Controversy Associated With Dissociative Disorders Assignment
Controversy Associated With Dissociative Disorders Assignment
Week 9: Dissociative Disorders
Have you ever been driving and realized you don’t remember the last few minutes of driving? Or have you gotten so wrapped up in a book or movie that you lose some awareness of your surroundings? These are examples of common and very mild dissociation, or a disconnect or lack of continuity between thoughts, feelings, actions, and sense of self.
There are three major dissociative disorders defined in the DSM-5: dissociative identity disorder, dissociative amnesia, and depersonalization-derealization disorder. Dissociative disorders may be associated with traumatic events in order to help manage difficult memories or experiences. Patients with these types of disorders are likely to also exhibit symptoms of a variety of other dysfunctions, such as depression, alcoholism, or self-harm and may also be more susceptible to personality, sleeping, and eating disorders. Controversy Associated With Dissociative Disorders Assignment
This week, you will analyze issues related to the diagnosis and treatment of dissociative disorders as well as associated legal and ethical considerations.
Analyze issues related to the diagnosis and treatment of dissociative disordersAnalyze legal and ethical considerations related to dissociative disordersLearning ResourcesRequired Readings (click to expand/reduce)
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
Chapter 12, “Dissociative Disorders”Required Media (click to expand/reduce)
Osmosis. (2017, November 20). Dissociative disorders – causes, symptoms, diagnosis, treatment, pathology [Video]. YouTube. https://youtu.be/XF2zeOdE5GY
Mad Medicine. (2019, August 18). Dissociative disorders (Psychiatry) – USMLE Step 1 [Video]. YouTube. https://youtu.be/Iz03M9pwhs0
Grande, T. (2018, October 22). The dissociative identity disorder controversy (Trauma vs. Iatrogenic). [Video]. YouTube. https://www.youtube.com/watch?v=zqTP0CP9aDk
Assignment: Controversy Associated With Dissociative Disorders
The DSM-5 is a diagnostic tool. It has evolved over the decades, as have the classifications and criteria within its pages. It is used not just for diagnosis, however, but also for billing, access to services, and legal cases. Not all practitioners are in agreement with the content and structure of the DSM-5, and dissociative disorders are one such area. These disorders can be difficult to distinguish and diagnose. There is also controversy in the field over the legitimacy of certain dissociative disorders, such as dissociative identity disorder, which was formerly called multiple personality disorder.
In this Assignment, you will examine the controversy surrounding dissociative disorders. You will also explore clinical, ethical, and legal considerations pertinent to working with patients with these disorders.
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Review this week’s Learning Resources on dissociative disorders.
Use the Walden Library to investigate the controversy regarding dissociative disorders. Locate at least three scholarly articles that you can use to support your Assignment.
The Assignment (2–3 pages)
Explain the controversy that surrounds dissociative disorders.
Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.
Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.
By Day 7 of Week 9
Submit your Assignment.
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What’s Coming Up in Week 10?
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In Week 10, you will explore effective assessment, diagnosis, and treatment for somatic symptom-related disorders. In these disorders, a patient has symptoms that can’t be traced to a definitive physical cause. The physical pain and symptoms are then attributed to psychological factors.
Week 9: Dissociative Disorders Sample Paper
Dissociative disorders are a group of mental disorders characterized by the fragmentation of personality. Personality disruptions in dissociative disorder are seen as a discontinuity in memory, consciousness, identity, perception, cognition, and sensorimotor functions. The DSM-5 recognizes dissociative disorders and classifies them into three related disorders: dissociative identity disorder (DID), dissociative amnesia, depersonalization, derealization disorder, and unspecified type of dissociative disorder. According to Dr. Todd Grande (2018), more controversy is seen towards DID than other types of dissociative disorders (Grande, 2018). The controversy and criticism around the result from different schools of thought around the diagnosis of DID. This paper described the controversy in DID and personal professional opinions about dissociative disorders
The Controversy in Dissociation Disorders
The controversy in dissociative identity disorder arises from the presentation of distinct personalities in one individual. DID is usually associated with childhood abuse and trauma that leads to brain adaptation to cope with this unusual environment. This theory believes that in the process of this adaptation, the personality of the individual fragments thus multiple personalities (Grande, 2018). The first school of thought believes that this condition is real and the diagnosis is genuine. These proponents of this disorder argue that the brain personalities are compartmentalized such that they do not communicate or have access to each other thus the distinct personality presentations (Wild Pages Press, 2018). This theory is also called the trauma (dynamic/developmental) model and is the most widely accepted and used. Controversy Associated With Dissociative Disorders Assignment
The opponents of the diagnosis of dissociative disorders argue that these disorders are unreal and sometimes enthusiastically over-diagnosed by clinicians. There are sometimes mixed thoughts about these disorders among the opponents of their diagnosis. Some clinicians believe that this disorder is real and the diagnosis may be misplaced. They believe that the symptom presented by the individuals ‘ labeled’ to have these disorders are actual symptoms but are seen in other disorders such as schizophrenia borderline personality disorder (Grande, 2018). The fantasy, also known as the socio-cognitive model is used by the opponents of dissociative disorders (Wild Pages Press, 2018). This model explains that dissociative symptoms are social constructs thus the made-up or learned symptoms. clinicians suggesting these symptoms objectively to the patients makes them aware of alternative personalities that they can act up. Therefore, factors such as underlying vulnerability, social conditioning, and clinical suggestions are responsible for the presentation of dissociative symptoms.
