{"id":70,"date":"2020-07-13T18:18:26","date_gmt":"2020-07-13T18:18:26","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/abnormalpsych\/chapter\/dissociative-disorders\/"},"modified":"2022-07-26T20:05:24","modified_gmt":"2022-07-26T20:05:24","slug":"dissociative-amnesia-fugue-and-depersonalization-derealization-disorder","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/chapter\/dissociative-amnesia-fugue-and-depersonalization-derealization-disorder\/","title":{"raw":"Dissociative Amnesia, Fugue, and Depersonalization\/Derealization Disorder","rendered":"Dissociative Amnesia, Fugue, and Depersonalization\/Derealization Disorder"},"content":{"raw":"<div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li>Describe and differentiate between dissociative amnesia and fugue<\/li>\r\n \t<li>Explain depersonalization\/derealization disorder<\/li>\r\n<\/ul>\r\n<\/div>\r\n\r\n[caption id=\"attachment_4086\" align=\"alignright\" width=\"270\"]<a href=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2017\/03\/31032825\/5879429534_90b400b642_z-1.jpg\"><img class=\"wp-image-4086\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2017\/03\/31032825\/5879429534_90b400b642_z-1.jpg\" alt=\"Blurry picture of a man showing a second image of his face detached from the first.\" width=\"270\" height=\"270\" \/><\/a> <strong>Figure 1<\/strong>. The most well-known\u00a0dissociative disorder is dissociative identity disorder, in which people exhibit more than one identity.[\/caption]\r\n\r\n<strong>Dissociative disorders<\/strong> are characterized by an individual becoming split off, or dissociated, from their core sense of self. Memory and identity become disturbed; these disturbances have a psychological rather than physical cause. Dissociative disorders listed in the DSM-5 include dissociative amnesia, depersonalization\/derealization disorder, and dissociative identity disorder.\r\n\r\n<\/div>\r\n<section>\r\n<h2>Dissociative Amnesia<\/h2>\r\nAmnesia refers to the partial or total forgetting of some experience or event. An individual with <strong>dissociative amnesia<\/strong> is unable to recall important personal information, usually following an extremely stressful or traumatic experience such as combat, natural disasters, or being the victim of violence. The memory impairments are not caused by ordinary forgetting.\u00a0<span style=\"font-size: 1em;\">One study of residents in communities in upstate New York reported that about 1.8% experienced dissociative amnesia in the previous year (Johnson, Cohen, Kasen, &amp; Brook, 2006).\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">Some individuals with dissociative amnesia will also experience <\/span><strong style=\"font-size: 1rem; text-align: initial;\">dissociative fugue<\/strong><span style=\"font-size: 1rem; text-align: initial;\"> (from the word \u201cto flee\u201d in French), whereby they suddenly wander away from their home, experience confusion about their identity, and sometimes even adopt a new identity (Carde\u00f1a &amp; Gleaves, 2006). Most fugue episodes last only a few hours or days, but some can last longer.\u00a0<\/span>\r\n\r\n[caption id=\"attachment_1763\" align=\"alignleft\" width=\"300\"]<img class=\"wp-image-1763 size-medium\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/07\/10010115\/fog-3914967_1920-300x200.jpg\" alt=\"Person wandering through field in fog.\" width=\"300\" height=\"200\" \/> <strong>Figure 2<\/strong>. People with dissociative fugue temporarily lose their sense of personal identity and impulsively wander away from their homes or places of work.[\/caption]\r\n<p id=\"__p5\">People with dissociative fugue may travel far distances during the fugue, as far as several thousand miles, and could remain in the fugue state for a couple of days, several weeks or even months.\u00a0Once they have returned to their pre-dissociative states, they do not remember any events that occurred during the fugue.\u00a0Dissociative fugue is a rare disorder and data available indicate a prevalence of 0.2% in the general population. The onset is often in adolescence or early adulthood and onset is usually sudden, and often related to traumatic or stressful life events. Dissociative fugue has also been noted to be associated with a previous history of child abuse. Other factors that could predispose someone to dissociative reactions include neuropsychological cognitive dysfunctions and genetic factors. Recovery is usually sudden and often complete, although the fugue state may end gradually in some individuals.<\/p>\r\nSome have questioned the validity of dissociative amnesia (Pope, Hudson, Bodkin, &amp; Oliva, 1998); it has even been characterized as a \u201cpiece of psychiatric folklore devoid of convincing empirical support\u201d (McNally, 2003, p. 275). Notably, scientific publications regarding dissociative amnesia rose during the 1980s and reached a peak in the mid-1990s, followed by an equally sharp decline by 2003; in fact, only 13 cases of individuals with dissociative amnesia worldwide could be found in the literature that same year (Pope, Barry, Bodkin, &amp; Hudson, 2006). Further, no description of individuals showing dissociative amnesia following a trauma exists in any fictional or nonfictional work prior to 1800 (Pope, Poliakoff, Parker, Boynes, &amp; Hudson, 2006). However, a study of 82 individuals who enrolled for treatment at a psychiatric outpatient hospital found that nearly 10% met the criteria for dissociative amnesia, perhaps suggesting that the condition is underdiagnosed, especially in psychiatric populations (Foote, Smolin, Kaplan, Legatt, &amp; Lipschitz, 2006).\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/de94a80b-048a-4941-b7b2-9cd2f50bc214\r\n\r\n<\/div>\r\n<\/section><section>\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Key Takeaways: Dissociative Amnesia<\/h3>\r\n<iframe title=\"15. Dissociative Amnesia\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291225916082234858\/embed\" width=\"1088\" height=\"758\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script>\r\n\r\n<\/div>\r\n<h2>Depersonalization\/Derealization Disorder<\/h2>\r\n<strong>Depersonalization\/derealization disorder<\/strong> is characterized by recurring episodes of depersonalization, derealization, or both. Depersonalization is defined as feelings of \u201cunreality or detachment from, or unfamiliarity with, one\u2019s whole self or from aspects of the self\u201d (APA, 2013, p. 302). Individuals who experience <strong>depersonalization<\/strong> might believe their thoughts and feelings are not their own; they may feel robotic as though they lack control over their movements and speech; they may experience a distorted sense of time and, in extreme cases, they may sense an \u201cout-of-body\u201d experience in which they see themselves from the vantage point of another person. <strong>Derealization<\/strong> is conceptualized as a sense of \u201cunreality or detachment from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surroundings\u201d (APA, 2013, p. 303). A person who experiences derealization might feel as though he is in a fog or a dream, or that the surrounding world is somehow artificial and unreal. Individuals with depersonalization\/derealization disorder often have difficulty describing their symptoms and may think they are going crazy (APA, 2013).\r\n<div class=\"textbox examples\">\r\n<h3>Watch it<\/h3>\r\nThis video explains depersonalization and derealization.\r\n\r\n<iframe src=\"\/\/plugin.3playmedia.com\/show?mf=5572746&amp;p3sdk_version=1.10.1&amp;p=20361&amp;pt=375&amp;video_id=mCcxWq_J0YU&amp;video_target=tpm-plugin-797ht97p-mCcxWq_J0YU\" width=\"800px\" height=\"450px\" frameborder=\"0\" marginwidth=\"0px\" marginheight=\"0px\"><\/iframe>\r\n\r\nYou can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/WhatAreDerealizationAndDepersonalizationDisorder_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for \"What Are Derealization &amp; Depersonalization Disorder?\" here (opens in new window)<\/a>.\r\n\r\n<\/div>\r\n<h3>Etiology<\/h3>\r\n[caption id=\"attachment_1767\" align=\"alignright\" width=\"213\"]<img class=\"wp-image-1767 size-medium\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/07\/10020647\/Photo-of-Pierre-Janet-213x300.jpg\" alt=\"Photo of Pierre Janet\" width=\"213\" height=\"300\" \/> <strong>Figure 3<\/strong>. Pierre Janet was one of the first people to allege a connection between events in a subject's past life and their present-day trauma, and coined the words \"dissociation\" and \"subconscious.\"[\/caption]\r\n\r\nOne prominent interpretation of the origins of dissociative disorders is that they are the direct result of exposure to traumatic experiences. The exposure is known as the <em>post-traumatic model<\/em> or PTM. According to the post-traumatic model <em>(<\/em>PTM), dissociative symptoms can best be understood as mental strategies to cope with or avoid the impact of highly aversive experiences. Within post-traumatic model <em>(<\/em>PTM), individuals rely on dissociation to escape from painful memories. Once individuals have learned to use this\u00a0defensive coping mechanism, it can become automatic and habitual, even emerging in response to minor stressors.