32 Dissociative, Schizophrenic, And Personality Disorders
Dissociative, Schizophrenic, andPersonality Disorders32Lesson PLanning CaLendarUse this Lesson Planning Calendar to determine how much time to allot for each topic.ScheduleDay OneDay TwoDay ThreeTraditional Period (50 minutes)Dissociative DisordersSchizophrenic DisordersPersonality DisordersBlock schedule (90 minutes)Dissociative DisordersSchizophrenic Disorders (continued)Schizophrenic DisordersPersonality Disorders568aB2E3e book ATE.indb 13/19/12 10:51 AM
32aCTiviTy PLanner From The TeaCher’s resourCe maTeriaLsUse this Activity Planner to bring active learning to your daily lessons.TopicActivitiesdissociative disordersGetting Started: Critical Thinking Activity: Fact or Falsehood? (10 min.)Digital Connection: The Brain (2nd ed.), Module 23: “Multiple Personality” (10 min.)Analysis Activity: Questionnaire of Experiences of Dissociation (30 min.)Building Vocabulary/Graphic Organizer: Crossword Puzzle (15 min.)Enrichment Lesson: Psychogenic Versus Organic Amnesia (15 min.)Enrichment Lesson: The Dissociative Disorders Interview Schedule and Multiple Personality (15 min.)Digital Connection: DVD: Lost in the Mirror (30 min.)schizophrenic disordersDigital Connection: The Brain (2nd ed.), Module 26: “Schizophrenia: Symptoms” (10 min.)Digital Connection: The Brain (2nd ed.), Module 27: “Schizophrenia: Etiology” (10 min.)Demonstration Activity: The Referential Thinking Scale (15 min.)Demonstration Activity: Magical Ideation Scale (20 min.)Digital Connection: DVD: Full of Sound and Fury: Living With Schizophrenia (60 min.)Digital Connection: The Brain (2nd ed.), Module 29: “Autism” (13 min.)ChawapatnitEnrichment Lesson: Infantile Autism (15 min.)Digital Connection: Film: Silent Snow, Secret Snow (17 min.)Personality disordersDigital Connection: The Mind (2nd ed.), Module 35: “The Mind of the Psychopath” (10 min.)Demonstration Activity: Antisocial Personality Disorder (25 min.)Portfolio Project: Exploring Psychological Disorders on the World Wide Webhbsinah568bB2E3e book ATE.indb 23/19/12 10:51 AM
32MODULE 32inTroduCe The moduLeDissociative, Schizophrenic,and Personality DisordersGetting Started TRMThe disorders featured in this moduleare the ones most commonly associassociated with having a mental illness. Havestudents consider what it means tolose touch with reality. What behaviorswould people exhibit if they lost touchwith reality?You may wish to use CriticalThinking Activity: Fact or Falsehood? as a prereading strategy toevaluate what students already knowabout dissociative, schizophrenic,and personality disorders. The activactivity, along with its results, will primestudents to note terms and conceptsin the text that confirm or dispel theirpreconceptions about these disorders.Dissociative Disorders Dissociative Amnesia Dissociative Fugue Dissociative IdentityDisorderSchizophrenicDisorders Symptoms ofSchizophrenia Types of Schizophrenia Causes ofSchizophreniaPersonality Disorders Personality DisordersRelated to Anxiety Personality DisordersWith Odd or EccentricBehaviors Personality DisordersWith Dramatic orImpulsive BehaviorsIs it possible to be two different people? Can you really split from reality? Seriouspsychological disorders are the topic of this module.Building Vocabulary TRMHelp students understand how theterms in this module are relatedby having them complete BuildingVocabulary/Graphic Organizer:Crossword Puzzle.Consider Gene Saunders. Gene was a manager at a manufacturing company. Workhad become a struggle, with missed production goals, criticism from his supervisor,and disappointment when an expected promotion didn’t come through. The stress atwork led to additional problems at home, including a violent argument with his teenage son. Two days after the argument, Gene disappeared. A year and a half later,police in a town hundreds of miles away picked up a drifter who had been working asa short-order cook. The drifter’s name was Burt Tate, and although Burt knew whattown he was in, he had no knowledge of his life before arriving in town. There wereno physical or drug problems that would account for the memory loss. You guessedit—Gene and Burt were the same person (Spitzer et al., 1989).Consider Emilio. His twelfth hospitalization occurred when he was 40 becausehis mother, with whom he lived, feared him. He dressed in a ragged old coat andbedroom slippers, with several medals around his neck. Much of what he said wassimply nonsense. When interviewed, he