-
Der Nervenarzt May 2017Patients with factitious disorders intentionally fabricate, exaggerate or feign physical and/or psychiatric symptoms for various open and covert psychological reasons.... (Review)
Review
Patients with factitious disorders intentionally fabricate, exaggerate or feign physical and/or psychiatric symptoms for various open and covert psychological reasons. There are many issues regarding the diagnostic state and classification of factitious disorders. Both the categorical differentiation of and clinical continuum ranging from somatoform/dissociative disorders to malingering are being controversially debated. Epidemiological studies on the frequency of factitious disorder meet basic methodological difficulties. Reported rates of prevalence and incidence in the professional literature most probably have to be considered underestimations. Illness deception and self-harm as core features of the abnormal illness behaviour in factitious disorder may refer to various highly adverse and traumatic experiences during early development in a subgroup of patients. Chronic courses of illness prevail; however, there are also episodic variants.
Topics: Diagnosis, Differential; Dissociative Disorders; Evidence-Based Medicine; Factitious Disorders; Humans; Malingering; Self-Injurious Behavior; Somatoform Disorders; Treatment Outcome
PubMed: 28451707
DOI: 10.1007/s00115-017-0337-8 -
Journal of Trauma & Dissociation : the... 2016The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise...
The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise specified with a recent history of nonsuicidal self-injury (NSSI) and suicide attempts from those patients without recent self-harm. A total of 241 clinicians reported on recent history of patient NSSI and suicide attempts. Of these clinicians' patients, 221 completed dissociative, depressive, and posttraumatic stress disorder symptomatology measures. Baseline cross-sectional data from a naturalistic and prospective study of dissociative disorder patients receiving community treatment were utilized. Analyses evaluated dissociative, depressive, and posttraumatic stress disorder symptom severity as methods of classifying patients into NSSI and suicide attempt groupings. Results indicated that dissociation severity accurately classified patients into NSSI and suicidality groups, whereas depression severity accurately classified patients into NSSI groups. These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment.
Topics: Adolescent; Adult; Aged; Cross-Sectional Studies; Depressive Disorder; Dissociative Disorders; Female; Humans; Male; Middle Aged; Prospective Studies; Risk Factors; Self-Injurious Behavior; Severity of Illness Index; Stress Disorders, Post-Traumatic; Suicide
PubMed: 26211678
DOI: 10.1080/15299732.2015.1067941 -
The Journal of Nervous and Mental... Jan 2002The goal of this study was to investigate the dissociative phenomenology of dissociative identity disorder (DID). The Multidimensional Inventory of Dissociation (MID)...
The goal of this study was to investigate the dissociative phenomenology of dissociative identity disorder (DID). The Multidimensional Inventory of Dissociation (MID) was administered to 34 patients with DID, 23 patients with dissociative disorder not otherwise specified (DDNOS), 52 patients with mixed psychiatric disorders, and 58 normal individuals. DID patients obtained significantly higher scores than the other three groups on 27 dissociation-related variables. DDNOS patients had significantly higher scores than normals and mixed psychiatric patients on 17 and 15 dissociation-related variables, respectively. The findings of the present study are virtually identical to a large body of replicated findings about the dissociative phenomenology of DID. This broad range of dissociation-related phenomena, which routinely occurs in individuals with DID, is largely absent from the DSM-IV-TR account of DID. Factor analysis of the 11 dimensions of dissociation that are measured by the MID extracted only one factor that accounted for 85% of the variance. It was concluded that dissociation is a unifactorial taxon or natural type that has different aspects or epiphenomena (i.e., amnesia, depersonalization, voices, trance, etc.).
Topics: Adult; Analysis of Variance; Diagnosis, Differential; Dissociative Disorders; Dissociative Identity Disorder; Female; Humans; Male; Mental Disorders; Middle Aged; Personality Inventory
PubMed: 11838024
DOI: 10.1097/00005053-200201000-00003 -
Psychological Trauma : Theory,... May 2024The dissociative subtype of posttraumatic stress disorder (PTSD) was incorporated into the diagnostic criteria for PTSD in , Fifth Edition (DSM-5). The subtype requires...
OBJECTIVE
The dissociative subtype of posttraumatic stress disorder (PTSD) was incorporated into the diagnostic criteria for PTSD in , Fifth Edition (DSM-5). The subtype requires the presence of persistent or recurrent depersonalization or derealization; however, several authors have suggested that a broader array of dissociative symptoms could be included in the criteria. The objective of the present study was to gather data on a wide range of dissociative symptoms in a sample of highly traumatized individuals.
METHOD
The authors administered a set of measures to 62 inpatients in a private psychiatric inpatient program specializing in PTSD and dissociative disorders.