\u00a0The idea that dissociation can serve a defensive function can be traced back to Pierre Janet (1899\u20131973), one of the first scholars to link dissociation to psychological trauma.\r\n\r\nThe empirical evidence that trauma\u00a0<em>leads\u00a0<\/em><em>to<\/em>\u00a0dissociative symptoms is the subject of intense debate.\u00a0Most important, however, is that the PTM does not tell us\u00a0<em>how\u00a0<\/em>trauma produces dissociative symptoms. Therefore, workers in the field have searched for other explanations. Clinicians and researchers proposed that due to their dreamlike character, dissociative symptoms such as derealization, depersonalization, and absorption are associated with sleep-related experiences. Clinicians and researchers further noted that sleep-related experiences can explain the relationship between highly aversive events and dissociative symptoms.\r\n\r\n<\/section>\r\n<h3>Treatment<\/h3>\r\nOverall, the most common form of treatment for dissociative disorders is psychotherapy, which generally focuses on the dissociative psychopathology and associated trauma or stressor. The types of psychotherapy can include psychodynamic, cognitive-behavioral, supportive, hypnotherapeutic, free association, and drug-assisted. A therapist has to be flexible in the approach and technique applied because of the challenging symptoms people experience with these disorders.\r\n\r\nApplying skill-building interventions at the beginning stages of treatment helps stabilize the patient and improve the disabling dissociative symptoms, allowing treatment to progress and help patients to cope with painful affect and recollections of the traumatic experience. Patients with dissociative amnesia and dissociative fugue generally recover more quickly, especially when the dissociative event is of short duration, and their symptoms may even resolve spontaneously when the person is removed from the previous trauma or stressor. Treatment of dissociative amnesia is aimed at the restoration of missing memories while treatment of dissociative fugue is focused on the recovery of memory for identity and events preceding the fugue. Cognitive and psychodynamic therapy are the most common techniques applied in the treatment of dissociative amnesia and dissociative fugue; however, hypnotherapy and drug-assisted interviews are frequently necessary techniques to assist with memory recovery.\r\n\r\nOverall, the use of pharmacotherapy in the treatment of dissociative disorders is limited and controversial, as most medications (such as antidepressants and anxiolytics) are initiated to alleviate comorbid anxiety and mood symptoms, but do not treat the actual dissociative symptoms. Currently, no pharmacological treatment has been found to reduce dissociation, and\u00a0no medication has been shown to be efficacious to date; research has been limited, and thus no definitive medication treatment guidelines exist.\r\n\r\n<section>\r\n<div>\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/bbecbe6d-cd58-4d8c-b468-83602696d17b\r\n\r\n<\/div>\r\n<\/div>\r\n<div><section>\r\n<div class=\"textbox key-takeaways\">\r\n<h3>Key Takeaways:\u00a0Depersonalization\/Derealization Disorder<\/h3>\r\n<iframe title=\"16. Depersonalization\/derealization disorder\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291225922424475418\/embed\" width=\"1088\" height=\"598\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script>\r\n\r\n<\/div>\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/44dd4c34-bf55-4436-a11b-2a41d0be59ab\r\n\r\n<\/div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Glossary<\/h3>\r\n<strong>depersonalization\/derealization disorder:\u00a0<\/strong>dissociative disorder in which people feel detached from the self (depersonalization), and the world feels artificial and unreal (derealization)\r\n\r\n<strong>dissociative amnesia:\u00a0<\/strong>dissociative disorder characterized by an inability to recall important personal information, usually following an extremely stressful or traumatic experience\r\n\r\n<strong>dissociative disorders:\u00a0<\/strong>group of DSM-5 disorders in which the primary feature is that a person becomes dissociated, or split off, from their core sense of self, resulting in disturbances in identity and memory\r\n\r\n<strong>dissociative fugue:\u00a0<\/strong>symptom of dissociative amnesia in which a person suddenly wanders away from one\u2019s home and experiences confusion about their identity\r\n\r\n<\/div>\r\n<\/section><\/div>\r\n<\/section>","rendered":"<div>\n<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li>Describe and differentiate between dissociative amnesia and fugue<\/li>\n<li>Explain depersonalization\/derealization disorder<\/li>\n<\/ul>\n<\/div>\n<div id=\"attachment_4086\" style=\"width: 280px\" class=\"wp-caption alignright\"><a href=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2017\/03\/31032825\/5879429534_90b400b642_z-1.