Problem 3 - Abnormal Psychology: An Integrative Approach

Question

Diagnose the dissociative disorders described here by choosing one of the following: (a) dissociative fugue, (b) depersonalization-derealization disorder, (c) generalized amnesia, (d) dissociative identity disorder, and (e) localized amnesia. Terry complained about feeling out of control. She said she felt sometimes as if she were floating under the ceiling and just watching things happen to her. She also experienced tunnel vision and felt uninvolved in the things that went on in the room around her. This always caused her to panic and perspire. ______________

Step-by-Step Solution

Answer

Depersonalization-derealization disorder.

Step 1: Identify the Symptoms in the Description

First, we need to list out the symptoms and experiences Terry is having. According to the description, she feels like she is floating under the ceiling, watching things happen, experiences tunnel vision, and feels uninvolved in the activities around her. This causes her to panic and perspire.

Step 2: Review Characteristics of Each Disorder

Review the characteristics of each dissociative disorder: - **Dissociative Fugue:** Temporary loss of identity and traveling away from home. - **Depersonalization-Derealization Disorder:** Experiences of feeling detached from one's body or surroundings, like watching oneself as an outsider. - **Generalized Amnesia:** Inability to remember personal history or identity. - **Dissociative Identity Disorder:** Presence of two or more distinct identities or personality states. - **Localized Amnesia:** Inability to recall a specific event or period.

Step 3: Compare Symptoms with Disorder Characteristics

Terry's symptoms include feeling detached and as if she is floating and watching herself, which aligns with depersonalization-derealization disorder. This disorder specifically involves feelings of detachment from one's own body or immediate surroundings, aligning with Terry's experience of feeling out of control and uninvolved.

Step 4: Diagnose Based on Comparison

Based on the identification and comparison with characteristics of dissociative disorders, Terry's symptoms most closely match the description of depersonalization-derealization disorder due to the experiences of detachment and observation of oneself from an external perspective.

Key Concepts

Depersonalization-Derealization Disorder

Depersonalization-derealization disorder is a type of dissociative disorder where individuals feel detached from themselves or their surroundings. It often feels as though they are observing their own actions, thoughts, or body from a distance, almost like watching a movie. The world around them might seem unreal. It can be terrifying, particularly when it occurs frequently or for extended periods. This disorder does not mean the person loses touch with reality, like in psychotic disorders, but rather, they have a persistent feeling of detachment. They are aware that something isn’t right, which often causes anxiety and distress.

Symptoms Identification

Identifying the symptoms of depersonalization-derealization disorder is crucial for diagnosis. Someone with this disorder might describe:

• A sensation of being outside their own body, like floating above or observing themselves from afar.
• A sense of being disconnected from their thoughts and feelings, leading to a sensation of being on autopilot.
• Experiences of their environment or people around them seeming unreal, foggy, or dream-like.
• Feelings of numbness or lack of emotion, despite being aware of how they should feel.
• Episodes that can vary in length from minutes to months, often causing panic attacks as individuals struggle with the unfamiliar feelings.

Recognizing these symptoms can assist individuals in seeking the right help and obtaining an accurate diagnosis.

Disorder Diagnosis

Diagnosing depersonalization-derealization disorder involves a combination of personal assessments and clinical interviews. Mental health professionals look for recurrent episodes that cause significant distress or impairment in social, occupational, or other areas of functioning. The diagnosis is based on:
- **Interviewing the patient:** Understanding their history and specifics about the symptoms.
- **Ruling out other conditions:** Ensuring symptoms are not better explained by another mental disorder, substance abuse, or medical condition.
- **Examining the duration and impact:** Episodes must be persistent or recurrent, significantly affecting quality of life.
It's essential to differentiate this disorder from temporary feelings of detachment that everyone may experience due to extreme fatigue or stress.

Psychological Detachment

Psychological detachment is a key characteristic of depersonalization-derealization disorder. This concept involves a separation from normal emotional responses and a disconnect from one's sense of self or the environment. This can mean:
- **Feeling like an outsider:** Individuals might feel like they're watching their life unfold without participating.
- **Emotional blunting:** Many report feeling emotionally numb, where even significant events don’t provoke a reaction.
- **Disconnection from the physical self:** Often, there is a sense that one’s body is not theirs, similar to being an observer rather than a participant in one’s life.
These experiences are unsettling and can trigger anxiety since these detached states are involuntary and uncontrollable. Early recognition and intervention can help in managing these episodes and improving quality of life.