Two or more personality systems are created from stressful precipitating events
səhifə 11/30 tarix 27.04.2018 ölçüsü 469 b. #49225
Two or more personality systems are created from stressful precipitating events Personalities are dramatically different Needs inhibited in one personality are displayed in another Alter identities represent fragments of a single person Some alters may have more knowledge than others Switches can be sudden or gradual Often see depression, self-mutilation , suicide attempts and ideation, BPD, substance abuse, phobias Gaps in memory are common Usually starts in childhood, but not dx’d until 20s or 30s 3-9x more common in women—due to sexual abuse Number of alters has increased over time—50% now show more than ten identities; bizarre and unusual identities have also increased Before 1979, only 200 cases had ever been reported. Post-Sybil and Three Faces of Eve , that has risen to 30-40,000 in North America May have previously been dx’d as schizophrenia Use of DID as a criminal defense is rare—Kenneth Bianchi—The Hillside Strangler Use of DID as a criminal defense is rare—Kenneth Bianchi—The Hillside Strangler Factitious and malingering cases are rare Post-traumatic theory—over 95 % have memories of severe abuse. DID as a way to cope with overwhelming sense of hopelessness and powerlessness. Escape—dissociation—occurs through a process like self-hypnosis/ Only some abused kids develop DID—diathesis stress model Sociocognitive theory—DID develops when a highly suggestible person learns to adopt and enact the roles of MPD due to therapist suggestions and reinforcement and because identities allow person to achieve personal goals—unintentional process. Spanos and colleagues—normal college students could be induced by suggestion under hypnosis to show DID sx This is consistent with those who have no sx of DID before therapy, but emerges in tx; also consistent with increase in dx as therapists became aware of dx Tends to focus on integration Tends to focus on integration Few outcome studies. Many of those seem to be biased for positive results Recovered memories—real or fake Practitioners more likely to believe in recovered memories but Memory is malleable and memories are subject to modification Intense fear of gaining weight or becoming fat is coupled with a refusal to maintain minimal wt. Intense fear of gaining weight or becoming fat is coupled with a refusal to maintain minimal wt. At least 15 % wt loss without organic cause (usually 25-30%) Active pursuit of thinness Distorted body image Amenorrhea Two types: Restricting and Binge-eating/purging type—about 30-50% go from restricting to binge/purge Restrictors are admired Mortality: 3-21%--about 12x higher than other females age 15-24 Normal awareness of hunger, but terrified of giving in to impulse to eat. Distorted perception of satiety. Excessive activity. 90-95 % of cases are in females Peak onset between 14-18 .5-2% prevalence in clinical populations. Higher rates of behaviors when we use an epidemiological approach. Males tend to fall in a few specific groups—jockeys, wrestlers, models So called Golden Girls disease. Most common in industrialized nations (highest rates are here) but increasingly found everywhere. Medical complications: Hair and nails thin and become brittle, dry skin, lanugo, yellowish tinge to skin, cold all the time, low bp, kidney damage, heart arrhythmias , electrolyte imbalances, osteoporosis 40% totally recover 40% totally recover 30% considerably improve 20% unimproved, seriously impaired Remainder die Poor prognosis—chronicity, pronounced family difficulties, poor vocational adjustment Depression in 50-70%, appear to be separate disorders Depression in 50-70%, appear to be separate disorders OCD also fairly common Some studies have found increased rates of sexual abuse, but these have generally all been methodologically flawed 1st classified as a disorder in 1980, therefore less research Two types—purging and non-purging Some argue that anorexia with binge/purge is just an underweight form of bulimia Recurrent episodes of binge eating and repeated attempts to lose weight by severe dieting or purging (laxatives, vomiting, exercise) Typical picture: white female begins overeating around 18 and purging a year later, generally vomiting Dostları ilə paylaş:
