Chapter 5 - Understanding Dissociative Disorders: DID and Amnesia

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Questions and Answers

Which of the following is the MOST accurate definition of Dissociative Identity Disorder (DID)?

  • A subtype of schizophrenia characterized by disorganized thoughts and hallucinations.
  • A dissociative disorder involving two or more distinct personality states that control a person's behavior. (correct)
  • A condition where individuals experience persistent detachment from reality and a sense of derealization.
  • A disorder marked by a single, dominant personality state influenced heavily by external stressors.

What is a primary factor often associated with the development of Dissociative Identity Disorder (DID)?

  • Severe childhood trauma, such as physical or sexual abuse. (correct)
  • Congenital neurological abnormalities.
  • Genetic predisposition to obsessive-compulsive behaviors.
  • Exposure to prolonged periods of social isolation during adulthood.

Which of the following is a commonly observed symptom in individuals with Dissociative Identity Disorder (DID)?

  • A continuous state of heightened anxiety without any specific triggers.
  • Memory loss, identity disruption, and the presence of alternate personalities with distinct traits and memories. (correct)
  • Persistent delusions of grandeur, even when confronted with contradictory evidence.
  • Inability to form attachments with others.

What is 'interpersonality rivalry' as it relates to Dissociative Identity Disorder (DID)?

<p>A phenomenon where different personalities compete for control, potentially leading to self-destructive behaviors or amnesia. (C)</p> Signup and view all the answers

In treating a patient with Dissociative Identity Disorder (DID), why is it important to consider cultural influences?

<p>Because alternate personalities may manifest as spirits, demons, or mythical figures depending on cultural beliefs. (B)</p> Signup and view all the answers

What is the defining characteristic of dissociative amnesia?

<p>An inability to recall important personal information, usually following a traumatic or stressful event. (D)</p> Signup and view all the answers

A patient reports memory loss specifically for the few weeks after experiencing a car accident, but can recall other memories. Which type of dissociative amnesia is the patient MOST likely experiencing?

<p>Localized Amnesia. (B)</p> Signup and view all the answers

How does dissociative amnesia typically differ from memory impairments associated with conditions like dementia?

<p>Dissociative amnesia can be reversed suddenly or gradually, while dementia typically involves progressive memory decline. (A)</p> Signup and view all the answers

A client describes feeling detached from their body, as if they are watching themselves from outside. Based on this symptom, which disorder is MOST likely?

<p>Depersonalization/Derealization Disorder. (B)</p> Signup and view all the answers

Which of the following BEST describes the symptom of derealization?

<p>Perceiving surroundings as unreal, foggy, lifeless, or visually distorted. (A)</p> Signup and view all the answers

What is the PRIMARY characteristic of conversion disorder?

<p>Experiencing neurological symptoms without a corresponding medical explanation, often related to stress. (A)</p> Signup and view all the answers

What is 'la belle indifference' in the context of conversion disorder?

<p>Showing a lack of concern about their symptoms despite their potentially serious nature. (D)</p> Signup and view all the answers

What is the defining feature of Illness Anxiety Disorder?

<p>Excessive worry about having a serious illness, often without significant medical symptoms. (D)</p> Signup and view all the answers

What is the MAIN difference between 'care-avoidant' and 'care-seeking' types of illness anxiety disorder?

<p>Care-avoidant individuals avoid medical visits due to fear of bad news, while care-seeking individuals frequently visit doctors seeking reassurance. (C)</p> Signup and view all the answers

An individual experiences excessive concern about physical symptoms. These symptoms have no clear medical cause, are distressing, and lead to frequent medical visits. Which disorder is MOST consistent?

<p>Somatic Symptom Disorder. (C)</p> Signup and view all the answers

How does 'pain preoccupation' manifest in Somatic Symptom Disorder?

<p>Focusing primarily on physical pain despite no clear medical explanation, potentially reinforced by secondary gains. (C)</p> Signup and view all the answers

What is the PRIMARY motivation in factitious disorder?

<p>To receive attention, nurturance, or psychological gratification. (C)</p> Signup and view all the answers

In Factitious Disorder Imposed on Another (Munchausen by Proxy), who is the one inducing the symptoms and who are they being induced on?

<p>An individual induces symptoms in another person, often a child. (A)</p> Signup and view all the answers

How might reinforcement play a role in factitious disorder?

<p>The need for attention or nurturance reinforces symptom fabrication, leading individuals to undergo unnecessary medical procedures. (A)</p> Signup and view all the answers

Which of the following BEST describes Koro Syndrome and its cultural focus?

<p>A belief that one's genitals are retracting into the body, primarily found in China and Southeast Asia. (B)</p> Signup and view all the answers

Which area on the globe is Dhat Syndrome most often found?

