N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide

©2017 Achieve Test Prep Page 12 of 140 Dissociative Disorder Dissociative disorders usually involve impairment of consciousness, memory, and perception. There is a sudden disruption in the patient’s consciousness, identity, or memory. Defense mechanisms of dissociation and repression are used. Possible etiologies include traumatic experiences or severe physical, sexual, or emotional abuse. With a dissociative identity disorder, aspects of the self may emerge as distinct personalities, with individual losing a sense of who he/she is. Multiple Personality Disorder This occurs when there is a presence of two or more distinct personalities or identities in one person. An alter is a personality state or identity that recurrently takes over the behavior of a person with DID; alters are personalities with different influences and power over one another and may represent different ages or gender. Each alter has a relatively enduring pattern of perceiving, relating to, and thinking about itself and the environment. Alters communicate with one another through the “executive” alter. Some alters share “co-consciousness”, aware of each other’s experience and behavior; others are aware only of their existence. “Switching” occurs by dissociating from one alter to another. The host personality is the primary identity that holds the person’s name; it is typically unaware of alters, but alters are typically aware of the host personality. The patient “loses track of time” when the alternate personality is present. Usually the patient is unable to give full account of childhood memories because of dissociation; the patient may appear forgetful and is often accused of lying. Mental status variations include blinking, eye rolls, headaches, and marked variations in speech. Other signs and symptoms include: • Disruption of identity characterized by two or more distinct personality states • Multiple mannerisms, attitudes, and beliefs • Pseudo seizures or other conversion symptoms • Somatic symptoms that vary across identities • Distortion or loss of subjective time (a long time) • Current memory loss of everyday events • Depersonalization, derealization, and depression • Flashbacks of abuse/trauma • Sudden anger without a justified cause • Frequent panic/anxiety attacks and unexplainable phobias Depersonalization Disorder Depersonalization disorder is a feeling of detachment or separation from one’s self, as if in a dream- like state. The patient describes his/herself as “detached from the body” or “being in a dream.” The patient feels strange or unreal, but is able to function during the experience. Distress about experiences may be reported and patients become depressed and anxious. Often the patient fears being “crazy”. Feelings may be accompanied by derealization, a feeling that the external world is unreal or strange. This disorder is most common in teenagers and young adults.

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