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Here is a compilation of essays on ‘Dissociative Disorders’ for class 11 and 12. Find paragraphs, long and short essays on ‘Dissociative Disorders’ especially written for school and college students.
Essay on Dissociative Disorders
Essay Contents:
- Essay on Psychogenic Amnesia
- Essay on Psychogenic Fugue
- Essay on Multiple Personality Disorder
- Essay on Depersonalization Disorder
1. Essay on Psychogenic Amnesia:
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It is defined as a sudden inability to recall important personal information, an inability not due to an Organic Mental Disorder. If the patient travels to another locale and/or assumes a different identity, the amnesia may prove to be a symptom of psychogenic fugue or multiple personality disorder.
Epidemiology:
The exact prevalence of this disorder is unknown. It is more common in wartime or during natural disasters. It is most often observed in adolescent and young adult females.
Types:
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There are four types of disturbances in recall:
(i) Localized (or circumscribed):
It is the most common type and is characterized by failure to recall all events occurring during a circumscribed period of time usually the first few hours following a profoundly disturbing event.
(ii) Selective amnesia:
It is a failure to recall some, but not all of the events occurring during a circumscribed period of time.
(iii) Generalized amnesia:
In which failure to recall encompasses the individual’s entire life.
(iv) Continuous amnesia:
In which the individual cannot recall events subsequent to a specific time upto and including the present.
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Etiology:
Amnesia often begins suddenly, usually in the context of severe psychosocial stress e.g., war, disaster or acute trauma.
(i) Psychological:
Amnesia as the result of the repression of unacceptable thoughts and wishes that would otherwise cause distress.
(ii) Physiological:
The amnesia has a constitutional capacity to enter altered states in response to stressful stimuli.
(iii) Social:
Amnesia has a biological substrate but is not founded on neurological dysfunction. The amnesia begins suddenly, usually following severe psychosocial stress. Termination of the amnesia is typically abrupt and recovery is complete with recurrences rare.
Differential Diagnosis:
(i) Organic mental disorders
(ii) Substance-induced intoxication
(iii) Alcohol amnestic disorder
(iv) Post concussion amnesia
(v) Epilepsy
(vi) Catatonic stupor
(vii) Malingering
Management:
A high percentage of psychogenic amnesia cases may recover spontaneously when treated supportively. Hypnosis and sodium amytal have been used with success.
2. Essay on Psychogenic Fugue:
The predominant disturbance is sudden unexpected travel away from home or customary work locale with assumption of a new identity (partial or complete) and an inability to recall one’s previous identity. Perplexity and disorientation may occur. Following recovery, there is no recollection of events that took place during the fugue.
Epidemiology:
The exact incidence and prevalence are unknown. Although apparently rare, the disorder is most common in wartime or in the wake of a natural disaster.
Clinical Picture:
The individual may give himself or herself a new name, take up a new residence and engage in complex social activities that are well integrated and do not suggest the presence of a mental disorder. In most cases, however, the fugue is less elaborate and consists of little more than brief, apparently purposeful travel. Social contacts in these cases are minimal or even avoided; the new identity, while present is incomplete.
Etiology:
The literature is divided as to whether preexisting psychopathology or a difficult family background play a role. Many fugues begin in sleep or sleep deprivation or end in connection with sleep. Heavy alcohol use may predispose to the development of the disorder. The other factors like marital quarrels, personal rejections, losses, financial pressures, military conflict or natural disaster may play a role in the genesis of this disorder.
Differential Diagnosis:
i. Organic mental disorders:
They usually involve a disturbance of memory more marked for recent than for remote events; the memory disturbance is not isolated and disappears slowly, if at all; memory rarely is fully restored.
ii. Psychogenic amnesia:
Purposeful travel and the assumption of a new identity, partial or complete, are not present in this disorder.
iii. Temporal lobe epilepsy:
It involves travel, motoric activity which is usually simple rather than complex and there is no assumption of a new identity. Affect is dysphoric.
iv. Malingering.
v. Other psychiatric illnesses:
Depression, schizophrenia etc.
Management:
The use of hypnosis and/or sodium pentothal interviews in conjunction with psychotherapy may be useful. Ultimately rapid recovery occurs and recurrences are rare.
3. Essay on Multiple Personality Disorder:
Multiple personality disorder (MPD) is the existence within the individual of two or more distinct personalities, each of which is dominant at a particular time. Each personality is fully integrated and complex unit with unique memories, behaviour patterns and social relationships, that determine the nature of the individual’s act when the personality is dominant. Transitions from one personality to another is sudden and often associated with psychosocial stress.
Epidemiology:
The onset may be in early childhood or later. It is most often diagnosed in late adolescent and young adult females.