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4086\" class=\"wp-image-4086\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/855\/2017\/03\/31032825\/5879429534_90b400b642_z-1.jpg\" alt=\"Blurry picture of a man showing a second image of his face detached from the first.\" width=\"270\" height=\"270\" \/><\/a><\/p>\n<p id=\"caption-attachment-4086\" class=\"wp-caption-text\"><strong>Figure 1<\/strong>. The most well-known\u00a0dissociative disorder is dissociative identity disorder, in which people exhibit more than one identity.<\/p>\n<\/div>\n<p><strong>Dissociative disorders<\/strong> are characterized by an individual becoming split off, or dissociated, from their core sense of self. Memory and identity become disturbed; these disturbances have a psychological rather than physical cause. Dissociative disorders listed in the DSM-5 include dissociative amnesia, depersonalization\/derealization disorder, and dissociative identity disorder.<\/p>\n<\/div>\n<section>\n<h2>Dissociative Amnesia<\/h2>\n<p>Amnesia refers to the partial or total forgetting of some experience or event. An individual with <strong>dissociative amnesia<\/strong> is unable to recall important personal information, usually following an extremely stressful or traumatic experience such as combat, natural disasters, or being the victim of violence. The memory impairments are not caused by ordinary forgetting.\u00a0<span style=\"font-size: 1em;\">One study of residents in communities in upstate New York reported that about 1.8% experienced dissociative amnesia in the previous year (Johnson, Cohen, Kasen, &amp; Brook, 2006).\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">Some individuals with dissociative amnesia will also experience <\/span><strong style=\"font-size: 1rem; text-align: initial;\">dissociative fugue<\/strong><span style=\"font-size: 1rem; text-align: initial;\"> (from the word \u201cto flee\u201d in French), whereby they suddenly wander away from their home, experience confusion about their identity, and sometimes even adopt a new identity (Carde\u00f1a &amp; Gleaves, 2006). Most fugue episodes last only a few hours or days, but some can last longer.\u00a0<\/span><\/p>\n<div id=\"attachment_1763\" style=\"width: 310px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-1763\" class=\"wp-image-1763 size-medium\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/07\/10010115\/fog-3914967_1920-300x200.jpg\" alt=\"Person wandering through field in fog.\" width=\"300\" height=\"200\" \/><\/p>\n<p id=\"caption-attachment-1763\" class=\"wp-caption-text\"><strong>Figure 2<\/strong>. People with dissociative fugue temporarily lose their sense of personal identity and impulsively wander away from their homes or places of work.<\/p>\n<\/div>\n<p id=\"__p5\">People with dissociative fugue may travel far distances during the fugue, as far as several thousand miles, and could remain in the fugue state for a couple of days, several weeks or even months.\u00a0Once they have returned to their pre-dissociative states, they do not remember any events that occurred during the fugue.\u00a0Dissociative fugue is a rare disorder and data available indicate a prevalence of 0.2% in the general population. The onset is often in adolescence or early adulthood and onset is usually sudden, and often related to traumatic or stressful life events. Dissociative fugue has also been noted to be associated with a previous history of child abuse. Other factors that could predispose someone to dissociative reactions include neuropsychological cognitive dysfunctions and genetic factors. Recovery is usually sudden and often complete, although the fugue state may end gradually in some individuals.<\/p>\n<p>Some have questioned the validity of dissociative amnesia (Pope, Hudson, Bodkin, &amp; Oliva, 1998); it has even been characterized as a \u201cpiece of psychiatric folklore devoid of convincing empirical support\u201d (McNally, 2003, p. 275). Notably, scientific publications regarding dissociative amnesia rose during the 1980s and reached a peak in the mid-1990s, followed by an equally sharp decline by 2003; in fact, only 13 cases of individuals with dissociative amnesia worldwide could be found in the literature that same year (Pope, Barry, Bodkin, &amp; Hudson, 2006). Further, no description of individuals showing dissociative amnesia following a trauma exists in any fictional or nonfictional work prior to 1800 (Pope, Poliakoff, Parker, Boynes, &amp; Hudson, 2006). However, a study of 82 individuals who enrolled for treatment at a psychiatric outpatient hospital found that nearly 10% met the criteria for dissociative amnesia, perhaps suggesting that the condition is underdiagnosed, especially in psychiatric populations (Foote, Smolin, Kaplan, Legatt, &amp; Lipschitz, 2006).