Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This was informed by several exam prep programs, and can be used like flashcards or as a presentation

1. Review of DSM5 Mental Disorders for NCMHCE Study

2. 1. Dissociative identity disorder
2. Depersonalization/derealization disorder
3. Dissociative amnesia
4. Other specified/unspecified dissociative disorder

3. Assessments
Mental Status Exam
Cambridge Depersonalization Scale CDS

4. Treatments
1. Medication
Antidepressants
Anticonvulsants
Atypical anti-psychotics
2. Therapies
 Safety or Crisis Plan
 Psychodynamic Psychotherapy, insight
oriented
 Cognitive Behavioral Therapy, for coping
 Hypnotherapy
 Relaxation Training
 REBT, disputing irrational beliefs

6. Diagnosis
1. Disruption of identity
characterized by two or more distinct
personality states
 Observed by others or reported by
the individual
2. Recurrent memory gaps of
everyday events, personal
information and/or traumatic events
Not ordinary forgetting
Comorbid
PTSD
Borderline Personality Disorder
Avoidant Personality Disorder
Somatic Symptom Disorder
Eating disorders
Substance related disorders
OCD
Sleep disorders
Rule Out
PTSD
Schizophrenia
Bipolar Disorder
Borderline Personality Disorder

7. S1. Find Out
Detailed history
Medical history
Affective functioning
Suicide history
Anxiety
Cognitive functioning
Trauma and loss history
Current family and social
environment (safety)
Substance abuse history
S2. Refer & Assess
Psychiatric evaluation
Begin outpatient therapy and
identify possible dissociated aspects
 Verify alternate personalities

8. S4. Treatments
1. Medication
Antidepressants
Anticonvulsants
Atypical anti-psychotics
2. Therapies
 Safety or Crisis Plan
 Psychodynamic Psychotherapy, insight
oriented
 Cognitive Behavioral Therapy, for coping
 Hypnotherapy

9. S5. Monitoring
1. Follow through on referrals
2. Medication compliance
3. Journaling dissociative episodes
and memory lapses
4. Self destructive behavior
S6. Termination
Medication monitoring for
compliance, to reduce high rate of
relapse
Return to therapy if relapse
Support group

11. Diagnosis I
Inability to recall important
autobiographical information
usually of a traumatic or stressful
nature outside of ordinary forgetting
Not attributed to use of substances,
medical or neurological condition
Specify
With/without dissociative fugue:
Purposeful travel or bewildered
wandering
Rule Out
Dissociative Identity Disorder
PTSD
Acute Stress Disorder
Somatic Symptom Disorder

12. S1. Find Out
Detailed history
Medical history
Affective functioning
Suicide history
Anxiety
Cognitive functioning
Trauma and loss history
Current family and social
environment (safety)
Substance abuse history
S2. Refer & Assess
Psychiatric evaluation

13. S4. Treatments
1. Medication
Antidepressants
Anticonvulsants
Atypical anti-psychotics
2. Therapies
 Psychodynamic Psychotherapy, insight
oriented
 Cognitive Behavioral Therapy, for coping
 Hypnotherapy

15. Diagnosis
1. Persistent or recurrent experiences of
depersonalization, derealization or both
Depersonalization:
 Experience of unreality, detachment, or
being an outside observer
 In regards to one’s thoughts, feelings,
sensations, body actions
Derealization:
 Experiences unreality or detachment in
regards to surroundings
 Objects or people are thought to be
unreal, dreamlike, foggy, lifeless or
distorted
2. During these
experiences reality
testing remains intact
Often associated
with early trauma
Rule Out
Schizophrenia

16. S1. Find Out
Cognitive functioning
Mental health history
Work functioning
Substance abuse history
Anxiety history
Trauma history
Social history
S2. Assess or Refer
Mental Status Exam
Cambridge Depersonalization
Scale CDS

17. S4. Treatments
1. Medication
Antidepressants
Anti anxiety
2. Therapies
 Psychoeducation
 Identifying stressors
 Relaxation Training
 REBT, disputing irrational beliefs

18. S5. Monitoring
Frequency and intensity of
depersonalization episodes
Affective functioning
S6. Termination
Continue relaxation methods
Keep a journal to record potential
stressors that trigger the symptoms
Join a meditation or relaxation
group