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Results for “Dissociative Disorders”

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PubMed1976

Psychotherapeutic management of a potential spirit medium.

Psychotherapeutic management of a potential spirit medium (shaman) in a modern University Hospital setting in Malaysia is described. Magical thinking, projection and spirit possession (trance state) occur during management. Discussion of management was based on what Heinz Wolff described as the psychotherapist's functions of (1) psychodynamic understanding; (2) the therapeutic function; and (3) the developmental function. This patient did not conform to the general criteria of a suitable patient for psychotherapy. But her willingness to engage in therapy contributed to a satisfactory outcome. The therapist's growth in cross-cultural therapeutic encounter seems to be prominent.

Adjustment Disorders↗
PubMedDate not supplied

Making sense of 'possession states': psychopathology and differential diagnosis.

Possession is a common manifestation of distress in a multicultural setting. It is increasingly likely to be encountered by mental health professionals who may be unaware of the phenomenon. A review of the literature is presented with clinical guidelines for a culturally sensitive assessment and management.

Adolescent↗
PubMed2002

Assessing dissociation as a risk factor for posttraumatic stress disorder: a study of adult offspring of holocaust survivors.

Dissociative symptoms are frequently present in trauma survivors with posttraumatic stress disorder (PTSD). However, the possibility that dissociative symptoms may comprise a risk factor for the development of PTSD has not been examined. The current research investigates this possibility by evaluating dissociative symptoms in a group of adult offspring of Holocaust survivors, whom we have previously shown to be at increased risk of PTSD. Eighty-seven Holocaust survivor offspring and 39 comparison participants completed the Dissociative Experiences Scale, and assessments of trauma exposure, psychopathology, and parental PTSD. Dissociative symptoms were elevated in individuals with current PTSD, but not in those with past PTSD or with the risk factor of parental PTSD. Dissociative symptoms were also associated with forms of psychopathology other than PTSD. The results suggest that dissociative symptoms are related to current psychiatric symptomatology, including PTSD, rather than representing an enduring trait or preexisting risk factor for the development of PTSD.

Adult↗
PubMed1995

Psychological sequelae in adult females reporting childhood ritualistic abuse.

The present study sought to increase current scientific knowledge about the controversial issue of subjectively reported childhood ritualistic abuse by addressing several key unresolved issues. In particular, the possibility that those reporting ritualistic abuse may be characterized primarily by the severity of their abuse histories or the severity of their present psychological symptoms, rather than the veridicality of the ritualistic events, was explored. Adult female outpatients reporting childhood sexual abuse with ritualistic features were compared with a second group of women who reported childhood sexual abuse without ritualism. Measures included characteristics of childhood sexual and physical abuse, current posttraumatic stress disorder (PTSD) diagnostic status and symptom severity, and severity of current dissociative experiences. Women reporting ritualistic features scored significantly higher on measures of childhood sexual and physical abuse. Neither PTSD diagnostic status nor severity for PTSD nor dissociative experiences were significantly different between the groups. While preliminary in nature, these results suggest that it may be helpful to conceptualize reported childhood ritualistic abuse as indicative of the need to assess carefully for severe abuse and its predictable sequelae within existing traumatic victimization conceptual frameworks.

Adolescent↗
PubMed1999

Successful treatment of refractory obsessive-compulsive disorder.

UNLABELLED: A case study is presented of a 40-year-old man with obsessive-compulsive disorder (OCD). He had been treated with long-term institutional placement, electroconvulsive therapy, exhaustive pharmacotherapy, and psychodynamic and cognitive-behavioral psychotherapy. Nothing had relieved his excessive hand washing and door checking. Records from previous treatment revealed a diagnosis of dissociative identity disorder (DID). This information led to reconceptualization of the OCD symptoms as manifestations of the patient's ego fragmentation. When his fragments were catalogued and addressed, all overt OCD symptoms abated within weeks. It is believed that the patient's most anxious ego fragment communicated dread from the background of the patient's psyche, the executive component only being aware of the anxiety and not the triggering stimulus. The patient was taught to address this fragment verbally to elicit its cooperation, whereupon the fragment stopped sounding alarm, creating anxiety and driving the patient to check and recheck, wash and rewash. Symptoms have returned only when the patient has suspended his announcing behavior and have abated when this was resumed. Connections between OCD and DID are addressed. CONCLUSION: Patients exhibiting refractory OCD symptoms should be assessed for dissociative symptomatology.

Adult↗
PubMed1985

Patients with medically unexplained symptoms: DSM-III diagnoses and demographic characteristics.

This study reports DSM-III diagnoses and demographic characteristics of 100 patients consecutively referred to a university hospital consultation-liaison service for evaluation of medically unexplained symptoms suggesting physical disorders. Thirty-seven percent of patients received diagnoses of somatoform, dissociative, or factitious disorders, and 14% were felt to have psychologic factors affecting physical conditions. Although black and male patients were less often referred for medically unexplained symptoms, once referred they were more likely than white and female patients to receive diagnoses of somatoform, dissociative, or factitious disorders. Among patients with somatoform disorders, those with conversion disorder and somatization disorder tended to be young women, whereas those with psychogenic pain disorder were older and equally likely to be male or female.

