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Psychiatric Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Dissociative disorders include dissociative amnesia or fugue, formerly called psychogenic amnesia; dissociative identity disorder, formerly called multiple personality disorder; depersonalization disorder; and transient global amnesia. In the dissociative states, the patient dissociates himself from the stressful event through a fugue or multiple personality. Fugue is from the Latin for "flee" and is also used for a musical form that may be viewed as a flight. A fugue is a massive amnesia allowing the patient to flee all memory of the stressful event, but it often leaves the patient wandering aimlessly. Double or multiple personality also allows the patient to dissociate from the event by creating one or more separate identities with no ties to the stress.
Coping with the inescapable: survivors’ dissociation, ‘professional dissociation’
Published in Lis Garratt, Mavis Kirkham, Survivors of Childhood Sexual Abuse and Midwifery Practice, 2018
Dissociation exists as a continuum starting from normal everyday experiences extending to disorders that interfere with everyday functioning. At one end of the scale are activities considered to be normal such as becoming ‘lost’ in a good book or performing everyday actions involving a simultaneous multiplicity of tasks without an awareness of one or more of them, such as driving a car.8 At the other end of the continuum are out of body experiences and dissociative disorders. A small percentage of traumatised individuals also develop the syndrome of dissociative identity disorder (formerly multiple personality disorder). In its more extreme forms, dissociation is known to result from the experience of a traumatic event (or events) and is believed by many authorities to be highly predictive of the development of PTSD.9–14 When faced with a highly stressful event, in order to protect ourselves from being overwhelmed, we distance ourselves from it at the time, thereafter gradually integrating the experience until it becomes part of our consciousness and incorporated into memory. However, failure to integrate the memory on a semantic or linguistic level can lead to long-term psychological morbidity in the form of dissociative disorders, intrusive re-experiencing of the event/s and fragmentary memories.15,16
Signs and Symptoms in Psychiatry
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Dissociative identity disorder is characterized by the presence of two or more distinct personality states or an experience of possession, associated with recurrent episodes of amnesia. Individuals may experience discontinuities in identity and memory that may not be immediately evident to others or are obscured by attempts to hide dysfunction.
Reversal of Amnesia for Trauma in a Sample of Psychiatric Inpatients with Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified
Published in Journal of Child Sexual Abuse, 2022
Colin A. Ross, Jane Ridgway, Quinton Neighbors, Taylor Myron
A number of authors have stated that reversal of amnesia for childhood trauma, particularly sexual abuse, occurs rarely and that dissociative identity disorder (DID) is not a valid disorder (McHugh, 1995; Merskey, 1994; Merksey, 1995; Otgaar et al., 2019; Piper, 1990; Sarbin, 1995; Simpson etal., 1995; Shaw, 2017, 2020; Spanos, 1994). The two issues, the validity of DID, and the validity of recovered memories of childhood trauma, are often intertwined by critics of DID (Merksey, 1995; Merskey, 1994). Three studies have provided corroboration of the reported trauma histories in DID (Coons, 1994; Coons & Milstein, 1986; Lewis et al., 1997) but no research in this regard has been published in the last 25 years. Nor has any research on the circumstances and triggers for reversal of amnesia for childhood trauma in persons meeting criteria for DID or other specified dissociative disorder (OSDD) been published in the last 23 years (Chu et al., 1999; Kluft, 1995). In order to provide more recent data on the triggers and circumstances for reversal of amnesia in individuals meeting criteria for DID and OSDD, the authors conducted semi-structured interviews with a sample of highly dissociative psychiatric inpatients. Multiple personality disorder was renamed dissociative identity disorder (DID) in DSM-IV (American Psychiatric Association, 1994); the term, DID, will be used in this paper.
Discussion of “Phantom Penis: Extrapolating Neuroscience and Employing Imagination for Trans Male Embodiment”
Published in Studies in Gender and Sexuality, 2020
Cultural norms of sex and gender influence scientific research and medical treatment. Straayer opines that “Scientific disbelief in the actuality of phantoms could make patients hesitant to describe their unexplainable sensations of invisible body parts. For patients and doctors alike, speaking seriously about phantoms might solicit doubts of their reasonableness, even their sanity.” Gender-nonconforming individuals have historically been pressured to conform to diagnostic criteria for diagnoses of gender dysphoria in order to gain access to gender-related medical procedures or therapies (Ault and Brzuzy, 2009). This pressure to conform has delayed recognition of the spectrums of gender and sex now gaining scientific recognition (Joel et al., 2015; Chekroud et al., 2016; Ainsworth, 2015). Indeed, our initial report of alternating gender (Case and Ramachandran, 2012; Case et al., 2019) was met with significant skepticism from clinicians, most of whom had never encountered a patient reporting alternating gender. Many suggested it was a type of dissociative identity disorder, despite evidence to the contrary (Case et al., 2019). Scientists and clinicians must balance skepticism and rigor with open-mindedness to unrecognized identities and experiences in order to accurately study the complexities of sex and gender as they exist in a given culture.
Considerations of Dissociation, Betrayal Trauma, and Complex Trauma in the Treatment of Incest
Published in Journal of Child Sexual Abuse, 2020
David M. Lawson, Sinem Akay-Sullivan
Finally, some research supports the effectiveness of the Guidelines for Treating Dissociative Identity Disorder in Adults (International Society for the Study of Trauma and Dissociation [ISSTD], International Society for the Study of Trauma and Dissociation, 2011; B. L. Brand et al., 2013). The guidelines follow the three-stage model that is supported by other major trauma organizations (e.g., International Society for the Study of Trauma): safety and stabilization in the first stage, processing trauma memories in the second stage, and reconnection with other aspects of life and integration of trauma into life story in the third stage. As noted, less severe DD (e.g., derealization) and other symptoms are easier to treat than more severe disorders (e.g., DID), particularly when paired with CSA. Thus, adjustments in treatment such as a longer stabilization phase would be important with more severe cases. Finally, the ISSTD Guidelines and Jepsen et al. (2014) support addressing DID alternate identities directly, encouraging collaboration and problem-solving between identities.