<\/p>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_de94a80b-048a-4941-b7b2-9cd2f50bc214\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/de94a80b-048a-4941-b7b2-9cd2f50bc214?iframe_resize_id=assessment_practice_id_de94a80b-048a-4941-b7b2-9cd2f50bc214\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<\/section>\n<section>\n<div class=\"textbox key-takeaways\">\n<h3>Key Takeaways: Dissociative Amnesia<\/h3>\n<p><iframe loading=\"lazy\" title=\"15. Dissociative Amnesia\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291225916082234858\/embed\" width=\"1088\" height=\"758\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script><\/p>\n<\/div>\n<h2>Depersonalization\/Derealization Disorder<\/h2>\n<p><strong>Depersonalization\/derealization disorder<\/strong> is characterized by recurring episodes of depersonalization, derealization, or both. Depersonalization is defined as feelings of \u201cunreality or detachment from, or unfamiliarity with, one\u2019s whole self or from aspects of the self\u201d (APA, 2013, p. 302). Individuals who experience <strong>depersonalization<\/strong> might believe their thoughts and feelings are not their own; they may feel robotic as though they lack control over their movements and speech; they may experience a distorted sense of time and, in extreme cases, they may sense an \u201cout-of-body\u201d experience in which they see themselves from the vantage point of another person. <strong>Derealization<\/strong> is conceptualized as a sense of \u201cunreality or detachment from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surroundings\u201d (APA, 2013, p. 303). A person who experiences derealization might feel as though he is in a fog or a dream, or that the surrounding world is somehow artificial and unreal. Individuals with depersonalization\/derealization disorder often have difficulty describing their symptoms and may think they are going crazy (APA, 2013).<\/p>\n<div class=\"textbox examples\">\n<h3>Watch it<\/h3>\n<p>This video explains depersonalization and derealization.<\/p>\n<p><iframe loading=\"lazy\" src=\"\/\/plugin.3playmedia.com\/show?mf=5572746&amp;p3sdk_version=1.10.1&amp;p=20361&amp;pt=375&amp;video_id=mCcxWq_J0YU&amp;video_target=tpm-plugin-797ht97p-mCcxWq_J0YU\" width=\"800px\" height=\"450px\" frameborder=\"0\" marginwidth=\"0px\" marginheight=\"0px\"><\/iframe><\/p>\n<p>You can view the <a href=\"https:\/\/course-building.s3-us-west-2.amazonaws.com\/Abnormal+Psychology\/transcripts\/WhatAreDerealizationAndDepersonalizationDisorder_transcript.txt\" target=\"_blank\" rel=\"noopener\">transcript for &#8220;What Are Derealization &amp; Depersonalization Disorder?&#8221; here (opens in new window)<\/a>.<\/p>\n<\/div>\n<h3>Etiology<\/h3>\n<div id=\"attachment_1767\" style=\"width: 223px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-1767\" class=\"wp-image-1767 size-medium\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/07\/10020647\/Photo-of-Pierre-Janet-213x300.jpg\" alt=\"Photo of Pierre Janet\" width=\"213\" height=\"300\" \/><\/p>\n<p id=\"caption-attachment-1767\" class=\"wp-caption-text\"><strong>Figure 3<\/strong>. Pierre Janet was one of the first people to allege a connection between events in a subject&#8217;s past life and their present-day trauma, and coined the words &#8220;dissociation&#8221; and &#8220;subconscious.&#8221;<\/p>\n<\/div>\n<p>One prominent interpretation of the origins of dissociative disorders is that they are the direct result of exposure to traumatic experiences. The exposure is known as the <em>post-traumatic model<\/em> or PTM. According to the post-traumatic model <em>(<\/em>PTM), dissociative symptoms can best be understood as mental strategies to cope with or avoid the impact of highly aversive experiences. Within post-traumatic model <em>(<\/em>PTM), individuals rely on dissociation to escape from painful memories. Once individuals have learned to use this\u00a0defensive coping mechanism, it can become automatic and habitual, even emerging in response to minor stressors.\u00a0The idea that dissociation can serve a defensive function can be traced back to Pierre Janet (1899\u20131973), one of the first scholars to link dissociation to psychological trauma.<\/p>\n<p>The empirical evidence that trauma\u00a0<em>leads\u00a0<\/em><em>to<\/em>\u00a0dissociative symptoms is the subject of intense debate.