identity with at least two distinct personality states.o Amnesia/gaps in memory.o Not due to effects of substances, not part of culturally accepted religious practice, and not due to medical condition.o DID and schizophrenia are not the same disorder.o Associated features. Onset is usually childhood; however dx is usually in adulthood. Common alters:- Child, persecutor, protector/helper. Hyponotizability/suggestibility. Transient psychotic experiences. Self-mutilation and suicide attempts. Comorbidities; depression, anxiety, PTSD, OCD, personality disorders, substances use disorders, eating disorders, psychosis.- Controversial Diagnosis:o Is DID a real diagnosis?o Increase prevalence rates. Media coverage, inclusion in DSM-III.o Rates of detection of DID by clinician.o Worsening of symptoms when in treatment.o Suggestibility.- Theories of DID:o Posttraumatic model. Dissociation to cope with trauma. Develop different aspects of experience as a defense.o Sociocognitive model. Role-playing/learning theories. Trying to please authority figures. Symptoms of DID reinforced.- Treatments for DID:o General approach to treatment. Gentle, supportive, empathic stance. Goal is to eliminate client’s need to split into difference personalities.o Psychodynamic therapy. Overcome repression, gain insight into causes for defense mechanism. Hypnosis access repressed memories.o CBT treatment for trauma. Remove reinforces for personality shifts.o No studies on the effectiveness of different