Clinical Picture:
The essential feature is the existence of two or more distinct entities within a single person, traditionally called personalities, which may be associated with markedly different voices, accents, vocabularies, social expressions, movement characteristics, headedness, allergies, symptoms, eye glass prescriptions, findings on psychological tests, ethnicity, gender, ancestory and physical characteristics may be quite disparate.
Common types of personalities are varieties of children’s personalities, protectors, helpers, guardians persecutors, apologists for and defenders of the abusers, avengers, expressers of strong affect and forbidden impulses.
The transitions called Switches may be instigated by psychosocial stress, by intrapsychic conflict, by conflicts among the personalities in response to idiosyncratic social or environmental cues or by arrangements among the personalities. Hypnosis, drug facilitated interviews or simple requests may trigger switches in the therapeutic setting. The personalities awareness of one another varies.
Diagnosis:
Several cues suggest careful scrutiny for this disorder are: Prior treatment failure; 3 or more prior diagnoses; concurrent psychiatric and somatic symptoms; fluctuating symptoms and levels of function; severe headaches, time distortion or time lapses; being told of disremembered behaviours; others’ noting observable changes; discovery of objects or handwritings in one’s possession that one cannot account for or recognize; the hearing of voices that are experienced as separate, urging the patient toward some activity; the use of “we” in a collective sense and the eliciting of other entities through hypnosis or sodium pentothal interview.
Complications:
The common complications include transient psychotic episodes, psychosexual disorder, disorder of impulse, somatoform disorders and social or occupational impairment.
Differential Diagnosis:
(i) Psychogenic fugue and psychogenic amnesia.
(ii) Psychotic disorders such as schizophrenia and mood disorder with psychotic symptoms.
(iii) Borderline personality disorder.
(iv) Malingering.
(v) Temporal lobe seizure and Postictal phenomenon.
Management:
Psychotherapy (Individual as well as psychodynamic) often facilitated with hypnosis and/ or sodium pentothal interview has been used by most successful workers. Anxiolytics and sedatives are usually palliatives, notwithstanding their abuse potential. Other drugs (e.g., Antidepressants, Anticonvulsants, Antipsychotics etc.) are useful only if specific disorders are present. Often groups and family interventions can be helpful.
The course tends to be more chronic than other dissociative disorders.
4. Essay on Depersonalization Disorder:
The essential feature of this disorder is the occurrence of one or more episodes of depersonalization that causes social or occupational impairment.
Epidemiology:
Mild depersonalization without significant impairment is estimated to occur at some time in 30%- 70% of young adults. The disorder per se begins in adolescence or early adulthood and is more common in young women.
Clinical Picture:
The symptoms of depersonalization (a disorder of perception) involve an alteration in the perception or experience of the self so that the usual sense of one’s own reality is temporarily lost or changed. This is manifested by a sensation of self-estrangement or unreality which may include the feeling that one’s extremities have changed in size or the experience of seeming to perceive oneself from a distance.
Depersonalization has been found to be associated with depression, phobic, anxiety states, schizophrenia, obsessive compulsive neurosis, drug abuse (mild altering drugs like LSD), sleep deprivation, temporal lobe epilepsy and migraine.
The incidence of this disorder is high under conditions of sustained traumatization such as in war or concentration camps or in near-death experiences.
De-realization is frequently present. This is manifested by a strange alteration in the perception of one’s surroundings to that a sense of the reality of the external world is lost.
Predisposition is due to fatigue, recovery from substance intoxication, hypnosis, medication, physical pain, anxiety, depression, high grade fever and severe stress such as auto accident, natural disaster or military combat.
Hypochondriasis and social or occupational impairment may be the complications.
Etiology:
The following theories have been put forward:
a) Depersonalization has been attributed to a preformed response of the brain in certain individuals.
b) It is a defense in which by denying one’s experiencing self, one denies the authorship of guilt-provoking feelings.
c) Depersonalization follows the attempts to repudiate a self-image associated with unacceptable drives or alternations of the ego boundaries.
d) Depersonalization is a common response to life-threatening circumstances.
Differential Diagnosis:
(i) Symptom of depersonalization:
Even if recurrent that does not cause any social or occupational impairment.
(ii) Other psychiatric disorders:
Such as depression, schizophrenia, organic mental disorder (drug intoxication or withdrawal) anxiety disorders, epilepsy and personality disorders.
(iii) Other dissociative disorders.
Management:
Some reports suggest that clozapine and phenazepam may be of use, especially when the patients are seen fairly shortly after the onset of the disorder.
Therapeutic hypnosis is useful in patients with high hypnotizability.
The course of this disorder is usually chronic and marked by remissions and exacerbations.