claimed he had been “eating wires and lighting fires.” He alternated from being angry toward his mother to childlike giggling,and he heard nonexistent voices. Emilio had been unable to hold a job since his firsthospitalization at age 16 (Spitzer et al., 1989, 2002).569resource nalysis571Digital Connection575Lost in the Mirror570Critical Thinking569, 582The Brain (2nd ed.), Module 23572Demonstration574, 581The Brain (2nd ed.), Module 27574, 577, 578Enrichment571, 572, 575Full of Sound and Fury: Living With Schizophrenia574Graphic Organizer569The Brain (2nd ed.), Module 26575Portfolio Project582The Brain (2nd ed.), Module 29575Vocabulary569Silent Snow, Secret Snow576The Mind (2nd ed.), Module 35581569B2E3e book ATE.indb 5693/19/12 10:51 AM
32570 I n d I v I d u a l v a r I a t I o n s Psychological Disordersdissociative disorders Disorders in which the sense of selfhas become separated (dissociated) from previous memories,thoughts, or feelings.TeaChFYITRMThe DSM-IV-TR lists 14 different categories of disorders.Disorders that aren’t discussed indetail in this textbook include thefollowing: Disorders first diagnosed ininfancy, childhood, or adolescence, such as mental retardation, learning disorders, andtic disorders (that is, Tourette’ssyndrome)Delirium, dementia, amnesia,and other cognitive disorders,including Alzheimer’s diseaseand organic amnesiaMental disorders due to a general medical conditionSubstance-related disordersFictitious disorders, includingMunchausen’s syndrome andmalingeringSexual and gender identity disorders, such as sexual dysfunction and paraphiliaEating disordersSleep disordersImpulse control disorders, suchas kleptomania, pathologicalgambling, and pyromaniaAdjustment disordersAt this point, you may want towatch Lost in the Mirror.Memory and YourSense of SelfWe often joke about forgetfulness, but the dissociativedisorders all involve seriousdisruption of memory.Dissociative Disorders32-1 What are the symptoms and causes ofdissociative disorders?Dissociate is the opposite of associate (to make connections). If a person hasa dissociative disorder, his sense of self has become separated (dissociated)from his memories, thoughts, or feelings. Dissociative disorders are quiterare and usually represent a response to overwhelming stress. Three specificforms are dissociative amnesia, fugue, and identity disorder (see Figure 32.1).Figure 32.1Dissociative DisordersThree dissociative disordersare dissociative amnesia,dissociative fugue, and dissociative identity disorder.Dissociative DisordersTwo or moredistinct personalitiesDissociative FugueLoss of identity andtravel to a new location570B2E3e book ATE.indb 570shwtsDifidwitatHifpvspbnttDissociative IdentityDisorderLoss of memory ofa traumatic eventCAihocatSdi1eDLoss of selfDissociative AmnesiaDDWHAT’S THE POINT?www.cartoonstock.com Consider Mary. She was 26 years old when referred for hospitalization by hertherapist because she had urges to cut herself with a razor. For more than 10 years,Mary struggled with issues related to religion and philosophy. Her academic performance in college dropped when she began experimenting with a variety of drugs.When Mary entered therapy, she became both hostile and demanding, sometimesinsisting on two therapy sessions a day. She did not exhibit stability in her moods orrelationships (Spitzer et al., 1989).Gene, Emilio, and Mary suffer from psychological disorders we discuss in thismodule. These disorders are not nearly as common as anxiety disorders (such asphobias) and mood disorders (such as depression), but they represent an interesting sample of the types of disturbances that can plague people. Keep in mind that inthis text we do not come even close to examining all disorders—the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fourthedition, text revision (DSM-IV-TR), lists more than 200 specific mental disorders.Several of the people you read about in this module have lost some aspect of theirsense of self like Gene (dissociative disorders). Others have lost contact with reality like Emilio (schizophrenic disorders). And still others have developed lasting andcounterproductive patterns of behavior like Mary (personality disorders).3/19/12 10:51 AM
