Dissociative Disorders In DSM-5

Background: We present recommendations for revision of the diagnostic criteria for the Dissociative Disorders (DDs) for DSM-5. The periodic revision of the DSM provides an opportunity to revisit the assumptions underlying specific diagnoses and the empirical support, or lack of it, for the defining diagnostic criteria. Methods: This paper reviews clinical, phenomenological, epidemiological, cultural, and neurobiological data related to the DDs in order to generate an up-to-date, evidence-based set of DD diagnoses and diagnostic criteria for DSM-5. First, we review the definitions of dissociation and the differences between the definitions of dissociation and conceptualization of DDs in the DSM-IV-TR and the ICD-10, respectively. Also, we review more general conceptual issues in defining dissociation and dissociative disorders. Based on this review, we propose a revised definition of dissociation for DSM-5 and discuss the implications of this definition for understanding dissociative symptoms and disorders. Results: We make the following recommendations for DSM-5: 1. Depersonalization Disorder (DPD) should derealization symptoms as well. 2. Dissociative Fugue should become a subtype of Dissociative Amnesia (DA). 3. The diagnostic criteria for DID should be changed to emphasize the disruptive nature of the dissociation and amnesia for everyday as well as traumatic events. The experience of possession should be included in the definition of identity disruption. 4. Should Dissociative Trance Disorder should be included in the Unspecified Dissociative Disorder (UDD) category. Conclusions: There is a growing body of evidence linking the dissociative disorders to a trauma history, and to specific neural mechanisms. Depression and Anxiety 28:824-852, 2011. (C) 2011 Wiley-Liss, Inc

Early emotional processing deficits in depersonalization:An exploration with event-related potentials in an undergraduate sample

<p>Emotional stimuli may draw attention to such an extent that they hamper the processing of subsequent signals, a phenomenon termed emotion-induced blindness (EIB). As depersonalization is associated with self-reported attenuated emotional responses, the present study explored whether individuals scoring high on the Cambridge Depersonalization Scale (CDS; n=15) exhibit a diminished EIB effect relative to low CDS scoring individuals (n=15), and whether attentional processes reflected in event-related potentials (ERPs) are implicated in this effect. We obtained an EIB effect such that emotional distractors that preceded targets with a lag of 200 ms reduced correct detection of targets. Although the magnitude of this effect was similar for high and low CDS participants, high CDS participants exhibited a significantly lower ERP amplitude at the frontal lead in the 200-300 ms window than did low CDS individuals to targets that followed emotional versus neutral distractors. This latter effect was significantly related to the Alienation factor of the CDS. This pattern suggests that difficulties in the discrimination between emotional and neutral stimuli relate to the feeling of unreality in depersonalization. (C) 2012 Elsevier Ireland Ltd. All rights reserved.</p>

Magical Flight and Monstrous Stress: Technologies of Absorption and Mental Wellness in Azeroth

An erratum to this article can be found at http://dx.doi.org/10.1007/s11013-011-9204-4Videogame players commonly report reaching deeply ‘immersive’ states of consciousness, in some cases growing to feel like they actually are their characters and really in the game, with such fantastic characters and places potentially only loosely connected to offline selves and realities. In the current investigation, we use interview and survey data to examine the effects of such ‘dissociative’ experiences on players of the popular online videogame, World of Warcraft (WoW). Of particular interest are ways in which WoW players’ emotional identification with in-game second selves can lead either to better mental well-being, through relaxation and satisfying positive stress, or, alternatively, to risky addiction-like experiences. Combining universalizing and context-dependent perspectives, we suggest that WoW and similar games can be thought of as new ‘technologies of absorption’—contemporary practices that can induce dissociative states in which players attribute dimensions of self and experience to in-game characters, with potential psychological benefit or harm. We present our research as an empirically grounded exploration of the mental health benefits and risks associated with dissociation in common everyday contexts. We believe studies such as ours may enrich existing theories of the health dynamics of dissociation, relying as they often do on data drawn either from Western clinical contexts involving pathological disintegrated personality disorders or non-Western ethnographic contexts involving spiritual trance