RESULTS
Almost every participant met , 11th Edition criteria for complex PTSD, DSM-5 criteria for the dissociative subtype of PTSD, and DSM-5 criteria for dissociative identity disorder or other specified dissociative disorder; these four diagnoses seem to identify largely the same patients and may not be separate disorders.
CONCLUSIONS
A broad range of dissociative symptoms was endorsed on the Dissociative Experiences Scale and the Dissociative Disorders Interview Schedule. The results support a recommendation that a broad array of symptoms be included in the criteria for the dissociative subtype of PTSD in future editions of the . (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Topics: Humans; Dissociative Disorders; Stress Disorders, Post-Traumatic; Adult; Male; Female; Middle Aged; Diagnostic and Statistical Manual of Mental Disorders; Young Adult; Psychiatric Status Rating Scales
PubMed: 38032629
DOI: 10.1037/tra0001612 -
Journal of Obstetrics and Gynaecology :... Nov 2006
Topics: Adult; Dissociative Disorders; Female; Humans; Pregnancy; Pregnancy Complications
PubMed: 17130040
DOI: 10.1080/01443610600986953 -
Transcultural Psychiatry Feb 2015This study examined the association between exposure to domestic violence and dissociative symptoms. A sample of 68 Israeli opiate use disorder patients in recovery, 80...
Dissociative disorders and possession experiences in Israel: a comparison of opiate use disorder patients, Arab women subjected to domestic violence, and a nonclinical group.
This study examined the association between exposure to domestic violence and dissociative symptoms. A sample of 68 Israeli opiate use disorder patients in recovery, 80 battered Arab Israeli women, and 103 respondents from a community sample participated in structured interviews that included the Dissociative Disorders Interview Schedule (DDIS), the Dissociative Trance Disorder Interview Schedule (DTDIS), and the Dissociative Experiences Scale (DES). As predicted, community participants reported significantly less exposure to traumatizing events and lower levels of dissociative psychopathology than individuals sampled from specialized treatment centers. In all, 91% of battered female participants were taxon-positive for dissociative disorder with 1 of every 2 respondents reporting symptoms corresponding to dissociative amnesia and depersonalization disorder, suggesting that this group may be particularly vulnerable to dissociative psychopathology. Extrasensory and paranormal experiences (ESP) and dissociative trance disorder experiences were strongly related to dissociative experiences and features of dissociative identity disorder (DID). These statistical associations suggest that dissociative disorders and ESP/trance experiences may share an underlying construct. Further research is needed on trauma and dissociation among female victims of domestic abuse in patriarchal, collectivist societies, particularly in the Arab world.
Topics: Adult; Arabs; Dissociative Disorders; Domestic Violence; Female; Humans; Interview, Psychological; Israel; Substance-Related Disorders
PubMed: 25300648
DOI: 10.1177/1363461514552584 -
The American Journal of Clinical... 2001Dissociative Identity Disorder (DID), a chronic childhood onset posttraumatic stress disorder, is currently recognized as a treatable condition. It is considered the... (Review)
Review
The wreathing protocol: the imbrication of hypnosis and EMDR in the treatment of dissociative identity disorder and other dissociative responses. Eye Movement Desensitization Reprocessing.
Dissociative Identity Disorder (DID), a chronic childhood onset posttraumatic stress disorder, is currently recognized as a treatable condition. It is considered the paradigmatic dissociative condition and carries with it extreme posttraumatic symptomatology. Therapists skilled in the treatment of DID are typically fluent in the uses of hypnosis for stabilization, affect management, building a safe place and grounding to name of few. EMDR, which has come to the forefront of clinical awareness in the last ten years, seems aptly suited for the treatment of trauma, but can be destabilizing. This paper proposes a protocol, called Wreathing Protocol, for the imbricated use of EMDR and hypnosis in the treatment of not only DID (though this will be the primary focus of the paper), but also Dissociative Disorder Not Otherwise Specified (DDNOS) and chronic Posttraumatic Stress Disorder (PTSD). This protocol is useful to advanced clinicians skilled in both modalities independently. The sequential steps of the Wreathing Protocol will be described and illustrated by a clinical vignette on DID. The clinical implications of the use of the Wreathing Protocol will be discussed in DID as well as the chronic post traumatic spectrum.
Topics: Adult; Clinical Protocols; Desensitization, Psychologic; Dissociative Disorders; Dissociative Identity Disorder; Eye Movements; Female; Humans; Hypnosis
PubMed: 11269630
DOI: 10.1080/00029157.2001.10404282 -
The Journal of Clinical Psychiatry Oct 2006The purpose of this study was to examine the dissociative disorder comorbidity of borderline personality disorder and its relation to childhood trauma reports in a... (Comparative Study)
Comparative Study
OBJECTIVE
The purpose of this study was to examine the dissociative disorder comorbidity of borderline personality disorder and its relation to childhood trauma reports in a nonclinical population.
