Dissociative Disorders

 

Dissociative Disorders

Dissociative disorders involve a disruption or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, or body representation. These are frequently associated with a history of significant psychological trauma.

Disorder Key Features
Dissociative Identity Disorder (DID) Presence of two or more distinct personality states (formerly Multiple Personality Disorder). Gaps in memory for daily events.
Dissociative Amnesia Inability to recall important personal information (usually traumatic/stressful). May include dissociative fugue (purposeful travel associated with amnesia).
Depersonalization / Derealization Persistent feelings of detachment from self (depersonalization) or surroundings (derealization). Reality testing remains intact.
High-Yield Clinical Notes:

  • Trauma Association: Always perform a comprehensive assessment for histories of physical, sexual, or emotional abuse when these symptoms are present.
  • Treatment: Primarily psychotherapeutic. The goal is the integration of the dissociated components into a unified consciousness.
  • Reality Testing: Crucial to differentiate dissociative disorders from psychotic disorders (like schizophrenia). Patients with dissociative disorders typically maintain reality testing, whereas those with psychosis do not.