\u00a0Most important, however, is that the PTM does not tell us\u00a0<em>how\u00a0<\/em>trauma produces dissociative symptoms. Therefore, workers in the field have searched for other explanations. Clinicians and researchers proposed that due to their dreamlike character, dissociative symptoms such as derealization, depersonalization, and absorption are associated with sleep-related experiences. Clinicians and researchers further noted that sleep-related experiences can explain the relationship between highly aversive events and dissociative symptoms.<\/p>\n<\/section>\n<h3>Treatment<\/h3>\n<p>Overall, the most common form of treatment for dissociative disorders is psychotherapy, which generally focuses on the dissociative psychopathology and associated trauma or stressor. The types of psychotherapy can include psychodynamic, cognitive-behavioral, supportive, hypnotherapeutic, free association, and drug-assisted. A therapist has to be flexible in the approach and technique applied because of the challenging symptoms people experience with these disorders.<\/p>\n<p>Applying skill-building interventions at the beginning stages of treatment helps stabilize the patient and improve the disabling dissociative symptoms, allowing treatment to progress and help patients to cope with painful affect and recollections of the traumatic experience. Patients with dissociative amnesia and dissociative fugue generally recover more quickly, especially when the dissociative event is of short duration, and their symptoms may even resolve spontaneously when the person is removed from the previous trauma or stressor. Treatment of dissociative amnesia is aimed at the restoration of missing memories while treatment of dissociative fugue is focused on the recovery of memory for identity and events preceding the fugue. Cognitive and psychodynamic therapy are the most common techniques applied in the treatment of dissociative amnesia and dissociative fugue; however, hypnotherapy and drug-assisted interviews are frequently necessary techniques to assist with memory recovery.<\/p>\n<p>Overall, the use of pharmacotherapy in the treatment of dissociative disorders is limited and controversial, as most medications (such as antidepressants and anxiolytics) are initiated to alleviate comorbid anxiety and mood symptoms, but do not treat the actual dissociative symptoms. Currently, no pharmacological treatment has been found to reduce dissociation, and\u00a0no medication has been shown to be efficacious to date; research has been limited, and thus no definitive medication treatment guidelines exist.<\/p>\n<section>\n<div>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_bbecbe6d-cd58-4d8c-b468-83602696d17b\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/bbecbe6d-cd58-4d8c-b468-83602696d17b?iframe_resize_id=assessment_practice_id_bbecbe6d-cd58-4d8c-b468-83602696d17b\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<\/div>\n<div>\n<section>\n<div class=\"textbox key-takeaways\">\n<h3>Key Takeaways:\u00a0Depersonalization\/Derealization Disorder<\/h3>\n<p><iframe loading=\"lazy\" title=\"16. Depersonalization\/derealization disorder\" src=\"https:\/\/lumenlearning.h5p.com\/content\/1291225922424475418\/embed\" width=\"1088\" height=\"598\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><script src=\"https:\/\/lumenlearning.h5p.com\/js\/h5p-resizer.js\" charset=\"UTF-8\"><\/script><\/p>\n<\/div>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_44dd4c34-bf55-4436-a11b-2a41d0be59ab\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/44dd4c34-bf55-4436-a11b-2a41d0be59ab?iframe_resize_id=assessment_practice_id_44dd4c34-bf55-4436-a11b-2a41d0be59ab\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<div class=\"textbox learning-objectives\">\n<h3>Glossary<\/h3>\n<p><strong>depersonalization\/derealization disorder:\u00a0<\/strong>dissociative disorder in which people feel detached from the self (depersonalization), and the world feels artificial and unreal (derealization)<\/p>\n<p><strong>dissociative amnesia:\u00a0<\/strong>dissociative disorder characterized by an inability to recall important personal information, usually following an extremely stressful or traumatic experience<\/p>\n<p><strong>dissociative disorders:\u00a0<\/strong>group of DSM-5 disorders in which the primary feature is that a person becomes dissociated, or split off, from their core sense of self, resulting in disturbances in identity and memory<\/p>\n<p><strong>dissociative fugue:\u00a0<\/strong>symptom of dissociative amnesia in which a person suddenly wanders away from one\u2019s home and experiences confusion about their identity<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/section>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-70\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Modification, adaptation, and original content. <strong>Authored by<\/strong>: Chrissy Hicks for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Dissociative Disorders. <strong>Authored by<\/strong>: OpenStax College. