Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Dissociative Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 865 records · Page 48Linked to original sources
PubMed1995

Vicarious traumatization in the work with survivors of childhood trauma.

1. Persons working with victims of childhood trauma may experience traumatic countertransference and vicarious traumatization. After hearing a patient's trauma story, which is a necessary part of childhood trauma therapy, staff may experience post-traumatic stress disorder, imagery associated with the patient's story and the same disruptions in relationships as the patient. 2. During the first 6 months of working with survivors of childhood trauma, common behaviors of staff members were identified, including a lack of attention, poor work performance, medication errors, sick calls, treatment errors, irreverence, hypervigilance, and somatic complaints. 3. Staff working with victims of childhood trauma can obtain the necessary staff support through team support, in traumatic events, and in a leadership role.

Adaptation, Psychological↗
PubMed1987

Unsuspected multiple personality disorder: an uncommon source of protracted resistance, interruption, and failure in psychoanalysis.

Multiple personality disorder (MPD) is being recognized with increasing frequency. A great imitator, it may be encountered among patients who appear to have a wide range of other diagnoses, and have been in treatment for years without the presence of MPD being discovered. Nine of 241 MPD patients interviewed by the author, 3.7%, had been accepted for psychoanalysis. In only one case had the diagnosis been appreciated by the analyst prior to his accepting the patient for analytic treatment. Four patients were profoundly resistant and or inaccessible to analysis for protracted periods. In one of these cases the diagnosis became clear and successful analysis was concluded, but three analyses ended unsuccessfully with the diagnosis still unknown. Two patients' analyses were interrupted due to abrupt regressive events initially perceived to indicate severe ego weakness incompatible with sustaining an analytic process, but later appreciated as signs of MPD. In three cases it appeared that the patients' being accepted for analysis triggered the emergence of the dissociative process, and either the patient or the analyst decided to pursue a different form of therapy. Unsuspected MPD appears to account for a small percentage of stalemates, failures, interruptions, and early flights from analysis.

Adult↗
PubMed1991

Hospital treatment of multiple personality disorder. An overview.

MPD patients are not rare. They frequently need hospital treatment. This brief and necessarily incomplete communication has attempted to share what is generally known and accepted with regard to their inpatient care. Such knowledge, however, even though it represents the current state of the art, is, like all state-of-the art knowledge, preliminary with regard to what remains to be discovered and developed. It is anticipated that within the next decade the increasing recognition of such patients will result in their becoming commonplace within most psychiatric hospital settings, drawing the attention of more and more hospitals and psychiatrists alike to the study of their care. At that point, the concentrated attention and endeavors of large numbers of skilled mental health professionals and administrators will, in all likelihood, bring fresh insights and offer new approaches that will enrich and perhaps supplant the observations and advices offered in this contribution.

Combined Modality Therapy↗
PubMed2006

Dissociative symptomatology in posttraumatic stress disorder and disorders of extreme stress.

The present study was designed to assess differences in dissociative symptoms in adults with Posttraumatic Stress Disorder (PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified (DESNOS). This study was done for two reasons: (1) to better understand the clinical profile of DESNOS clients in order to inform more effective treatment, and (2) to further empirical research on the validity of the DESNOS construct. To assess severity of dissociative symptoms, the authors administered the Dissociative Experiences Scale (DES) to 155 participants with PTSD. Using the Structured Interview for Disorders of Extreme Stress (SIDES), participants were divided into two groups: those who also met criteria for DESNOS and those who did not. DES means are provided for the two groups. Participants with PTSD plus DESNOS scored higher than participants with only PTSD on the measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two groups did not differ on the amnesia subscale of the DES. Findings support the construct validity of the DESNOS concept and further delineate the clinical profiles of community-based PTSD with and without DESNOS, thus contributing to the knowledge base on the assessment of complex adaptations to trauma.

Adolescent↗
PubMed1991

Psychotherapy and case management for multiple personality disorder. Synthesis for continuity of care.

Patients with MPD are often difficult to manage in the community. These patients have a chaotic lifestyle with acting out behaviors and traumatic relationships. They have difficulty in managing time, maintaining good function, and being safe. The prognosis is good, however, with intensive psychotherapy. Still, containment of the treatment, which is often stormy, is a difficult task. Clinical case management is a treatment modality that strives to bring order out of chaos, stabilize the patient in the community, and encourage the highest level of function during treatment. It is useful to conceptualize case management as a framework for MPD psychotherapy, both to contain the therapy and to be drawn on for strength and resources. The stages of MPD therapy can be intertwined with the core case management functions of assessing, planning, linking to resources, monitoring, and advocacy to facilitate continuity of care for the patient. The synthesis of psychotherapy and case management can decrease chaos for both the patient and therapist, facilitate the patient's function on a daily basis, and increase connectedness for the patient and needed services. There is an art and a subtlety to the synthesis that grows with awareness and experience of the therapist/case manager. It is a synthesis worthy of development and implementation.

