DISSOCIATIVE DISORDER
DISSOCIATIVE DISORDER
Introduction:
- Other names: Conversion disorder/previously referred “hysteria”.
- Characterized by disturbances in one or more of mental functions (memory, identity, perception, consciousness & motor behavior).
Symptoms:
- Due to psychological trauma (stressful events/disturbed relationship).
- Appear suddenly due to “psyche” (mind) to deal with unconscious conflicts producing anxiety.
- Helps patient be attentive.
- Genesis is explained in terms of primary, secondary & tertiary gains.
- All these gains function unconsciously.
La belle indifference:
- Phrase used to describe the feeling of indifference which patients of conversion disorders have towards their symptoms.
- For example, if person suddenly has sensory loss (loss of vision)- patient expected to get extremely concerned about it.
- Cconversion disorder patient are completely unconcerned.
- This unconcern/indifference towards their symptoms is called “la belle difference”.
Types:
Dissociative amnesia:
- Main feature = Loss of memory.
- Amnesia usually for traumatic events of personal significance (accidents or unexpected bereavements).
Dissociative fugue:
- Characterized by a sudden, unexpected travel away from home or workplace, with inability to recall some or all of one’s past.
- Basic self-care is maintained during travel & patients behavior during this time may appear completely normal to independent observers.
Dissociative stupor:
- Caused by psychological factors.
Dissociative trance & possession disorder:
- Characterized by loss of sense of identity & full awareness of surroundings.
Dissociative disorders of movement & sensation:
- Symptoms suggest deficit in motor or sensory functions.
- Sensory deficit symptoms do not conform with anatomical & physiological princlples (e.g. sensory loss which doesn’t conform to any nerve lesion).
Depersonalization/derealization disorder:
- Feeling of unreality of self.
Dissociative identity disorder (multiple personality disorder):
- Two or more distinct personalities exist within an individual, with only one of them being evident at any particular time.
Other dissociative disorders:
Ganser’s syndrome –
- Frequently seen in prisoners – Not confined to them.
- Characteristic symptom –Approximate answers (vorbeigehen).
- Clouding of consciousness.
- Auditory & visual hallucinations.
Treatment:
Psychological modalities:
- Behavioral therapy.
- Abreaction – Attempt to bring unconscious memories & emotions, into conscious awareness using hypnosis, medications & other techniques).
- Psychoanalysis.
Exam Important
- La belle indifference describes the feeling of indifference which patients of conversion disorders have towards their symptoms.
- Dissociative amnesia usually for traumatic events of personal significance (accidents or unexpected bereavements).
- Dissociative fugue characterized by a sudden, unexpected travel away from home or workplace.
- In dissociative fugue basic self-care is maintained.
- In dissociative disorders of movement & sensation sensory deficit symptoms do not conform with anatomical & physiological princlples (e.g. sensory loss which doesn’t conform to any nerve lesion).
- Ganser’s syndrome is a dissociative disorder seen in prisoners but not confined to them.
- Characteristic symptom seen in ganser’s syndrome is approximate answers (vorbeigehen), clouding of consciousness, auditory & visual hallucinations.
- Abreaction is an attempt to bring unconscious memories & emotions, into conscious awareness using hypnosis, medications & other techniques) used in dissociative disorder.
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