ssnhs.rds)ec.Dissociative AmnesiaCan you remember the meaning of the word amnesia?Amnesia is memory loss, and any number of factors,including drug use, can cause it. Drinking too much alcohol, for example, can lead to a blackout of all memoriesof the drinking episode. Head injury, fatigue, and physical disorders such as Alzheimer’s disease can also causeamnesia. To qualify as dissociative amnesia, however,the memory loss must be a reaction to a traumatic event.Serious personal threats are the most common causes ofdissociative amnesia. Combat soldiers may report losing their memory for hours or days (van der Hart et al.,1999). Survivors of natural disasters, such as floods or wildfires, sometimesexperience similar losses (Kihlstrom et al., 1993).In one case of dissociative amnesia, an 18-year-old man lost his memory ofsailing with friends off the coast of Florida. A storm had come up, and only hehad the foresight to put on a life jacket and tie himself to the boat. His friendswere swept overboard in the high waves. Because of the emotional trauma,the young man lost all memory of the tragic storm and the several days hespent hoping to be rescued (Spitzer et al., 1989).TeaChing TiP TRMTeascott nelson/Getty ImaGesrs,s.sr32Dissociative, Schizophrenic, and Personality Disorders M o d u l e 3 2 571Trauma and AmnesiaPeople under extremestress, such as soldiers incombat, may experiencedissociative amnesia.Students should understand that disdissociation is not the same as psychosis.Dissociation involves breaking awayfrom the sense of self, either by losingmemory and identity or by adding perpersonalities. Psychosis involves a breakwith reality, believing things that areuntrue, or having hallucinations aboutthings that aren’t there. At this point,you may want to use Analysis Activity: Questionnaire of Experiences ofDissociation.Differentiation TRMThere are two types of amnesia: Dissociative FugueDissociative fugue is an extended form of dissociative amnesia characterized by loss of identity and travel to a new location. (The word fugue comesfrom the same root as fugitive.) A dissociative fugue state can be short, lasting only a few hours, or long, lasting months or even years. The person maydevelop a new identity, form new friendships, or even enter a new line ofwork. As with other dissociative disorders, the development of a fugue stateis an unconscious response to extreme stress. The case of Gene Saunders atthe beginning of this module represents dissociative fugue. His stressful workand home situations led to his disappearance, and even he was not aware ofthe history behind his transformation into Burt Tate. At this point, you may want to useEnrichment Lesson: PsychogenicVersus Organic Amnesia.Dissociative Identity DisorderHave you ever felt like a different person? Have you ever said, “I have noidea why I did that”? Magnified to an extreme, these feelings are centralfeatures of dissociative identity disorder (formerly known as multiplepersonality disorder)—a rare and controversial disorder in which an individual exhibits two or more distinct and alternating personalities. Thesesubpersonalities reportedly can differ in age, sex, and self-perception ofphysical characteristics. Some researchers have even reported changes inbrain function (Elzinga et al., 2007; Putnam, 1991) or handedness (Henninger, 1992) as a patient switches from one personality to another. Sometimes subpersonalities seem to be aware of one another, and sometimesthey do not.FYIdissociative amnesia A dissociative disorder characterizedby loss of memory in reaction toa traumatic event.The Latin root of the word fuguemeans “flight,” which makes thisan appropriate name for the disorder dissociative fugue.dissociative fugue A dissociative disorder characterized byloss of identity and travel to anew location.dissociative identity disorderA rare and controversial dissociative disorder in whichan individual exhibits two ormore distinct and alternatingpersonalities.Beyond the Classroom TRMBellringers Use the following promptsas discussion starters: A ctIve L eArnIngTRMDissociative AmnesiaA famous case of dissociative amnesia concerns the daughter of the last Russian czar,Nicholas II. In 1920, people believed that an amnesiac woman named Anna Anderson wasAnastasia, the youngest daughter of the czar. Have students research the Romanov familyand the conflicting evidence surrounding Anna Anderson. Retrograde amnesia occurs whenold memories are lost. This is themost common type of amnesia.Memories for experiences thatoccurred in the time surrounding anevent fall under this type of amnesia.Anterograde amnesia occurs whenthe ability to form new memories islost. This form is less common, butsome instances of head