Dissociative Disorders

Department of Psychology, University of California, Berkeley, California 94720-1650, USA.
Annual Review of Clinical Psychology (Impact Factor: 12.67). 02/2005; 1(1):227-53. DOI: 10.1146/annurev.clinpsy.1.102803.143925
Source: PubMed


The dissociative disorders, including "psychogenic" or "functional" amnesia, fugue, dissociative identity disorder (DID, also known as multiple personality disorder), and depersonalization disorder, were once classified, along with conversion disorder, as forms of hysteria. The 1970s witnessed an "epidemic" of dissociative disorder, particularly DID, which may have reflected enthusiasm for the diagnosis more than its actual prevalence. Traditionally, the dissociative disorders have been attributed to trauma and other psychological stress, but the existing evidence favoring this hypothesis is plagued by poor methodology. Prospective studies of traumatized individuals reveal no convincing cases of amnesia not attributable to brain insult, injury, or disease. Treatment generally involves recovering and working through ostensibly repressed or dissociated memories of trauma; at present, there are few quantitative or controlled outcome studies. Experimental studies are few in number and have focused largely on state-dependent and implicit memory. Depersonalization disorder may be in line for the next "epidemic" of dissociation.

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    • "El hecho de que, dentro de la población general, la mayor o menor frecuencia con que se experimentan estados disociativos sea considerada propia de la idiosincrasia personal (Kihlstrom, 2005), aparte de confirmar la idea de que la disociación no supone la ocurrencia de un proceso patológico en sí misma, sugiere que la tendencia a disociar podría estar relacionada con alguna variable de personalidad. De esta forma, algunos autores se han centrado en estudiar la posible relación entre la tendencia a disociar y factores de personalidad conocidos. "
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    DESCRIPTION: tesis doctoral defendida en octubre de 2010
    Full-text · Research · May 2015
    • "Following Janet's definition of dissociation, Bleuler described that the process of splitting in schizophrenia is the same as splitting of psychic connections in hysteria and can lead to manifestations of alter personalities and typical amnesia (Janet, 1890; Bleuler and Brill, 1924; van der Hart and Friedman, 1989; Bob, 2003; Foote and Park, 2008; Moskowitz, 2008). In this context, a high prevalence of trauma history found both in schizophrenia (Read et al., 2005; van Os and Kapur, 2009) and dissociative identity disorder has been documented in recent studies (Spiegel, 1997; Kihlstrom, 2005). In addition, several studies have shown that the level of dissociative symptomatology is strongly correlated with psychoticism and/or schizotypy (Startup, 1999; Moskowitz et al., 2005). "
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    ABSTRACT: Abstract According to recent research, disturbances of self-awareness and conscious experience have a critical role in the pathophysiology of schizophrenia, and in this context, schizophrenia is currently understood as a disorder characterized by distortions of acts of awareness, self-consciousness, and self-monitoring. Together, these studies suggest that the processes of disrupted awareness and conscious disintegration in schizophrenia might be related and represented by similar disruptions on the brain level, which, in principle, could be explained by various levels of disturbed connectivity and information disintegration that may negatively affect usual patterns of synchronous activity constituting adaptive integrative functions of consciousness. On the other hand, mental integration based on self-awareness and insight may significantly increase information integration and directly influence neural mechanisms underlying basic pathophysiological processes in schizophrenia.
    No preview · Article · Mar 2015 · Reviews in the neurosciences
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    • "Interpretation of the older literature is complicated by the then-common psychoanalytic orientation of practitioners that emphasized intrapsychic processes in dissociative disorders (Edelson, 1990; Loewenstein, 1996). Kihlstrom and Schacter (2005) discussed variations of case presentations and diagnostic criteria, whereas Dalenberg et al. (2012) reviewed the evidence for trauma and the development of dissociation. The more recent literature presents results of positron emission tomography and functional magnetic resonance imaging scans. "
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    ABSTRACT: Abstract Dissociative fugue refers to loss of personal identity, often with the associated loss of memories of events (general amnesia). Here we report on the psychological assessment of a 54-year old woman with loss of identity and memories of 33 years of her life, attributed to dissociative fugue, along with a follow-up 11 years later. Significant levels of personal injury and stress preceded the onset of the amnesia. A detailed neuropsychological assessment was completed at a university psychology clinic, with a follow-up assessment there about 11 years later with an intent to determine if changes in her cognitive status was associated with better recall of her life and with her emotional state. Psychomotor slowing and low scores on measures of attention and both verbal and visual memory were present initially, along with significant psychological distress associated with the diagnosis of post-traumatic stress disorder. While memories of her life did not return by follow-up, distress had abated, and memory test scores improved. The passage of time and better emotional state did not lead to recovery of lost memories. Contrary to expectations, performance on tests of executive functions was good on both occasions. The role of multiple stressful events is attributed as having a role in maintaining the loss of memories.
    Full-text · Article · Nov 2014 · Journal of Trauma & Dissociation
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