3ĭissociative symptomology is most commonly associated with Cluster B personality disorders, presumably because these individuals often have a history of psychic or physical trauma. 2, 9 Frequently, these diagnoses include personality disorders, which are described in the DSM-IV-TR as “enduring subjective experiences and behavior that deviate from cultural standards, are rigidly pervasive with onset in late adolescence or early adulthood, are stable through time, and result in unhappiness and impairment.” The 10 recognized personality disorders are divided into three groups or clusters with Cluster A (paranoid, schizoid, schizotypal) perceived as odd and eccentric Cluster B (antisocial, borderline, histrionic, narcissistic) being dramatic, emotional, and erratic and Cluster C (avoidant, dependent, obsessive compulsive) described as anxious and fearful. Nearly all individuals with DA have significant comorbid psychiatric diagnoses, which if not treated will predispose the individual to recurrent eposides of amnesia. 10 This results in the loss of memory for discrete periods of time rather than for discrete events. Gabbard conceptualizes DA in the following way: “Memories of the traumatized self must be dissociated because they are inconsistent with the everyday self that appears to be in full control.” 9 Unlike repression, which can be thought of as horizontal split in the memory system, dissociation involves a vertical split. Van der Hart described the Janetian view of dissociation as “the process and the product of psychological and somatic splitting, which result from the impact of trauma emotions.” 8 Posttraumatic amnesia can be thought of as faulty ego integrative functioning in the setting of traumatic emotions. However, it is worthwhile noting how several experts in the field conceptualize DA. 7 There is a large body of literature on peritraumatic dissociation, which is too extensive to be covered here. Recent advances in neurophysiology have clarified the process of memory from a biologic perspective, but DA also has a significant psychological component. *Except in the case of generalized amnesia, in which retrograde memory loss occurs as well Alternatively, memory deficits can result from extreme psychological stress, as seen in dissociative disorders.ĭissociative amnesia (DA) is generally considered the most common dissociative disorder 2 and is defined in the Diagnostic and Statistical Manual (Fourth Edition), Text Revision (DSM-IV-TR) as “one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness” ( Table 1). Loss of any of these types of memory can arise from organic damage to the neocortex, as in the case of a traumatic brain injury, a cerebral vascular accident (CVA), a space-occupying lesion, or a toxic exposure. Procedural memory is the ability to remember motor routines, such as combing one's hair. Semantic memory is knowledge about the world and memory of words, dates, and facts. 1 Episodic memory is remembering events as one would recall a movie. As defined by Tulving, humans have three major types of memory.
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