DISSOCIATIV DISORDER Caangay分离性障碍 caangay.pptVIP

DISSOCIATIVE DISORDER Loss of unitary sense of self as a single human being with a single basic personality Arises as a defense mechanism Contradictory representations of the self, which conflict with each other, are kept in separate compartments Types: Dissociative Amnesia Dissociative Fugue Dissociative Identity DO Depersonalization DO Dissociative Amnesia Characterized by inability to remember information, usually related to stressful or traumatic event Cannot be explained by ordinary forgetfulness, the ingestion of substances, or a general medical condition Dissociative phenomena is limited to amnesia Epidemiology Women, young adults Usually associated with stressful and traumatic events; domestic settings Etiology Learning is state dependent: memory of a traumatic event is laid down during an event, and the emotional state may be so extraordinary that it is hard for the affected person to remember information learned during that state Psychoanalytic approach: defense mechanism, a way to deal with an emotional conflict or an external stressor Diagnosis Forgotten information is usually of a traumatic or stressful nature Not due to a general medical condition or ingestion of a substance Clinical Features History: precipitating emotional trauma charged with painful emotions and psychological conflict Onset: often abrupt Depression and anxiety: common predisposing factors and seen in MSE Amnesia may provide a primary or secondary gain Forms: Localized amnesia: most common; loss of memory for a short time (a few hours to a few days) Generalized amnesia: loss of memory for a whole lifetime of experience Selective amnesia: failure to recall some but not all the events that occurred during a short time Differential Diagnosis Medical history, PE, lab work-up, psych history, MSE Dementia/delirium Postconcussion amnesia Epilepsy Transient global amnesia Other mental disorder Course and Prognosis Symptoms usually terminate abruptly and recovery is generally complete T