User:Allysch/Dissociative disorders

Dissociative disorders involve involuntary dissociation as an unconscious defense mechanism, wherein the individual with a dissociative disorder experiences separation in these areas as a means to protect against traumatic stress. Some dissociative disorders are caused by major psychological trauma, though the onset of depersonalization-derealization disorder may be preceded by less severe stress, by the influence of psychoactive substances, or occur without any discernible trigger. The types of disorders, causes, treatment options, neuroscience, and current data are as follows.

There are no medications to cure or completely treat dissociative disorders; however, drugs to treat associated symptoms (eg., anxiety and depression are readily available). Antipsychotics such as Aripiprazole, Olanzapine, and Risperidone may be prescribed to treat the frequency of dissociated experiences of DID. Although medication is known to lower the frequency of episodes, psychotherapy is proven to have the longest lasting effect in terms of treatment.

DSM-5 Dissociative disorders

The dissociative disorders listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are as follows:

• Dissociative identity disorder (DID, formerly multiple personality disorder): the alternation of two or more distinct personalities with impaired recall of the alternative personality; however, the alternate personalities can be aware of all the existing personalities.
• Dissociative amnesia (formerly psychogenic amnesia): the loss of recall memory, specifically episodic memory, typically as a reaction to traumatic or stressful events. It is considered the most common dissociative disorder amongst those documented. This disorder can occur abruptly or gradually and may last minutes to years.
• Dissociative fugue was previously a separate category but is now treated as a specifier for dissociative amnesia, though many patients with dissociative fugue are ultimately diagnosed with dissociative identity disorder.
• Depersonalization-derealization disorder (DpDr): periods of detachment from self or surroundings which may be experienced lack control of ones "outside" self) while retaining awareness that this is a feeling and not reality. Individuals often show little emotion or report "out of body" experiences. Individuals may see distorted perceptions of their environment (fuzziness, blurriness, flatness, cloudiness), difficulty feeling emotions, and difficulty recognizing familiar things, including one's own reflection in a mirror. They may see objects as larger or smaller than the actual size. They may lose certain bodily sensations like hunger and/or thirst. Many patients experience these symptoms continuously everyday while others experience the above symptoms in discrete episodes.
• The DSM-IV category of dissociative disorder not otherwise specified was split into two diagnoses: other specified dissociative disorder and unspecified dissociative disorder. These categories are used for forms of pathological dissociation that do not fully meet the criteria of the other specified dissociative disorders.

Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association. 2013. pp. 291–306

Causes

Dissociative disorder are most often caused by the attempt to cope with psychological trauma. Most individuals were subjected or part of a form of physical, emotional, mental, or sexual trauma or abuse. While these traumatic experiences typically happen when the individual is a child, some may experience dissociation due to an event in adulthood. An example of this is death of a loved one, abuse from a spouse, or a post-war/combat period.

Dissociative identity disorder, dissociative amnesia, and depersonalization-derealization disorder (different diagnosis' within dissociation disorder) all are typically resulted from a form of trauma.

Treatment

Treatment options for dissociative disorders include psychotherapy, cognitive therapy, or medication.

Psychotherapy can be described as a form of treatments used together to find the main cause of a disorder. This form of therapy dives into past emotions and experiences to find personal growth and ways to cope with those past occurrences. Cognitive therapy is a form of psychotherapy that aims to change ways of thinking and behaving. This form of therapy exposes the individual to triggering acts, such as an individual with anxiety stepping into a large crowded room. While there are no medications that treat dissociative disorder, medications that treat anxiety and depression may be helpful. Examples of these medications include antidepressants, SSRI's, or OCD medication Buspirone.

Neuroscience

Individuals with dissociative disorder have higher levels of brain activity in their prefrontal lobe. The prefrontal lobe is responsible for memory processing, decision making, and response. MRI scans have shown notable difference in cortical and subcortical activity in the hippocampus and the amygdala. The amygdala is responsible for emotional response to stimuli while the hippocampus is responsible for memory. An MRI completed on a patient with dissociative disorder may show less activity in the hippocampus.

Diagnosis

The Dissociative Experience Scale, Adolescent Dissociative Experiences Scale, and Child Dissociative Checklist are available resources in diagnosing someone with dissociative disorder. It is difficult for mental health professionals to diagnose someone with this particular disorder as the symptoms may mimic symptoms of hysteria or psychosis. It may take multiple sessions of therapy or trails of medications to accurately diagnose someone with DD. It is especially difficult to diagnose children, as they may have difficulty describing their emotions. Researchers and mental health professionals are working diligently to develop a better process for diagnosing DD and catching it at its earlier stages. These plans may mean treating DD differently during different stages of life.

References

1. Salter, Micahel; Dorahy, Martin; Middleton, Warwick. "Dissociative identity disorder exists and is the

result of childhood trauma". The Conversation. 3, January 2018.

2. Bailey, Tyson D.; Boyer, Stacey M.; Brand, Bethany L. (2019). "Dissociative Disorders". In Segal, Daniel L. (ed.).

Diagnostic Interviewing (5th ed.).

out of body image

After reviewing the feedback from my peers, I have decided to make a few changes to my work. Michellevp16 recommended I separate the DSM-5 criteria from the lead paragraph and add a title. Sawyerbrady44 recommended I take out the word "best" to avoid being biased in terms of treatment options. I have now referred to psychotherapy as a more proven form of therapy instead of the "best". Cjanneellen said I should make the sentences more clear, so that someone with no prior knowledge of DID would be able to understand the article. I took out excess wording but left enough to get the points across well. Maddimcg recommended I add more information to the lead in order to preface the rest of the article. I added a sentence to the end of my lead as a reminder to preface further material. I am undecided how I will have the lead cover all paragraphs/sections at this time. I was not provided with a peer review from Makylam18. AngelOffley stated I need to add more information overall and browse for more images. I have added additional information from the original article and will continue to add and edit for further assignments. I greatly appreciate the time my peers have taken to give good quality feedback.

Dissociative identity disorder

Dissociation (psychology)

Depersonalization-derealization disorder

Other specified dissociative disorder

International Society for the Study of Trauma and Dissociation