DISSOCIATVIE DISORDERS
DISSOCIATVIE DISORDERS
COUN 646
Research Paper – DISSOCIATVIE DISORDERS Outline Template Comment by Dr. Dumont: Include a title page Comment by Dr. Dumont: The running head appears on all subsequent pages absent the words ‘Running head:’ (e.g., ‘RUNNING HEAD IS ALL CAPITAL LETTERS’) (Chapter 2, 2.01, p. 23) (Figure 2.1, p. 41). DISSOCIATVIE DISORDERS
I. ABSTRACT
II. INTRODUCTION OF DISSOCIATIVE DISORDERS
A. The prevalence of dissociative disorders in the general population is as high as 18% (Fine, 2012, p. 334).
B. There are three fundamental dissociative ways of responding to a traumatic experience: detach from it (depersonalization/derealization), forget it (amnesia), or separate the memory of the experience from one’s present identity (dissociative flashback, DID) (Spiegel, Lewis-Fernández, Lanius, Vermetten, Simeon, & Friedman, 2013, p. 307).Comment by Dr. Dumont: For six or more authors, cite the primary author followed by ‘et al.’ for the first and all following mentions of the work (Chapter 6, 6.12, p. 175).
III. AN OVERVIEW OF DISSOCIATVIE DISORDERS
A. Dissociative Identity Disorder
– Dissociative experiences include amnesia, identity disturbance, age regression, difficulty with concentration, and trance states (APA, 2013, p. 292).
1. Formerally known as Multiple Personality Disorder
2. Characteristics from DSM-5
i. The existence of two or more identities Comment by Dr. Dumont: These should be lower-case letters
ii. Ongoing gaps in memory
iii. Significant distress in different areas of functioning
B. Dissociative Amnesia
1. Characteristics from DSM-5
i. Amnesia involves a deficit in functioning episodic memory such that information that was presumably encoded cannot be retrieved under normal circumstances (APA, 2013, p. 297). Comment by Dr. Dumont: These should be lower-case letters
ii. Not being able to remember information about oneself
iii. Dissociation Fugue
C. Depersonalization/Derealization
1. Characteristics from DSM-5
i. Depersonalization is significant recurring experiencing detachment from one’s mind, self, or body Comment by Dr. Dumont: These should be lower-case letters
ii. Derealization disorder is detachment from one’s environment
iii. Depersonalization and derealization provide an immediate means of modulating the acute perceptual impact of a traumatic experience, but if they persist, then over time they can become disturbing persistent or recurrent symptoms that hamper processing of past and present experiences (APA, 2013, p.303) .
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IV. POTENTIAL CAUSES
A. Biological/Neurobiological
1. Research is limited; There are no known biological causes
2. Neuroimaging studies show patterns of brain activation and inhibition consistent with other dissociative disorders. Three consistent findings have emerged:
i. altered activation of posterior cortical sensory association areas, primarily the inferior parietal lobe Comment by Dr. Dumont: These should be lower-case letters
ii. prefrontal activation
iii. limbic inhibition
3. They highlight a neural mechanism common among dissociative disorders—prefrontal activation and limbic inhibition.
4. Suppression of emotion would plausibly inhibit the neural connectivity that would facilitate integration of information about memory, identity, and consciousness (Spiegel, Lewis-Fernández, Lanius, Vermetten, Simeon, & Friedman, 2013, p. 316). Comment by Dr. Dumont: For six or more authors, cite the primary author followed by ‘et al.’ for the first and all following mentions of the work (Chapter 6, 6.12, p. 175).
B. Life Events
1. Emotional, Physical, and Sexual Abuse
i. Survivors of chronic childhood abuse can suffer from problems in several developmental domains: Comment by Dr. Dumont: These should be lower-case letters
a. affect regulation Comment by Dr. Dumont: These should be lower case Roman numerals
b. interpersonal functioning
c. self-perception
d. cognition
e. impulse control
f. (Brand, Classen, McNary & Zaveri, 2009, p. 653).
2. Trauma in Early Childhood
i. Dissociative disorders (DD) prevail as sequelae to overwhelming experiences in childhood (Fine, 2012, p. 333). Comment by Dr. Dumont: These should be lower-case letters
3. Combat
i. Discuss the overlap of misdiagnosing DD for PTSD Comment by Dr. Dumont: These should be lower-case letters
4. Natural Disasters
5. Loss of a Loved One
V. EVALUATING FOR THESE DISORDERS
A. It would be beneficial to use a systematic assessment tools such as structured interviews to document in a laborious way Axis I and Axis II diagnoses. DISSOCIATVIE DISORDERS
B. Standardized measures to assess other areas of functioning within life
C. Measures to assess symptoms and overall functioning of the patient should be given at the beginning of treatment and readministered periodically so as to document the treatment progress Comment by Dr. Dumont: Nice work on including assessment tools in this section
D. (Aadil & Shoaib, 2017, p. 408).
VI. TREATMENT OPTIONS
A. Patients with dissociative disorder who integrated their dissociated self states were found to have reduced symptomatology compared with those who did not integrate (Brand, Classen, McNary & Zaveri, 2009, p. 646). Comment by Dr. Dumont: For three to five authors, cite all of the authors the first time the work is mentioned and the primary author followed by ‘et al.’ for all successive times the work is mentioned. (Chapter 6, 6.12, p. 175).