<p>India (D)</p> Signup and view all the answers

According to the psychodynamic perspective, what is the role of dissociation?

<p>A defense mechanism against trauma, repressing painful memories or conflicts. (D)</p> Signup and view all the answers

How does the social-cognitive perspective explain the development of dissociative disorders?

<p>As a learned behavior reinforced by attention, media portrayals, or therapist suggestion. (B)</p> Signup and view all the answers

What is the biological perspective on the origins of dissociative disorders?

<p>Some individuals may have a genetic predisposition to dissociative symptoms, supported by neurobiological differences. (D)</p> Signup and view all the answers

According to the trauma model, how does dissociation function as a coping mechanism?

<p>By providing a way to mentally escape extreme stress or abuse. (D)</p> Signup and view all the answers

What is the MAIN goal when using psychoanalysis to treat dissociative disorders?

<p>To uncover and integrate traumatic memories through techniques like free association and dream analysis. (A)</p> Signup and view all the answers

What is the primary focus of Cognitive-Behavioral Therapy (CBT) in treating dissociative disorders?

<p>Addressing maladaptive thought patterns and behaviors contributing to dissociative symptoms. (B)</p> Signup and view all the answers

How might behavior therapy be applied in the treatment of dissociative disorders?

<p>By reducing secondary gains from symptoms through reinforcement pattern modification and stress-management techniques. (B)</p> Signup and view all the answers

Why is the use of hypnosis in dissociative disorder treatment considered controversial?

<p>It can lead to the creation of false memories. (B)</p> Signup and view all the answers

For what purpose is Eye Movement Desensitization and Reprocessing (EMDR) primarily used regarding dissociative disorders?

<p>To help individuals process distressing memories related to trauma. (A)</p> Signup and view all the answers

According to the DSM-5, what is a key characteristic that distinguishes dissociative fugue from dissociative amnesia?

<p>Memory loss accompanied by leaving home and potentially establishing a new identity. (B)</p> Signup and view all the answers

In the Winnipeg Study, what percentage of participants reported dissociative experiences?

<p>25% (B)</p> Signup and view all the answers

Which of the following is an example of a dissociative symptom involving derealization?

<p>Feeling that the world around you is unreal or distorted. (A)</p> Signup and view all the answers

A patient reports significant memory gaps, identity confusion, and feeling detached from their body. Which of the following best describes the relationship between these symptoms?

<p>These symptoms are all indicative of potential dissociative disorder. (A)</p> Signup and view all the answers

When differentiating between dissociative amnesia and general amnesia, what is typically preserved in dissociative amnesia?

<p>General knowledge and skills (implicit memory). (A)</p> Signup and view all the answers

Localized amnesia is a form of dissociative amnesia. What is a defining characteristic of localized amnesia?

<p>Memory loss for events within a specific period. (C)</p> Signup and view all the answers

How does dissociative fugue differ from localized amnesia?

<p>Dissociative fugue involves unexpected travel and possible identity assumption, while localized amnesia does not. (B)</p> Signup and view all the answers

What is the primary distinction between malingering and dissociative fugue?

<p>Malingering involves intentionally feigning symptoms for external gain, while dissociative fugue is not deliberate. (D)</p> Signup and view all the answers

A patient with dissociative amnesia is able to ride a bike, but cannot remember where they live. What does this tell us about their memory impairment?

<p>The patient's implicit (procedural) memory is intact, but their autobiographical memory is impaired. (C)</p> Signup and view all the answers

In the New York Study, women were observed to do which of the following...?

<p>Report seeking help slightly more than men. (C)</p> Signup and view all the answers

How do the memory deficits in dissociative amnesia DISTINCTLY present compared to typical, everyday forgetting?

<p>Dissociative Amnesia involves an inability to recall important life-related information beyond what is considered normal forgetting. (B)</p> Signup and view all the answers

What differentiates the amnesia experienced in Dissociative Amnesia from memory loss due to brain injury according to the content?

<p>Dissociative Amnesia occurs in the absence of any identifiable organic cause like brain injury, while memory loss caused by brain injury has an identifiable organic cause. (B)</p> Signup and view all the answers

What is the key characteristic that distinguishes dissociative fugue from dissociative amnesia, based on descriptions?

<p>Dissociative fugue involves sudden, unexpected travel away from one’s home or workplace. (C)</p> Signup and view all the answers

In the context of Dissociative Identity Disorder (DID), what is meant by the term 'alters' and their relationship among each other?

<p>Alters are distinct personalities within an individual who may or may not be aware of each other. (B)</p> Signup and view all the answers

What is a mutually amnesic relationship among alters in Dissociative Identity Disorder (DID)?

