conversion and dissociation disorder were synonymously used. in these disorder, ability to exercise conscious and selective control is impaired to a degree that can vary from day to day or even from hour to hour.
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Dissociative and Conversion Disorder and its associated types
1.
2. Dissociative Disorder
Prof. (Dr.) Rahul Sharma
Professor
HOD of Mental Health Nursing
Ph.D. coordinator
Seedling School of Nursing, Jaipur
National University, Jaipur
3. Dissociative Disorder
Definitions: Dissociation is one type of
defense mechanism whereby the
person will be protected from
traumatic events by allowing the mind
to forgot or remove itself from painful
situation or memory.
4. Incidence
* Common in women and among first
degree biological relatives of
individual.
* In adolescence or early adulthood,
but any age it can occur.
5. Causes
Psychological stress or conflict or frustration.
Childhood trauma or sexual abuse.
Traumatic memories.
Lack of attachment have effect on
neurotransmitters like serotonin.
Depersonalization cause block in
neurotransmitter link.
6. Causes
Drug abuse like alcohol, barbiturates etc.
Traumatic life events like rape, kidnapping.
Abuse, threats to death, physical violence,
witness to violence.
7. Types of dissociative disorder
a. Dissociative Amnesia: Impairment of
integration of memories will occur, it is form
of psychogenic amnesia, common form of
dissociative disorder.
8.
9. causes of dissociative amnesia
Genetic
Neurophysiological dysfunction
Traumatic events
Repression process- painful events was stored
in unconscious level
Unexpected bereavements
Stressful life situations
10. causes of dissociative amnesia
Overwhelming stress
Anxiety provoking internal urges
Significant distress
Impairment in social, occupational and other
areas of functioning
11. C/M of dissociative amnesia
Clouding of consciousness
Sudden inability to recall important personal
information
Loss of memory
Depressive symptoms
Memory gap span few minutes, few hours, few
days and years
13. Types of dissociative amnesia
Generalized amnesia: unable to recall
information about their entire life time.
Localized amnesia: unable to remember all
events of a circumscribed period (few hours to
few days), loss of memory is localized within a
specific window of time like death of a loved
person.
14. Types of dissociative amnesia
Selective amnesia: the ability to remember
some events but not others for a short period
e.g. remembering the stressful events but not
remembering the loss of people during specific
stressful situation.
Continuous amnesia: inability to recall events
even though they are alert and aware.
15. Types of dissociative amnesia
Systematized amnesia: individual can not
remember event that related to specific
information or particular event.
16. b. Dissociative fugue
It increase in stressful situation. It is psychogenic
state, a sudden unexpected travel away from
home, work place, a feeling of new identity,
unable to recall the past.
20. c. Dissociative identity disorder
Definition: A condition in which 2 or more
distinct identities or personalities states
alternative in controlling the patients
consciousness and behavior.
In multiple personality disorder, the person is
dominated by 2 or more personality of which
only one is manifested at a time.
21.
22. c. Causes of Dissociative identity
disorder
Repeated episodes of severe physical or sexual
abuse in childhood
Lack of supportive person
Influence of other relatives
Absence of situational support
Intense anxiety
Negative role models
23. c. Causes of Dissociative identity
disorder
Unspecified long term societal changes
Rigid religious beliefs
Isolation from community
Lack of cooperation among the employees
24. c. C/M of Dissociative identity
disorder
Inadequate defense to handle the intense
anxiety
Client with dissociative disorder experience
their alters as different names, histories and
personality traits
Dissociative process are split off from memory
of the primary personality
25. c. C/M of Dissociative identity
disorder
Usually primary personality is religious and
moralistic
Aggressive
Pleasure seeking
Voice will have different sounds
Transition from one personality to another
often during time of stress.
26. d. Depersonalization disorder
Definition : A persistent or recurrent alteration in
the perception of the self to the extent that
sense of one own reality is temporarily lost,
while reality ability testing remain intact.
In which patients feel that his body is unreal, is
changing or is dissolving.
27.
28. Cause of Depersonalization disorder
CNS disease like brain tumours, epilepsy
Severe sensory deprivation
Psychological conflicts
Unpleasant emotions or emotional pain
29. C/M of Depersonalization disorder
Person may feel dreamy or detached from the
body
Ego dystonic e.g. perceiving limbs to be larger
or smaller than normal
Impairment in social, occupational functioning
make distress
30. e. Dissociative stupor
Clients are motionless, mute
Will not respond to stimulation
Aware of surrounding
Ganser’s syndrome
Rarely occurs 4 cardinal symptoms
Clouding of consciousness
Hallucination
Answering approximately
Physical symptoms
34. D/E of Dissociative disorder
Complete medical history
Physical examination
Psychological examination
35. T/t of Dissociative disorder
Tranquilizers or antidepressants
Hypnosis
I.V. pentothal sodium may be helpful
Psychotherapy
Family therapy
Diversion therapy
Yoga, art therapy
Meditation
36.
37. Conversion disorder
Definition: Conversion disorder (also known as
functional neurological system disorder) is a
condition in which a person experiences physical
and sensory problems, such as paralysis,
numbness, blindness, deafness or seizures, with
no underlying neurologic pathology.
38. Conversion disorder
It is a partial or complete loss of normal
integration between immediate sensations and
control of bodily movements or deficits involving
voluntary motor or sensory function due to
underlying psychological conflicts or anxiety.
39. Causes of Conversion disorder
Traumatic events
Unacceptable emotions
Sexual abuse in childhood
Disturbance in CNS arousal
Lack of situational support
40. C/M of Conversion disorder
Motor deficit
Lack of coordination or balance
Dysphagia
Akinesia
Urinary retention
Lack of clients social, occupational
functioninng
41. C/M of Conversion disorder
Paralysis
Sensory deficit
Double vision
Deafness
Sensation of a lump in the throat
Lack of pain sensation
blindness
42. C/M of Conversion disorder
Hallucination
Environmental misperception
43. Types of Conversion disorder
a. Dissociative motor disorder:
• Motor disturbances
• Paralysis – monoplegia, paraplegia,
quadriplegia
• Abnormal body movement
• Gait disturbances
44. Types of Conversion disorder
b. Dissociative sensory and anesthesia:
• Sensory disturbance are more common
• Hemi anesthesia
• Blindness
• Deafness
• Glove and stocking anesthesia (absence of
sensation at wrist and ankle)
45. Types of Conversion disorder
c. Dissociative convulsion:
Hysteria is a Greek word means womb. It is a
clinical epileptic seizures in which body
movement are common. Hysteria is a term often
used to describe emotionally charged behavior
that seems excessive and out of control. When
someone responds in a way that seems
disproportionately emotional for the situation.
46. D/E of Conversion disorder
• History collection
• Physical examination