METHOD
In April 2003, 1301 college students were screened for borderline personality disorder using the Structured Clinical Interview for DSM-IV Personality Disorders. The Childhood Trauma Questionnaire and Steinberg's dissociation questionnaires were also administered. During May and June 2003, 80 students with a diagnosis of borderline personality disorder and 111 nonborderline students were evaluated using the Structured Clinical Interview for DSM-IV Dissociative Disorders by an interviewer blind to the diagnosis and scores obtained during the first phase.
RESULTS
The prevalence of borderline personality disorder was 8.5%. A significant majority (72.5%; 58/80) of the borderline personality disorder group had a dissociative disorder, whereas this rate was only 18.0% (20/111) for the comparison group (p < .001). Childhood emotional and sexual abuse, physical neglect, and total childhood trauma scores had significant effect for borderline personality disorder (p < .001, p = .038, p = .044, and p = .003, respectively), whereas emotional neglect and diminished minimization of childhood trauma had significant effect for dissociative disorder (p = .020 and p = .007, respectively).
CONCLUSION
A significant proportion of subjects with borderline personality disorder have a comorbid dissociative disorder. Lack of interaction between dissociative disorder and borderline personality disorder diagnoses for any type of childhood trauma contradicts the opinion that both disorders together might be a single disorder. Recognizing highly prevalent but usually neglected Axis I dissociative disorder comorbidity in patients with borderline personality disorder may contribute to conceptual clarification of this spectrum of psychopathology.
Topics: Adolescent; Adult; Borderline Personality Disorder; Child; Child Abuse; Child Abuse, Sexual; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Female; Humans; Life Change Events; Male; Prevalence; Psychiatric Status Rating Scales; Surveys and Questionnaires
PubMed: 17107251
DOI: 10.4088/jcp.v67n1014 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2022The article provides an overview of scientific publications devoted to the study of the problem of functional cognitive disorders (FCD), which are one of the variants of... (Review)
Review
The article provides an overview of scientific publications devoted to the study of the problem of functional cognitive disorders (FCD), which are one of the variants of functional neurological disorders (FND). The authors provide data on the frequency of occurrence of this pathology, the differences between the concepts of FCD and «subjective cognitive disorders» (dissociative (conversion) disorders - F44). The authors show the traditional views on the study of this pathology in the mainstream of hysterical disorders. The modern concepts of information processing disorders as a mechanism of FCD development are considered. Special attention is paid to the role of executive dysfunction in the genesis of FCD. The descriptions of the main clinical manifestations of FCD are given. The basic principles of diagnostic examination of patients with FCD are considered. The article presents modern approaches to the therapy of FCD, with special attention paid to psychotherapeutic correction in this pathology.
Topics: Cognition; Cognition Disorders; Cognitive Dysfunction; Conversion Disorder; Dissociative Disorders; Humans
PubMed: 35271235
DOI: 10.17116/jnevro202212202143 -
Comprehensive Psychiatry 2003The aim of our study was to determine the frequency of dissociative disorders (DDs) among inpatients with conversion disorder (CD) in a university clinic settled in...
The aim of our study was to determine the frequency of dissociative disorders (DDs) among inpatients with conversion disorder (CD) in a university clinic settled in Eastern Turkey. During a period of 24 months, 59 consecutively admitted adult CD patients were screened with the Dissociative Experience Scale (DES). Patients who scored above 30 (DDs group) did not differ by age or gender from a group of inpatients who scored below 10 on the scale (comparison group). All patients in the two groups were then interviewed in a blind manner using the Dissociative Disorders Interview Schedule (DDIS) and Structured Interview for DSM-IV Dissociative Disorders (SCID-D). According to the SCID-D, 18 of 59 patients (30.5%) received a diagnosis of dissociative disorder; nine of these 18 patients (50%) were diagnosed as having dissociative identity disorder, eight (44.4%) were diagnosed as having dissociative disorder not otherwise specified (NOS), and one (5.6%) was diagnosed as having dissociative amnesia. Accordingly to the DDIS, borderline personality disorder was frequent in the DDs group, and all of the patients in the DDs group reported sexual abuse and neglect during childhood, latency, or adolescence. A high proportion of CD patients have significant dissociative pathology. The proper diagnosis of these patients has important implications for their clinical course.
Topics: Adolescent; Adult; Borderline Personality Disorder; Conversion Disorder; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Female; Hospitalization; Hospitals, Psychiatric; Humans; Male; Middle Aged; Surveys and Questionnaires; Turkey
PubMed: 12923711
DOI: 10.1016/S0010-440X(03)00087-7