<p>Alters have no awareness of each other. (D)</p> Signup and view all the answers

Prior to the 1800s, what was the prevalence of reported cases of Dissociative Identity Disorder (DID)?

<p>No cases had been reported or identified (A)</p> Signup and view all the answers

What is a reasonable conclusion based on the differing results between studies regarding DID?

<p>Differences in research methodologies may influence the understanding and diagnosis of DID. (C)</p> Signup and view all the answers

What are common co-occurring conditions (comorbidities) often observed in individuals with Dissociative Identity Disorder (DID)?

<p>PTSD, depression, anxiety, substance use disorder, and suicidal ideation. (D)</p> Signup and view all the answers

What is the key criterion differentiating malingering from genuine psychological disorders?

<p>Malingering involves intentionally faking symptoms for external gains. (D)</p> Signup and view all the answers

What is the primary intention behind the actions of someone with Factitious Disorder?

<p>Assuming the role of a sick person for attention. (B)</p> Signup and view all the answers

How could someone pretending to have an illness possibly use the internet?

<p>To join internet support groups and pretend to have an illness. (A)</p> Signup and view all the answers

What differentiates Conversion Disorder from both Factitious Disorder and Malingering?

<p>Conversion Disorder is characterized by genuine, neurological symptoms that lack a neurological origin, and the person is not consciously feigning symptoms. (D)</p> Signup and view all the answers

How does the presentation of motor or sensory symptoms relate to the diagnosis of Conversion Disorder?

<p>The presence of motor or sensory symptoms that cannot be explained by medical evidence lead to the probable diagnosis of Conversion Disorder. (D)</p> Signup and view all the answers

How does viewing dissociation as a 'normal experience' affect understanding of dissociative disorders?

<p>It helps contextualize the range of dissociative experiences, distinguishing normal zoning out from clinically significant dissociation. (B)</p> Signup and view all the answers

What did the Winnipeg study reveal about dissociation in the general population?

<p>Approximately 5% of participants showed symptoms consistent with a clinical diagnosis, and older participants reported less dissociation. (C)</p> Signup and view all the answers

In the New York Study, what did researchers find regarding gender differences and the experience/reporting of dissociative symptoms?

<p>Women were slightly more likely to report seeking assistance for symptoms related to dissociative disorders than men. (D)</p> Signup and view all the answers

According to the presented information, what is the association between trauma and the symptoms of dissociative disorders?

<p>Dissociative symptoms are usually associated with trauma. (D)</p> Signup and view all the answers

What did the New York Study reveal about the co-occurrence of other psychological disorders with dissociative experiences?

<p>Anxiety, depression, and personality disorders were found to be comorbid with dissociative experiences. (C)</p> Signup and view all the answers

What is the primary implication of neuroimaging studies on individuals with Dissociative Identity Disorder (DID)?

<p>These studies show altered brain activity when presenting trauma stories. (D)</p> Signup and view all the answers

How do the symptoms of depersonalization typically manifest which can be associated with dissociative disorders?

<p>Feeling detached from one’s own thoughts, feelings or body. (B)</p> Signup and view all the answers

How are somatic symptoms defined in the context of Somatic Symptom Disorder?

<p>Physical symptoms that cause distress or disruption without a fully explained medical cause, accompanied by excessive related thoughts, feelings, or behaviors. (C)</p> Signup and view all the answers

An individual displays excessive worry about having or acquiring a serious illness despite medical reassurance and minimal or no symptoms. What is MOST likely the appropriate diagnosis?

<p>Illness Anxiety Disorder (B)</p> Signup and view all the answers

How does the primary symptom presentation in Somatic Symptom Disorder differ from that of Illness Anxiety Disorder?

<p>Somatic Symptom Disorder involves prominent and distressing physical symptoms, while Illness Anxiety Disorder involves minimal to no physical symptoms and a preoccupation with the possibility of developing a disease. (D)</p> Signup and view all the answers

Which of the following scenarios BEST exemplifies 'psychological factors affecting a medical condition'?

<p>A patient's asthma symptoms worsen due to anxiety about public speaking. (D)</p> Signup and view all the answers

What is the key characteristic that distinguishes Factitious Disorder from Malingering?

<p>The motivation for producing symptoms. (B)</p> Signup and view all the answers

An individual intentionally falsifies symptoms of a neurological disorder to gain admission to a prestigious research program. Which disorder is MOST consistent with this behavior?

<p>Malingering (A)</p> Signup and view all the answers

A patient reports blindness that began immediately after witnessing a traumatic event. Neurological examinations reveal no physical explanation for the blindness. Which condition is MOST likely?