Adult↗
PubMed1996

Interpersonal violence: expanding the search for long-term sequelae within a sample of battered women.

Lifetime sexual and physical victimization histories were examined within a shelter and outpatient sample of battered women (N = 43). Rates of prior victimization were very high with 71% of women reporting a childhood experience of physical abuse and 53% of women reporting a childhood experience of sexual abuse. These experiences were then examined as predictors of intra- and interpersonal functioning. Difficulties with identity development, low self-worth, borderline personality characteristics, and (at the trend level) difficulties with intimacy, received some support as long-term outcomes associated with reports of chronic experiences of childhood physical abuse. These findings provide some empirical support for the theorized relationship between childhood abuse and difficulties in the domains of intra- and interpersonal functioning.

Adolescent↗
PubMed1979

Some aspects of order and symbolism in schizophrenia.

Developing out Rümke's term of "PraecoxGefühl", it is described that the schizophrenic disorder in his way of being is the fundamental underlying reason for dissociation of his thoughts and feelings. This consequently leads to a distortion in his system of sign recognition and the meaning attached to the different semantic and syntactic levels. By means of the "Wahnarbeit" and other mechanisms the schizophrenic tries to build another order in which he can feel more at ease with his overwhelming experiences. The conceptualization of his thoughts is performed by using a "principle of symmetry"--attaching the meaning of one perceived object (I) of reality to another conceptualized object (II). Very often we are unable to understand the individualistic nature of schizophrenic symbolization because of this mechanism.

Anomie↗
PubMed2006

[On the relationship between traumatization, amnesia and symptom stress--an empirical pilot study].

OBJECTIVES: In the present study we examined facial affective behavior in acutely traumatized patients undergoing EMDR therapy. Furthermore, we analyzed whether a decrease in emotional numbing was due to a reduction of symptoms. Amnestic tendencies were used as a moderator variable. METHODS: The facial affective behaviour was coded using the Emotional Facial Acting Coding System, an instrument for the registration of facial movements with emotional relevance. The facial affective behavior of the patient's first and last EMDR session was compared. RESULTS: A significant increase in facial affective behavior as well as an increase in mental complaints were found. Furthermore, the reduction in amnestic tendencies did not result in a reduction of symptoms. CONCLUSIONS: Under the influence of the treatment it is possible to improve access to episodic affective memory. Nevertheless, a positive influence cannot be denoted at the end of the treatment.

Adult↗
PubMed2001

A randomized controlled trial of community-oriented and hospital-oriented care for discharged psychiatric patients: influence of personality disorder on police contacts.

An important forensic psychiatric measure, contacts with police, was compared in a randomized, controlled trial of 155 patients with severe mental illness with a previous admission within the past two years. The patients, who also had their personality status addressed formally before randomization, were allocated to community multidisciplinary teams or to hospital-based care programs after discharge from in-patient care and were followed up for one year. A total of 138 patients (89%) had at least one post-baseline assessment and of these patients, 16 (12%) had at least one police contact in the year of the study, most of which were emergency assessments. The data showed significantly greater numbers of police contacts in patients with increasing severity of personality disturbance. Patients with such disturbance were six times more likely to have police contacts than those with no personality disorder. There were significantly more contacts in patients with borderline and antisocial (dissocial) personality disorder allocated to community-oriented care compared with hospital-oriented care. These findings have important implications for risk assessment in severe mental illness.

Adolescent↗
PubMed2004

Psychogenic movement disorders: diagnosis and management.

Psychogenic movement disorders (PMDs) are best defined as hyper- or hypo-kinetic movement disorders, often associated with gait disorders, that cannot be directly attributed to a lesion or dysfunction of the nervous system and which are derived in most cases from psychological or psychiatric causes. There are a variety of PMDs including tremor, dystonia, parkinsonism, gait disorders and, even, unusual forms including paroxysmal dyskinesias. As has been recognised in the recent literature, PMDs cannot be strictly classified into clearly defined psychiatric disorders such as somatoform, dissociative or conversion disorders. In this review, we discuss the diagnosis of various PMDs (including hyper- and hypo-kinetic disorders; and current evidence for underlying comorbid disorders) and the current therapeutic approach to them. The therapy of PMDs is not well established, is very challenging to the clinician, and a better outcome can be achieved in the setting of a team approach involving movement disorders specialists, psychiatrists and therapists who specialise in cognitive-behavioural techniques. Current pharmacological and non-pharmacological approaches to treatment focus on therapy of underlying comorbid psychiatric and psychological issues, although compliance is a major concern.

Anxiety↗
PubMed2000

[Psychogenic vertigo incapacitates patients longer. What psychiatric illnesses might manifest as vertigo].

Dizziness is a common symptom that, despite extensive medical evaluation, often remains unexplained. Psychiatric or psychosomatic disorders underlie the condition in 30-55% of the cases. The most common disturbances are phobic and anxiety disorders, followed by dissociative, depressive and somatoform disorders. The assessment of psychiatric and psychosomatic symptoms should always be included in the neuro-otological examination of dizziness. Early interdisciplinary treatment should be initiated with the aim of preventing chronification of psycho-genetic vertigo.

Diagnosis, Differential↗