B. Treatment Options for individuals diagnosed with PTSD are similar to those diagnosed with DD. Patients diagnosed with DID, the most severe form of DD, have been shown to have the highest psychiatric costs among patients entitled to psychiatric disability payments in Massachusetts, which suggests there are also economic reasons for identifying effective treatments for this population (Brand, Classen, McNary, and Zaveri, 2009, p. 649). Comment by Dr. Dumont: For three to five authors, cite all of the authors the first time the work is mentioned and the primary author followed by ‘et al.’ for all successive times the work is mentioned. (Chapter 6, 6.12, p. 175).
C. Although there is a small but growing body of controlled trials examining treatments for adult survivors of child abuse, there are no controlled trials for the treatment of DD (Foote, B & Van Orden, 2016, p. 351). Comment by Dr. Dumont: Delete. Comment by Dr. Dumont: Good job on overview of the treatment options
VII. Review the different types of effective treatment options
A. A variety of theoretical approaches are reported to be effective including: Comment by Dr. Dumont: You can’t have an A without a B
i. cognitive behavioral hypnotherapy Comment by Dr. Dumont: These should be numeric numbers
ii. psychopharmacological treatment
iii. psychodynamic therapy
iv. phenomenological treatment
v. contextual treatment
vi. cognitive analytic therapy
vii. feminist-informed treatment
viii. adjunctive treatment with Eye Movement Desensitization and Reprocessing (EMDR)
ix. (Brand, Classen, McNary & Zaveri, 2009, p. 653). Comment by Dr. Dumont: For three to five authors, cite all of the authors the first time the work is mentioned and the primary author followed by ‘et al.’ for all successive times the work is mentioned. (Chapter 6, 6.12, p. 175).
VIII. LIMITATIONS
A. There have been numerous case studies on the treatment of DID and DDNOS. More research is needed in order to fully understand this mental disorder (Foote & Van Orden, 2016, p. 351). Comment by Dr. Dumont: You can’t have an A without a B
i. lack of standardized measures Comment by Dr. Dumont: These should be numeric numbers
ii. unclear generalizability
iii. potential for experimenter bias
iv. demand characteristics
IX. CONCLUSION
A. In conclusion, there is a emerging body of evidence connecting dissociative disorders to a traumatic past, and to certain neural mechanisms of behaviors. Given the frequency, constant symptoms, and wellness costs related with treating individuals with dissociative disorders, extensive research is required so that a strong conclusion can be determined about the appropriateness of treatment options. However, The treatment of dissociative disorder conditions are conventionally extended and prolonged; the number of sessions required to reach treatment goal varies based on resiliency, their distress tolerance, and the constancy of external forces throughout treatment. Comment by Dr. Dumont: One of the required sections needs to be included: 5. A biblical perspective of these disorders and their treatment
References
Aadil, M., & Shoaib, M. (2017). Diagnostic challenges leading to underdiagnosis of
dissociative disorders. Neuropsychiatric Disease and Treatment, 13, 407-410. doi:10.2147/NDT.S131439
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Brand, B. L., Classen, C. C., McNary, S. W., & Zaveri, P. (2009). A review of dissociative
disorders treatment studies. The Journal of Nervous and Mental Disease, 197(9), 646-654. doi: 10.1097/NMD.0b013e3181b3afaa
Fine, C. G. (2012). Cognitive behavioral hypnotherapy for dissociative disorders. American Journal of Clinical Hypnosis, 54(4), 331-352. doi:10.1080/00029157.2012.656856
Foote, B., & Van Orden, K. (2016). Adapting dialectical behavior therapy for the treatment
of dissociative identity disorder. American Journal of Psychotherapy, 70(4), 343-364. doi: 10.1176/appi.psychotherapy.2016.70.4.343
Spiegel, D., Lewis-Fernández, R., Lanius, R., Vermetten, E., Simeon, D., & Friedman, M.
(2013). Dissociative disorders in DSM-5. Annual Review of Clinical Psychology, 9(1), 299-326. doi:10.1146/annurev-clinpsy-050212-185531
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