trauma orbrain disease can affect a person’sability to form new memories.Why did Anna arouse suspicions concerning her identity?What evidence supports Anna’s claims? What evidence disputes them?What means can researchers use to verify claims like Anna’s? Have you ever wanted to pick up,move, and start over somewhereelse? Why? What would be theadvantages and disadvantages ofsuch a move?Do you behave differently in different situations? Have people everaccused you of having differentpersonalities? How did that makeyou feel?At this point, you may want to useEnrichment Lesson: The Dissociative Disorders Interview Scheduleand Multiple Personality.At this point, you may want to use Enrichment Lesson: Psychogenic Versus OrganicAmnesia.571B2E3e book ATE.indb 5713/19/12 10:51 AM
32572 I n d I v I d u a l v a r I a t I o n s Psychological DisordersBeyond the Classroom TRM Does the difficulty of confirmingevidence necessarily deny patients’claims?How do investigators prove claimsof abuse that happened long ago?the everett collectIon John sprInGer collectIon/corbIsAnalyze Dissociative identity disorderis so controversial partly because theclaims of patients are so difficult toconfirm. Typically, it is not diagnoseduntil later in life when evidence of pastabuse or trauma may no longer bepresent.The Media andMental DisordersAt this point, you may want to useThe Brain (2nd ed.), Module 23:“Multiple Personality.”The controversy about dissociative identity disorderhas been partially fueledby the public’s interest inthe disorder. Two classicfilms—The Three Faces ofEve (left) and Sybil (right)—have showcased “multiplepersonality.” Some are concerned that these kinds offilms and other media attention lead to false diagnosesof this disorder.TeaChing TiPIf you show any of the popular filmsthat depict dissociative identity disorder, help students watch with a criticaleye. The goal of movies is not to depictreality but to entertain and tell a com-pelling story. The facts might not bean accurate depiction of what actuallyhappened.Beyond the ClassroomExplore Mental health professionals have only recently begun treatingfemale patients as having characteristics different from male patients.Freud and his contemporaries believedthat women who attended college hadshrunken ovaries because they did notbear as many children as their lesseducated sisters. Also, illnesses such asdissociative and somatoform disorderswere often only reported in women.Have students explore old stereotypesand new advances in women’s health. What were some other commonbeliefs about women’s health issues?What kind of influence did Freudand others have on the study ofwomen’s health?When did women’s health issuesstart to get serious notice as beingdistinct from men’s health issues?What advances have been made inrecent years that have made women’s health issues better understood?somatoform disorders Psychological disorders in whichthe symptoms take a bodily formwithout apparent physical cause.hypochondriasis A somatoform disorder characterized byimagined symptoms of illness.A ctIve L eArnIngDiagnosed cases of dissociative identity disorder increased dramaticallyin the final decades of the twentieth century. Before the 1970s, fewer than100 cases had ever been reported in professional journals. Then, in the 1980salone, reports of more than 20,000 diagnosed cases of dissociative identitydisorder appeared, almost all of them in North America (McHugh, 1995).The average number of subpersonalities also increased—from 3 to 12 (Goff &Simms, 1993). In some cases, dozens of personalities were reported.Psychologists debate whether dissociative identity disorder really exists.Are clinicians simply more knowledgeable about and willing to make thediagnosis? Are better diagnostic rules reducing the number of cases thatin the past were misdiagnosed as other disorders, such as schizophrenia?Skeptics believe the power of suggestion has been at work here. Clinicians,who now have read a great deal about these fascinating cases, may unintentionally suggest multiple personalities to their clients (Kihlstrom, 2005).Questions such as “Have you ever felt another part of you is in control?”may lead the patient (who has also read about the disorder or seen depictions on television) to construct subpersonalities in an effort to please thetherapist by responding to perceived expectations. This, of course, is alsounintentional.Sybil Dorsett’s famous case of dissociative identity disorder was the