Abreaction↗
PubMedDate not supplied

Trauma-related dissociation: conceptual clarity lost and found.

OBJECTIVE: Imprecise conceptualizations of dissociation hinder understanding of trauma-related dissociation. An heuristic resolution for research and clinical practice is proposed. METHOD: Current conceptualizations of dissociation are critically examined. They are compared with a new theory that incorporates classical views on dissociation with other contemporary theories related to traumatization, viewing dissociation as a lack of integration among psychobiological systems that constitute personality, that is, as a structural dissociation of the personality. RESULTS: Most current views of dissociation are overinclusive and underinclusive. They embrace non-dissociative phenomena--rigid alterations in the level and field of consciousness--prevalent in non-traumatized populations, and which do not require structural dissociation. These views also largely disregard somatoform and positive symptoms of dissociation and underestimate integrative deficiencies, while emphasizing the psychological defensive function of dissociation. They do not offer a common psychobiological pathway for the spectrum of trauma-related disorders. Structural dissociation of the personality likely involves divisions among at least two psychobiological systems, each including a more or less distinct apperceptive centre, that is, a dissociative part of the personality. Three prototypical levels of structural dissociation are postulated to correlate with particular trauma-related disorders. CONCLUSIONS: Limitation of the concept of dissociation to structural dividedness of the personality sets it apart from related but non-dissociative phenomena and provides a taxonomy of dissociative symptoms. It postulates a common psychobiological pathway for all trauma-related disorders. Trauma-related dissociation is maintained by integrative deficits and phobic avoidance. This conceptualization advances diagnosis, classification, treatment and research of trauma-related disorders.

Brain Injuries↗
PubMed2001

The responses of dissociative patients on the thematic apperception test.

This study compared the responses of dissociative inpatients and general inpatient psychiatric controls on the Thematic Apperception Test (TAT; Murray, 1943). We found the stories of dissociative participants to be characterized by a greater interpersonal distance and more trauma and dissociation responses than those of the controls. No significant differences were found regarding total number of emotional references, although references to positive emotions were almost nonexistent for the dissociative group. A post hoc analysis of the data found the testing behaviors of dissociative participants to be characterized by switching, trance states, intrainterview amnesias, and affectively loaded card rejections. Questions were raised regarding the relevancy of the findings to clinical practice and how they might explain some of the controversies surrounding the diagnosis of dissociative identity disorder (DID).

Adult↗
PubMed1991

Dissociation in hypnosis and multiple personality disorder.

The first part of this paper examines the concept of dissociation in the context of hypnosis. In particular, the neodissociative and social psychological models of hypnosis are compared. It is argued that the social psychological model, in describing hypnotic enactments as purposeful, does not adequately distinguish between behavior that is enacted "on purpose" and behavior that serves or achieves a purpose. 2 recent dissertations (Hughes, 1988; Miller, 1986) from the University of Waterloo are summarized, each of which supports the neodissociative view that hypnotic behavior can be purposeful (in the sense that the suggested state of affairs is achieved) and nonvolitional (in the sense that the suggested state of affairs is not achieved by high level executive initiative and ongoing effort). The second part of the paper employs a neodissociative view of hypnosis to help understand the current epidemic of multiple personality disorder (MPD). In particular, it is argued that many symptoms of MPD are implicitly suggested effects--particularly prone to occur in persons who have a lifelong tendency to use dissociative type defenses. The present author believes that this account is easier to sustain conceptually and empirically than the current view, which states that a secondary (tertiary, etc.) personality accounts for the striking phenomenological discontinuities experienced by MPD patients.

Adult↗
PubMed2002

Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors.

BACKGROUND: Dissociative symptoms during trauma predict post-traumatic stress disorder (PTSD), but they are often transient. It is controversial whether they predict chronic PTSD over and above what can be predicted from other post-trauma symptoms. AIMS: To investigate prospectively the relationship between dissociative symptoms before, during and after a trauma and other psychological predictors, and chronic PTSD. METHOD: Two samples of 27 and 176 road traffic accident survivors were recruited. Patients were assessed shortly after the accident and followed at intervals over the next 6 months. Assessments included measures of dissociation, memory fragmentation, data-driven processing, rumination and PTSD symptoms. RESULTS: All measures of dissociation, particularly persistent dissociation 4 weeks after the accident, predicted chronic PTSD severity at 6 months. Dissociative symptoms predicted subsequent PTSD over and above the other PTSD symptom clusters. Memory fragmentation and data-driven processing also predicted PTSD. Rumination about the accident was among the strongest predictors of subsequent PTSD symptoms. CONCLUSIONS: Persistent dissociation and rumination 4 weeks after trauma are more useful in identifying those patients who are likely to develop chronic PTSD than initial reactions.

