![]() Unbeknownst to the first personality, her second personality wrote a letter to her psychiatrist before Chris was ever placed under hypnosis or suspected of having multiple personalities. The symptoms are not due to substances (like alcohol) or a medical condition (like seizures)Ĭhris Sizemore, the woman described in The Three Faces of Eve, was apparently a spontaneous case of DID.The disturbance is not part of normal cultural or religious practices.The person must be distressed by the disorder and have trouble functioning.Amnesia: gaps in the recall of everyday events.Two or more distinct identities or personality states."Experiences of pathological possession"–spirit possession, in other words–are also included in DSM, in an effort to be "more applicable to culturally diverse situations."ĭSM-5 specifies five criteria for a diagnosis of DID: Sociocultural influences may be involved in DID, but that is almost irrelevant to the DSM-5. What percentage of psychiatrists were skeptical about DID, in one survey? 43% described themselves as "skeptical" about it, especially the tie between diagnosis of DID and recovered memory therapies (Gharaibeh, 2009). The most spectacular form of dissociative state is Dissociative Identity Disorder or "multiple personality." It was described in Chapter 11 (Personality) along with a review of controversies over its causation.Ī survey of 301 board-certified psychiatrists showed that only 21% believed there was strong evidence for DID. The father had been a patient in this hospital and on that floor at the time of his death. The patient suddenly emerged from his fugue, felt very embarrassed, made up some trivial excuse for being there, and walked back home. He must have walked the entire distance as he had no money with him.īy coincidence, an acquaintance saw him there and asked him whom he was visiting. and the next thing he knew he was on the eighth floor of a hospital about 5 miles from his home. The patient remembers walking down the stairway of his residence. Rice and Fisher (1976) reported a case in which a young man had fugue states lasting from minutes to hours that occurred every day. ![]() What are characteristics of a dissociative fugue state? Fugue states are often associated with epilepsy and may be set off by seizure activity. ![]() In DSM-5, fugue states are considered a form of dissociative amnesia. Much more rare than sleepwalking is the dissociative fugue state–an extended episode of automatic action or wandering followed by complete amnesia for the time of the activity. However, sleepwalking meets the three cognitive criteria of a dissociative state: (1) It is intelligent activity (sleepwalkers avoid obstacles, walk up and down stairs, open doors) (2) The person's normal awareness is absent or distracted (in fact, sleepwalkers are usually dreaming about something unrelated to the sleepwalk) (3) The individual has amnesia for the event later (sleepwalkers do not remember the events of the sleepwalk). Why can sleepwalking be defined as a dissociative state? Why is it not so classified, in DSM-5? Sleepwalking is described there as a "non-rapid eye movement sleep arousal disorder." It is listed under a separate section for Sleep Disorders. Ironically, it is not even categorized as a dissociative state in DSM-5, apparently because it is not an escape from reality. The most common dissociative state listed in DSM-5 is sleepwalking. What are criteria of a dissociative state "from a cognitive perspective"? A person will have amnesia for the period of time involved. When a stream of activity is independent of consciousness, it leaves no record in autobiographical memory. The task can be anything from knitting to picking peas to driving. An example of a normal dissociative state is carrying out a simple motor task absent-mindedly. This commonly occurs with motor activity that is highly practiced, as discussed in Chapter 7 under the heading of automaticity. From a cognitive perspective, a dissociative state is defined by three things: intelligent behavior, absence of normal awareness, and amnesia for the period of time during which the behavior is carried out. Not all dissociative states are abnormal. NAMI, the National Alliance on Mental Illness, defines dissociative disorders as "an involuntary escape from reality characterized by disconnection between thoughts, identity, consciousness, and memory." DSM-5 specifies three varieties: dissociative identity disorder (DID), dissociative amnesia, and depersonalization/ derealization disorder. ![]()
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