subject of a book, Sybil, and a made-for-TV movie of the same name in 1976(remade in 2007). However, after the death of Sybil’s psychiatrist, a differentpicture emerged. After reading her recently released records, some expertshave come to believe that Sybil’s multiple personalities were the result ofher therapist’s suggestions. By giving names to Sybil’s emotional states andasking her to take on these roles as part of the therapeutic process, the psychiatrist could have led Sybil to believe that she possessed multiple personalities. (Other problems that originate in the mind can have physical results, asdiscussed in Psychology in the Real World: Mind and Body in PsychologicalDisorders.)Pause Now or Move oNTurn to page 582 to review and apply what you’ve learned.TRMMental Illness on FilmHave students research the lives of Chris Sizemore and Sybil Dorsett. Ask: What abuse did they say they experienced?What types of relationships did they have with their therapists?What was the result of their therapy sessions? Did they experience personality integration? Why or why not?What impact did the movie versions of their lives have on them?Use Enrichment Lesson: The Dissociative Disorders Interview Schedule and Multiple Personality.572B2E3e book ATE.indb 5723/19/12 10:51 AM
ynsy.&.et?,.”eo32Dissociative, Schizophrenic, and Personality Disorders M o d u l e 3 2 573Psychology inTHE REAL WORLDFYIMind and Body in Psychological DisordersThe relationship between mind and body has fascinated psychologists since this science was born.Psychological disorders are a good place to lookfor this interaction, because such disorders almostalways have both psychological and physical components. This is most dramatic in the somatoformdisorders, in which the symptoms take a bodily formwithout apparent physical cause and the reasonsbehind many visits to the doctor are “medically unexplained” (Johnson, 2008). (Somatic comes
Dissociative Disorders Loss of self Figure 32.1 Dissociative Disorders Three dissociative disorders are dissociative amnesia, dissociative fugue, and dis-sociative identity disorder. Memory and Your Sense of Self We often joke about forget-fulness, but the dissociative disorders all involve serious disrupti
456 K. SALOMON, B. W. GAI3RIO, AND T. THALE mescaline sulfate (206.7 mgm. base) to one schizophrenic male and one schizophrenic female; 400 mgm. mescaline sulfate (275.6 mgm. base) to two schizophrenic males and one neurotic male. All doses were given orally in the morning while the subjects were in a fasting state.
thoughts in trauma-related deep wave Sleep, determine if parasomnia can be regarded as a variant of a dissociative process, 4) Identify if there is a correlation between overall Sleep quality, dissociative Disorders and parasomnia, 5) Study if parasomnia and dissociative disorder have commonCited by: 2Publish Year: 2017Author: Kader Semra Kara
screening dissociative disorders have been useful to resolve this matter. Dissociative experiences scale (DES) which is a subjective measure [19] and structured diagnostic interviews such as dissociative disorders interview schedule (DDIS), [20] and structured clinical intervi
Dissociative Disorders Interview Schedule (DDIS). As with the SCID-D, the DDIS is designed to give a DSM diagnosis for dissociative disorders (Ross et al., 1990). For diagnosis of dissociative identity disorder (DID), interrater reliability is 0.68, sensitivity is 90% and specificity is 1
Severe dissociative symptoms have been associated with suicidality and self-harm, depression symptoms and problems of occupational functioning (3). Dissociative symptoms were found to be present in 14.4 per cent of post-traumatic stress disorder patients in the World Mental Health Surveys (4). Dissociative identity disorder (DID) is a severe .
to other personality disorders such as antisocial personality disorder. Ogloff (2005) distinguishes psychopathy from antisocial personality disorder due to the emphasis on affective and personality rather than mostly behavioral elements of antisocial personality disorder. Besides antisocial personality disorder, there are other DSM-IV personality
The Dissociative Disorders Interview Schedule (DDIS) is a highly structured interview that makes DSM-5 diagnoses of somatic symptom disorder, borderline personality disorder and major depressive disorder, as well as all the dissociative disorders. It inquires about positive
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