HD100 dissociative disorders

HD100 dissociative disorders - 259 Comprehensive Handbook...

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Unformatted text preview: 259 Comprehensive Handbook of Psychopathology (Third Edi- tion), edited by Patricia B. Sutker and Henry E. Adams. Kluwer Academic / Plenum Publishers, New York, 2001. CHAPTER 10 Dissociative Disorders John F. Kihlstrom Introduction In current diagnostic nosology, the category of dissociative disorders includes a wide variety of syndromes whose common core is an alteration in consciousness that affects memory and identity (American Psychiatric Association [APA], 1994). In dissociative amnesia (formerly, psychogenic amnesia), the patient suffers a loss of autobio- graphical memory for certain past experiences; in dissociative fugue (psychogenic fugue), the amne- sia is much more extensive and covers the whole of the individual’s past life; and it is coupled with a loss of personal identity and, often, physical movement to another location; in dissociative identity disorder (multiple personality disorder), a single individual appears to manifest two or more distinct identities; each personality alternates in control over conscious experience, thought, and action and is separated by some degree of amnesia from the other(s); in depersonalization disorder , the person believes that he or she has changed in some way, or is somehow unreal (in derealization the same beliefs are held about one’s surround- ings). John F. Kihlstrom • Department of Psychology, University of California, Berkeley, California 94720-1650. Impairments of memory and consciousness are often observed in the organic brain syndromes, but dissociative disorders are functional: they are at- tributable to instigating events or processes that do not result in insult, injury, or disease to the brain, and produce more impairment than would nor- mally occur in the absence of this instigating event or process (Kihlstrom & Schacter, 2000). Disso- ciative disorders are rather rare, but for more than 100 years, these and related phenomena have been objects of fascination for clinicians and experi- mentalists alike (for other recent reviews, see Bremner & Marmar, 1998; Kihlstrom, Tataryn, & Hoyt, 1993; Klein & Doane, 1994; Lynn & Rhue, 1994; Michaelson & Ray, 1996; Ross, 1997; Spie- gel, 1991, 1994). Once considered exotic, in the 1990s, dissocia- tive disorders have become the syndromes of the moment. In March 1999, a search of the PsycINFO database revealed forty entries on psychogenic or dissociative amnesia; twenty-eight of them (70%) had appeared since the prior edition of this chapter was completed in 1990; there was also a total of eight entries on psychogenic or dissociative fugue, five of which (63%) had appeared in that same period. Multiple personality, or dissociative iden- tity disorder, the crown jewel of dissociative dis- orders, yielded 868 entries: more than half of these (485, or 56%) appeared since 1990, and 708 (82%) had appeared since the first edition of this hand- book was published in 1984. Remarkably, how- ever, little of this literature consists of quantitative clinical studies, much less experimental research.clinical studies, much less experimental research....
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HD100 dissociative disorders - 259 Comprehensive Handbook...

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