Abstract
Dissociative Disorders is the disruption in the integrated functions of consciences, memory, identity, or perception of the environment. They are marked by a dissociation from or interruption of a person’s fundamental aspect of waking consciousness such as personal identity and one’s personal history. In this paper I will be discussing the main dissociative disorders, which are: Dissociative Amnesia, Dissociative Fugue, Dissociative Identity Disorder, and Depersonalization Disorder. All of the dissociative disorders are thought to stem from trauma experienced by the individual with the disorder. (Maser, 2000) Seen in a number of other mental illnesses, including post-traumatic stress disorder, panic disorder, and obsessive compulsive disorder, symptoms of dissociative or even one or more of the disorders are shown. A cross-cultural perspective is particularly important in the evaluation of Dissociative Disorders because dissociative states are a common and accepted expression of cultural activities or religious experience in many societies. (Frances, 1994) Dissociative Amnesia
The first disorder is Dissociative Amnesia which is characterized by an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. This disorder is formerly known as Psychogenic Amnesia. Dissociative Amnesia involves a reversible memory impairment in which memories of personal experience cannot be retrieved in a verbal form. This disorder most commonly presents as a gap or a series of gaps in recall for aspects in an individual’s life history. Less commonly, Dissociative Amnesia presents a florid episode which is most likely to occur during wartime or in response to a natural disaster. (Frances, 1994) Several types of memory disturbances have been described in Dissociative Amnesia. The first one being local amnesia, in which the individual fails to recall events that occurred during a circumscribed period of time, usually the first few hours following a profoundly disturbing event. (Frances, 1994) The second type is selective amnesia, in which the person can recall some, but not all, of the events during a circumscribed period of time. (Frances, 1994)
Dissociative Amnesia is especially difficult to assess in preadolescent children, because it may be confused with inattention, anxiety, oppositional behavior, Learning Disorders, psychotic disturbances, and developmentally appropriate childhood amnesia. Therefore, a series of observations must be made before certain diagnosis is stated. This disorder can present in any age group, from young children to adults. (Frances, 1994) Individuals who have had an episode of Dissociative Amnesia may be predisposed to develop amnesia for subsequent traumatic circumstances. (Frances, 1994) Dissociative Fugue Dissociative fugue can be described as an individual who suddenly and unexpectedly takes physical leave of his or her surroundings and sets off on a journey of some find. (Maser, 2000) Individuals’ journeys can last up to hours, even several days or months. With these journeys, individuals are unaware or confused about their identity and in some cases will assume new identity. Once the individual returns to the prefugue state, there may be no memory for the events that occurred during the fugue. (Frances, 1994) With an individual’s new identity, they may assume a new name, take a new residence and engage in complex social activities. After return to the prefugue state, amnesia for traumatic events in the person’s past may be noted (e.g., after termination of a long fugue, a soldier remains amnestic for wartime events that that occurred several years previously in which the soldiers closest friend was killed.) (Frances, 1994) There are individuals who are known as having “running” syndromes which may have symptoms that meet diagnostic criteria for Dissociative Fugue. A prevalence rate of 0.2% for Dissociative Fugue has been reported in the general population. (Frances, 1994) Most cases described in adults are related to traumatic, stressful, or overwhelming life events. Dissociative Identity Disorder
Dissociative Identity Disorder has been defined as multiple personality disorder. This disorder is the presence of two or more distinct identities or personality states that take control of behavior. Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. (Frances, 1994) Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. (Frances, 1994) Individuals with this disorder have a primary identity that carries the individual’s given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity. (Frances, 1994) Some identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. (Frances, 1994) Depersonalization Disorder Last but not least, is Depersonalization Disorder which can be described as a feeling of detachment or distance from one’s own experience, body, or self. This disorder is the most easily identified. As a person who has been intoxicated feels out of control is the same feeling and individual with depersonalization disorder experiences. They feel this feeling so frequently and so severely that it interrupts his or her functioning. Often individuals with Depersonalization Disorder may have difficulty describing their symptoms and may fear that these experiences signify that they are “crazy.” (Frances, 1994) Some common associated features include anxiety symptoms, depressive symptoms, obsessive rumination, somatic concerns, and a disturbance in one’s sense of time. (Frances, 1994) Since dissociative disorders seem to be triggered as a response to trauma or abuse, treatment for individuals with such a disorder may stress psychotherapy, although a combination of psychopharmacological and psychosocial treatments is often used. (Maser, 2000) Though this may be true, they can be controlled by the same drugs used to treat disorders such as anxiety and depression. All in all, Dissociative Disorders are a group of psychiatric syndromes characterized by disruptions of aspects of consciousness, identity, memory, motor behavior, or environmental awareness. (Sharon, 2010)