PSYCH 333 1nd Edition Lecture 13 Outline of Last Lecture I DSM 5 Definition of Trauma II Post traumatic Stress Disorder PTSD III Associated Features IV Acute Stress Disorder V Predisposing Factors VI Neurobiological Factors VII Biological Treatments VIII Psychological Factors IX Psychological Treatments X Treatment Efficacy XI Complex PTSD XII Post traumatic Growth Outline of Current Lecture II What is Dissociation III Dissociative Amnesia IV Theories of Dissociative Amnesia V Depersonalization Derealization Disorder VI Theories of Depersonalization Derealization Disorder VII Treatments VIII Dissociative Identity Disorder IX Controversial Diagnosis X Theories of DID XI Treatments for DID Current 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 treatment