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:xK72Td1i@5\/Dissociative-Disorders\">http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:xK72Td1i@5\/Dissociative-Disorders<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em>. <strong>License Terms<\/strong>: Download for free at http:\/\/cnx.org\/content\/col11629\/latest\/.<\/li><li>Photo of man. <strong>Authored by<\/strong>: David Ensor. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.flickr.com\/photos\/dbensor\/5879429534\">https:\/\/www.flickr.com\/photos\/dbensor\/5879429534<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/pdm\">Public Domain: No Known Copyright<\/a><\/em><\/li><li>Dissociative fugue symptoms in a 28-year-old male Nigerian medical student: a case report. <strong>Authored by<\/strong>: Monday N Igwe. <strong>Provided by<\/strong>: NCBI. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3680202\/\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3680202\/<\/a>. <strong>Project<\/strong>: Journal of Medical Case Reports. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><li>Pierre Janet. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Pierre_Janet\">https:\/\/en.wikipedia.org\/wiki\/Pierre_Janet<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Dissociative Disorders. <strong>Authored by<\/strong>: Dalena van Heugten - van der Kloet. <strong>Provided by<\/strong>: Maastricht University. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/nobaproject.com\/modules\/dissociative-disorders\">https:\/\/nobaproject.com\/modules\/dissociative-disorders<\/a>. <strong>Project<\/strong>: The Noba Project. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\">CC BY-NC-SA: Attribution-NonCommercial-ShareAlike<\/a><\/em><\/li><li>Textbook of Psychiatry Dissociative Disorders\/Treatment. <strong>Provided by<\/strong>: Wikibooks. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Dissociative_Disorders\/Treatment\">https:\/\/en.wikibooks.org\/wiki\/Textbook_of_Psychiatry\/Dissociative_Disorders\/Treatment<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">All rights reserved content<\/div><ul class=\"citation-list\"><li>What Are Derealization &amp; Depersonalization Disorder?. <strong>Provided by<\/strong>: BetterHelp. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=mCcxWq_J0YU&#038;feature=emb_logo\">https:\/\/www.youtube.com\/watch?v=mCcxWq_J0YU&#038;feature=emb_logo<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section>","protected":false},"author":29,"menu_order":4,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Dissociative Disorders\",\"author\":\"OpenStax College\",\"organization\":\"\",\"url\":\"http:\/\/cnx.org\/contents\/Sr8Ev5Og@5.52:xK72Td1i@5\/Dissociative-Disorders\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"Download for free at http:\/\/cnx.org\/content\/col11629\/latest\/.\"},{\"type\":\"original\",\"description\":\"Modification, adaptation, and original content\",\"author\":\"Chrissy Hicks for Lumen Learning\",\"organization\":\"Lumen Learning\",\"url\":\"\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Photo of man\",\"author\":\"David Ensor\",\"organization\":\"\",\"url\":\"https:\/\/www.flickr.com\/photos\/dbensor\/5879429534\",\"project\":\"\",\"license\":\"pd\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Dissociative fugue symptoms in a 28-year-old male Nigerian medical student: a case report\",\"author\":\"Monday N Igwe\",\"organization\":\"NCBI\",\"url\":\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3680202\/\",\"project\":\"Journal of Medical Case Reports\",\"license\":\"cc-by\",\"license_terms\":\"\"},{\"type\":\"copyrighted_video\",\"description\":\"What Are Derealization & Depersonalization Disorder?\",\"author\":\"\",\"organization\":\"BetterHelp\",\"url\":\"https:\/\/www.youtube.com\/watch?v=mCcxWq_J0YU&feature=emb_logo\",\"project\":\"\",\"license\":\"other\",\"license_terms\":\"Standard YouTube License\"},{\"type\":\"cc\",\"description\":\"Pierre Janet\",\"author\":\"\",\"organization\":\"Wikipedia\",\"url\":\"https:\/\/en.wikipedia.org\/wiki\/Pierre_Janet\",\"project\":\"\",\"license\":\"cc-by-sa\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Dissociative Disorders\",\"author\":\"Dalena van Heugten - 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