Excerpt from Dissociative Disorders

Synonyms, Key Words, and Related Terms: dissociation, psychological trauma, repressed memory, psychiatric disorder, mental disorder, dissociative amnesia, DA, dissociative identity disorder, DID, dissociative fugue, depersonalization disorder, dissociative disorder not otherwise specified, disrupted consciousness, disrupted identity, disrupted memory, disrupted motor behavior, disrupted environmental awareness, posttraumatic stress disorder, PTSD, multiple personality disorder, multiple personalities, Ganser syndrome

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Since the 1980s, the concept of dissociative disorders has taken on a new significance. They now receive a large amount of theoretical and clinical attention from persons in the fields of psychiatry and psychology. Dissociative disorders are a group of psychiatric syndromes characterized by disruptions of aspects of consciousness, identity, memory, motor behavior, or environmental awareness. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) includes 4 dissociative disorders and one category for atypical dissociative disorders. These include dissociative amnesia (DA), dissociative identity disorder (DID), dissociative fugue, depersonalization disorder, and dissociative disorder not otherwise specified (DDNOS).

From a psychological perspective, dissociation is a protective activation of altered states of consciousness in reaction to overwhelming psychological trauma. After the patient returns to baseline, access to the dissociative information is diminished. Psychiatrists have theorized that the memories are encoded in the mind but are not conscious, ie, they have been repressed.

In normal memory function, memory traces are laid down in 2 forms, explicit and implicit. Explicit memories are available for immediate and conscious recall and include recollection of facts and experiences of which one is conscious, whereas implicit memories are independent of conscious memory. Further, explicit memory is not well developed in children, raising the possibility that more memories become implicit at this age. Alterations at this level of brain function in response to trauma may mediate changes in memory encoding for those events and time periods. Dissociation is also a neurologic phenomenon that can occur from various drugs and chemicals that may cause acute, subchronic, and chronic dissociative episodes.

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