<p>Conversion Disorder (B)</p> Signup and view all the answers

What is the primary difference between factitious disorder imposed on self and factitious disorder imposed on another?

<p>The target of the deceptive behavior (oneself vs. someone else). (B)</p> Signup and view all the answers

How might the internet be utilized in the context of Factitious Disorder?

<p>To research and convincingly mimic symptoms of various diseases. (C)</p> Signup and view all the answers

A healthcare worker with a history of multiple hospitalizations for mysterious illnesses is suspected of inducing illness in their child to gain attention and sympathy. What condition is MOST suggested by this?

<p>Factitious Disorder Imposed on Another (D)</p> Signup and view all the answers

Flashcards

Dissociative Identity Disorder (DID)

A dissociative disorder with two or more distinct personality states controlling behavior.

Dissociative Amnesia

Memory loss of important personal information, usually after a traumatic event.

Localized Amnesia

Memory loss for a specific period, often surrounding a trauma.

Selective Amnesia

Loss of memory for particular details while retaining others from that time.

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Generalized Amnesia

Complete loss of personal history and identity; rare.

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Continuous Amnesia

Ongoing memory loss extending beyond a traumatic event.

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Systematized Amnesia

Memory loss for a specific category of information.

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Depersonalization/Derealization Disorder

Experiencing detachment from one's body or unreality of the environment.

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Symptoms of Depersonalization

Feeling like an outside observer of one's own body; emotional numbing.

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Symptoms of Derealization

Perceiving surroundings as unreal, foggy, or visually distorted.

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Conversion Disorder

Neurological symptoms without medical explanation, in response to stress.

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La Belle Indifference

Lack of concern about one's symptoms in conversion disorder.

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Illness Anxiety Disorder

Excessive worry about having a serious illness without significant symptoms.

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Care-Avoidant

Avoids medical visits due to fear of bad news, increasing anxiety.

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Care-Seeking

Frequently visits doctors, seeking confirmation of illness, often dissatisfied.

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Somatic Symptom Disorder

Excessive concern about physical symptoms that interfere with daily life.

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Pain Preoccupation

Physical pain is the primary focus without medical explanation.

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Factitious Disorder

Faking or inducing symptoms for psychological reasons.

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Factitious Disorder Imposed on Another

Inducing symptoms in another person for psychological gratification.

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Psychodynamic View

Defense mechanism against trauma, repressing painful memories.

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Social-Cognitive View

Dissociation as learned behavior reinforced by attention or suggestion.

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Trauma Model

Dissociation helps individuals cope by mentally escaping the situation.

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Psychoanalysis

Uncovering traumatic memories with free association and dream analysis.

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Cognitive-Behavioral Therapy (CBT)

Addressing maladaptive thought patterns and behaviors.

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Behavior Therapy

Reducing secondary gains by modifying reinforcement patterns.

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Hypnosis

Used to recover dissociated memories, but controversial.

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Dissociative Fugue

Memory loss combined with physical flight from one's life situation.

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Depersonalization Disorder

Feeling detached from one's own self.

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Amnesia (Symptom)

Cannot recall important life-related information beyond normal forgetting.

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Derealization (Symptom)

Feeling detached from your surroundings.

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Depersonalization (Symptom)

Feeling detached from your thoughts, feelings, and body

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Dissociation (Symptoms)

Involuntarily losing continuity of memory, identity, and perception.

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Malingering

When someone fakes symptoms for external compensation.

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Functional Neurological Symptom Disorder

Neurological symptoms occur without neurological disease.

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Factitious Disorder by Proxy

Falsely presenting another person as ill, often a child.

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Illness Anxiety Disorder (Hypochondriac)

Excessive worry about having or getting a serious illness, even with mild or no symptoms, lasting at least six months.

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Factitious Disorder (Munchausen Syndrome)

The falsification of physical or psychological signs or symptoms, injury, or disease, in oneself or another, to assume the sick role.

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Study Notes

Somatic Symptom Disorder

  • Requires a minimum of six months of symptoms
  • Involves experiences of at least one upsetting or repeatedly disruptive physical symptom
  • Includes an unreasonable number of thoughts, feelings, or behaviors regarding the nature or implication of the physical symptoms
  • Must include at least one of the following to be diagnosed: repeated excessive thoughts about their seriousness, continued high anxiety about health implications, or disproportionate amounts of time and energy spent on the symptoms of health implications
  • There are two patterns: somatization (rare) and pain (more common)

Illness Anxiety Disorder (aka hypochondriac)

  • Requires a minimum of six months of symptoms
  • Includes preoccupation with thoughts about having or getting a serious illness when there are no (or very mild) somatic symptoms
  • Is characterized by easily triggered, high concerns about health and a high number of health-related behaviors or health avoidance behaviors

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