Dissociative is the adjective of the noun dissociation and the verb dissociate. From the medical
perspective, Merriam Webster Dictionary defined dissociation as separation of personalities.
Dissociation could occur at the level of character segments or specific mental processes from the
current state of consciousness or behavior (2015, “Dissociation”). If something is dissociative, it
has the characteristic of disconnection from other parts.
National Alliance for Mental Illnesses (NAMI) explained that patients of dissociative
disorder disconnect from the reality. They lose their thoughts and identity, as well as
consciousness and memory (2015). The abnormalities incapacitate the mental abilities of the
affected. They are prevalent in all populations regardless of ethnicity, geographical regions,
socioeconomic status or any other variations. NAMI pointed out that approximately 2% of the
States’ population experiences the disorder. However, mild episodes of the diseases affect half of
the Americans at least once in their lives. Gender influences the occurrence of the illnesses, and
females are more prone to them than males (2015).Dissociativedisorder accounts for a significant
percentage of the few psychiatric problems among the American population.
Signs and Symptom
In most cases, signs of dissociative disorder appear after exposure to physical or mental
trauma. War and accidents are major inducers of the symptoms. Victims progressively exhibit
deteriorating mental health characterized by stressful moments. Though signs and symptom vary
with the specific type of the disorders, stress is a common characteristic of all types. Other
common signs and symptoms as NAMI outlined include out-of-body feelings, where patients fail
to understand themselves. Patients also fail to develop self-identity, emotional availability, and
reliable memories.Usually, people develop anxiety and depression, and they are likely to
contemplate suicide (2015).Generally, mental torture is the predominant symptom of the
Types of Dissociative Disorders
In its DSM-5 manual, the American Psychiatric Association split dissociative disorder into three
categories. The three are Dissociative Identity Disorder (DID), Dissociative Amnesia, and
Depersonalization Disorder. Some psychiatrists, however, identify two more types of the
disorder. The additional two are Dissociative Fugue and the unspecified Dissociative
Disorder.Since Dissociative Fugue has most properties seen in Dissociative Amnesia,
psychiatrists often classify it under the latter (Spiegel, Fernandez, Lanius, Vermetten, Simeon, &
Friedman, 2013, Pg. 299). Different types of the disorder have varied severity of symptoms, as
well as thenature of their stressors (Steinberg, 2015).
Dissociative Identity Disorder
DID was commonly referred to as multiple personality disorderuntil recently. The disease mainly
traces origin from childhood exposure to physical, sexual or emotional abuse. People exhibit
more than one distinctive character. The affected people can assume different behavior and
thoughts with time. They easily lose memories about self and experience severe mood swings.
Also, patients could have attention deficit disorder impairing their ability to learn.
Diagnoses and Intervention for DID
DID is the severest of the five types of dissociative disorder. Its detection and diagnosis require
specialized tests and examinations. As Steinberg explained, hidden symptoms characterize DID,
and anxiety, depression or substance abuse could mask the symptoms. Again it is hard to
describe the symptomatic disconnection feeling that occur with the disease (2015). The nature of
the disease, therefore, makes it hard to diagnose. Psychotherapy is the first-line treatment for the
disorder though medication could as well be used.
Patients with dissociative amnesia suffer severe inability to recall their personal
information. The brain does not have to be necessarily damaged for the condition to occur
(Kikuchi, Fujii, Abe, Suzuki, Takaqi, Mukiqura, & Mori, 2010, Pg. 602) In most cases as
Steinberg wrote, a single traumatic event is sufficient to cause the disorder. Experiences of
disasters, violence and war are the major inducers of the disease (2015).
Diagnoses and intervention of Dissociative Amnesia
When signs of the disorder are present, the examiner would perform physical tests to close
out other possible causes of the symptoms, and zero into dissociative amnesia. Treatment is
crucial to help individuals restore their memories. Psychotherapy, cognitive therapy as well as
medication are the commonest approaches to the problem (Goldberg, 2014, Pg. 2).
Patients of depersonalization disorder experience unreal sensations. Their mind seems out of
touch with their bodies. The ill cannot connect to the reality and feel as though they are
dreaming. Complications of the condition are accompanied by moments of derealization. Again,
depersonalization traces origin from trauma and stress.
Diagnoses and intervention of depersonalization disorder
To diagnose depersonalization, physicians perform examinations such as blood tests.
Though highly prevalent, the condition is often misdiagnosed (Reutens, Nielsen, &Sachdev,
2010, Pg. 278). Drugs used with psychological counseling to manage depersonalization include
clonazepam, fluoxetine and clomipramine (Mayo Clinic Staff, 2014, Pg. 8).
Support for Dissociative Disorder Patients
Patients require assistant to cope with mental instabilities created by dissociative disorder. As
Halter and Varcarolis pointed out, victims of the disorder require education on best ways of
managing their situation. Nurses could for instance explain to the patients that the diseases result
as an adaptive means to experiences (2013, Pg. 319). People associating with the sick should
treat them with care to avoid inducing more emotional stress. The patients are emotionally
delicate, and they can react strangely to unfriendly stimuli. Nurses and other care givers should
offer emotional availability, especially when patients recall the events that traumatized them
(Varcarolis& Halter, 2012, Pg. 205).
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Goldberg, J. (2014, July 8). Mental Health and Dissociative Amnesia. WebMD.
Halter, M. J., &Varcarolis, E. M. (2013). Varcaroli’s Foundations of Mental Health Nursing.
Washington, DC: Elsevier.
Kikuchi, H., Fujii, T., Abe, N., Suzuki, M., Takaqi, M., Makiqura, S.,. . . Mori, E. (2010).
Memory Repression. NCBI, 22(3), 602-613 doi: 10.1162/jocn.2009.21212.
Mayo Clinic Staff. (2014). Depersonalization-derealization Disorder.
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Reutens, S., Nielsen, O., &Sachdev, P. (2010). Depersonalization Disorder. NCBI, 23(3), 278-
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(2011). Dissociative Disorders in DSM-5. NCBI, 28(2011), 824-852
Steinberg, M. (2015). Understanding Dissociative Disorders. Psych Central.
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