Professional Belief about Dissociative Disorders
The presence of the symptoms cannot be denied. However, I believe that overdiagnosis can be possible. I cannot deny the existence of these symptoms of some patients. The DSM-5 sets out clear criteria for the diagnosis of dissociative disorders (American Psychiatric Association, 2013) but leaves loopholes for overdiagnosis. I believe that dissociative disorders are real and may coexist with other mental health issues. The dynamic model suggests relatable outcomes of trauma and has been seen in other sequelae of trauma. trauma in childhood has various mental health consequences that do not necessarily present as a posttraumatic stress disorder. According to Peterson (2018) through the National Child Traumatic Stress Network (NCTSN), childhood trauma leads to varied outcomes in emotion, memory, identity, and consciousness because they lack a developed pattern in these domains of mental health. Therefore, a fragmentation change in personality may arise because of the developmental modifications to fit in these settings. Albin et al. (2020) acknowledge that physical trauma can cause physical outcomes but there is a need to watch out for the emotional and psychological outcomes in children that warrant counseling and other psychiatric interventions. Therefore, my stance in this debate is that dissociative disorders are real but there is a need to take care when making these diagnoses because of their resemblance with other mental illnesses.
Maintaining Therapeutic Relationship in Patients with Dissociative Disorders
The therapeutic relationship is important in promoting successful outcomes psychotherapy for every mental illness. In dissociative disorders, the therapist’s honesty, genuineness, and empathy are important in ensuring a positive therapeutic relationship. Strategies for maintaining a therapeutic relationship in a patient that may have the dissociative disorder may include keeping the trust, ensuring congruence and respect (Firestone, 2018). These patients may present symptoms that they may not disclose to other relatives because of their personal fears. Therefore, keeping this trust and ensuring respect for their information can keep the therapeutic relationship.
Ethical and Legal Considerations
The skepticism around dissociative disorders presents a difficult ethical dilemma and legal outcomes in the patient’s care. According to the DSM-5, culture plays a vital role in the patient’s understanding of their illnesses. Associating dissociative disorders with cultural entities such as spiritual possession, mythical figures, and religious deities makes psychoeducation about these disorders difficult, and the need to respect patient autonomy may override the need for psychiatric attention. Firestone (2018) associated dissociative disorders and high suicidal risks. Missing these suicidal tendencies during diagnosis may remotely be interpreted as medical negligence thus legal implications may follow. I feel the need to ensure these ethical, cultural, and legal considerations when managing patients with suspected dissociative disorders.
Despite the controversy and skepticism around dissociative disorders, their diagnosis is valid. I believe that their diagnosis is a volatile one and can be confused with other illnesses. The risk of suicide cultural determination of the patient’s beliefs around their presentations can cause dilemmatic situations when managing these patients. therefore, I will keep the patient’s trust respect their autonomy, and give my honest professional opinion during the management to maintain a good therapeutic relationship.
Albin, C. B., Feema, R., Aparna, L., Darpanarayan, H., Chandran, J., & Abhilash, K. P. P. (2020). Pediatric trauma etiology, severity, and outcome. Journal of Family Medicine and Primary Care, 9(3), 1583–1588. https://doi.org/10.4103/jfmpc.jfmpc_1081_19
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5 (R)) (5th ed.). American Psychiatric Association Publishing.
Firestone, L. (2018). Dissociation and Therapeutic Alliance. In M. Pompili (Ed.), Phenomenology of Suicide (Vol. 217, pp. 167–186). Springer International Publishing.
Grande, T. (2018, October 22). The dissociative identity disorder controversy (trauma vs. Iatrogenic). YouTube. https://youtu.be/zqTP0CP9aDk
Peterson, S. (2018, January 30). About Childhood Trauma: Effects. The National Child Traumatic Stress Network. https://www.nctsn.org/what-is-child-trauma/trauma-types/complex-trauma/effects
Wild Pages Press. (2018). Dissociative identity disorder: Journal/notebook 150 lined pages 6 X 9 softcover. Createspace Independent Publishing Platform. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787069/all/Dissociative_Identity_Disorder
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