Accidents, Traffic↗
PubMed1994

Belief in the existence of multiple personality disorder among psychologists and psychiatrists.

The present study surveyed the attitudes of psychiatrists and psychologists with regard to the existence of dissociative and multiple personality disorders. Questionnaires were sent to psychiatrists and psychologists in all VA Medical Centers. A total of 1,120 VA psychologists and psychiatrists completed the surveys. More than 97% of respondents indicated that they believed in dissociative disorders, while 80% reported a belief in multiple personality disorder. Belief in multiple personality disorder was related significantly to profession, age, and years of experience.

Adult↗
PubMed1993

Briquet's syndrome, dissociation, and abuse.

OBJECTIVE: To help clarify the complex association between childhood abuse and adult psychopathology, the authors examined the relationship among abuse, Briquet's syndrome (somatization disorder), and dissociative symptoms. METHOD: Ninety-nine female psychiatric clinic outpatients with a history of somatic complaints were assessed for Briquet's syndrome, dissociative symptoms, adult and childhood sexual abuse, childhood physical abuse, and childhood emotional abuse. RESULTS: Women with high dissociation scores and many somatic symptoms were more likely to report abuse than were subjects with low dissociation scores or with few somatic complaints. CONCLUSIONS: Briquet's syndrome, dissociation, and abuse are significantly associated. Awareness of this association may have a significant effect on the treatment of psychiatric patients.

Adult↗
PubMed1988

Dissociation and hypnotizability in posttraumatic stress disorder.

The authors compared the hypnotizability of 65 Vietnam veteran patients with posttraumatic stress disorder (PTSD) to that of a normal control group and four patient samples using the Hypnotic Induction Profile. The patients with PTSD had significantly higher hypnotizability scores than patients with diagnoses of schizophrenia (N = 23); major depression, bipolar disorder--depressed, and dysthymic disorder (N = 56); and generalized anxiety disorder (N = 18) and the control sample (N = 83). This finding supports the hypothesis that dissociative phenomena are mobilized as defenses both during and after traumatic experiences. The literature suggests that spontaneous dissociation, imagery, and hypnotizability are important components of PTSD symptoms.

Adult↗
PubMed1996

A dissociation between the ability to print and write cursively in lower-case letters.

This paper reports the case of a patient with a peripheral spelling impairment who is much more severely impaired at writing in lower-case letters than in upper-case letters. This pattern can be observed when writing both words and single letters of the alphabet. Despite this, his problems in writing lower-case letters are no longer present when he is writing cursively. This case therefore indicates that the ability to print letters in lower-case can be selectively impaired in the absence of similar problems in printing upper-case letters or in writing lower-case letters cursively. In terms of the model of writing put forward by Ellis (1982, 1988), this suggests that allographic level representations for print handwriting styles can be functionally dissociated from allographic representations for cursive styles.

Aged↗
PubMed2001

Dissociative flashbacks after right frontal injury in a vietnam veteran with combat-related posttraumatic stress disorder.

A Vietnam veteran with a combat-related posttraumatic stress disorder developed recurrent dissociative flashbacks (related to the atrocities of a specific war incident) several months after suffering a traumatic brain injury. CT disclosed a small lesion in the right dorsolateral prefrontal cortex. SPECT demonstrated more extensive functional changes in prefrontal and anterior paralimbic brain regions, mainly in the right hemisphere. This case further implicates the provocative effect of physical stimuli (brain damage) in reawakening old dormant memories and the preferential role of the right hemisphere for the storage of traumatic memories.

Brain Mapping↗
PubMed2006

Duloxetine for childhood depression with pain and dissociative symptoms.

Over two thirds of people suffering from depression complain of pain with or without reporting psychological symptoms. Physical symptoms are more prevalent among the women, the elderly, the poor, and in children population. Successful treatment of depression in children complicated by pain symptoms constitutes a great clinical challenge. Duloxetine has already emerged as a safe and effective treatment option for adult depressed patients with painful physical symptoms. However, no data exist in literature which suggests use of duloxetine in childhood and adolescent population for the same clinical indication. We report a case documenting successful use of duloxetine in a depressed girl child who also had severe pain and dissociative symptoms.

Antidepressive Agents↗
PubMedDate not supplied

The relationship of depression to dissociation in patients with bulimia nervosa.

Dissociative Experiences Survey scores were compared between bulimics with and without depression, and among depressed patients with and without bulimia. An association is noted between depression and dissociation, confounding the previously noted relationship between bulimia nervosa and dissociation.

Adolescent↗