DISSOCIATION VS DEPERSONALIZATION PROFESSIONAL
For those minimally affected, marital, family, relational, and parenting functions are more likely to be impaired by symptoms of dissociative identity disorder rather than their occupational and professional life. Impairment varies in adults from minimal (i.e., high functioning professionals) to profound. These identities present recurrently, are involuntary and unwanted, and cause significant distress or impairment (Criteria C).
The possession-form identities in dissociative identity disorder manifest most often as a spirit or supernatural being taking control and the individual speaking or acting in a distinctly different way.
It should be noted that most possession states occurring around the world are part of broadly accepted cultural or religious practice and should not be diagnosed as dissociative identity disorder (Criteria D). The dissociative amnesia presents as gaps in autobiographical memory, lapses in memory of well-learned skills or recent events, and discovering possessions for which there is no recollection of ever owning, and can involve everyday events and not just events that are stressful or traumatic. These gaps are more excessive than typical forgetting one may experience due to a lack of attention. The second main diagnostic criteria (Criteria B) for dissociative identity disorder is that there must be a gap in the recall of events, information, or trauma due to the switching of personalities. If the alternate identities are not observable, their presence is identified through sudden alterations or discontinuities in the individual’s sense of self and sense of agency, as well as recurrent dissociative amnesias (see the second criteria below APA, 2022). Generally, though, the identities in non-possession-form dissociative identity disorder are not overtly displayed or only subtly displayed and when they are, it is just in a minority of individuals and manifests as different names, hairstyles, handwritings, wardrobes, accents, etc. Those presenting as being possessed by spirits or demons and for a small proportion of non-possession-form cases, the alternate identifies are readily observable. How overt or covert the personality states are depends on psychological motivation, stress level, cultural context, emotional resilience, and internal conflicts and dynamics (APA, 2022), and severe or prolonged stress may result in sustained periods of identify confusion/alteration. The key diagnostic criteria for dissociative identity disorder is the presence of two or more distinct personality states or an experience of possession (Criteria A). There are three main types of dissociative disorders: dissociative identity disorder, dissociative amnesia, and depersonalization/derealization disorder. However, because of the identifiable stressor (and lack of additional symptoms listed below), they meet diagnostic criteria for a stress disorder as opposed to a dissociative disorder. Furthermore, individuals who suffer from acute stress disorder and PTSD often experience dissociative symptoms, such as amnesia, numbing, flashbacks, and depersonalization/derealization. Occasionally, one may experience temporary dissociative symptoms due to lack of sleep or ingestion of a substance however, these would not qualify as a dissociative disorder due to the lack of impairment in functioning. These symptoms are likely to appear following a significant stressor or years of ongoing stress (i.e., abuse Maldonadao & Spiegel, 2014).
Describe how depersonalization/derealization presents.ĭissociative disorders are a group of disorders characterized by symptoms of disruption and/or discontinuity in consciousness, memory, identity, emotion, body representation, perception, motor control, and behavior (APA, 2022).Describe how dissociative amnesia presents.Describe how dissociative identity disorder presents.Describe treatment options for dissociative disorders.Describe the etiology of dissociative disorders.Describe comorbidity in relation to dissociative disorders.Describe the epidemiology of dissociative disorders.Describe how dissociative disorders present.Be sure you refer Modules 1-3 for explanations of key terms (Module 1), an overview of models to explain psychopathology (Module 2), and descriptions of the various therapies (Module 3).
Our discussion will consist of dissociative identity disorder, dissociative amnesia, and depersonalization/ derealization. In Module 6, we will discuss matters related to dissociative disorders to include their clinical presentation, epidemiology, comorbidity, etiology, and treatment options.
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