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CMN 552 UNIT 3 QUESTIONS AND ANSWERS 2024
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CMN 552 UNIT 3 QUESTIONS AND ANSWERS 2024
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CMN 552 UNIT 3What are the functional consequences of depersonalization/derealization
disorder? Sadock Pg 456 - ANSWERS-Depersonalization after traumatic
experience or intoxication commonly remits spontaneously after removal from
the traumatic circumstance or ending of the episode of intoxication.
Depersonalizations accompany mood, psychotic, or other anxiety disorders
commonly remits with definitive treatment of these conditions.
Depersonalization disorder itself may have an episodic relapsing and remitting, or
chronic course. Many patients with chronic depersonalization may have a coarse
characterization by severe impairment in occupational, social, and personal
functioning. Mean age of onset is thought to be in the late adolescence or early
adulthood in most case
What are the differential diagnosis to consider in determining
depersonalization/derealization disorder? Page 456 sadock - ANSWERS-
Differential Diagnosis
The variety of conditions associated with depersonalization complicate the
differential diagnosis of depersonalization disorder. Depersonalization can result
from a medical condition or neurological condition, intoxication or withdrawal
from illicit drugs, as a side effect of medications, or can be associated with panic
attacks, phobias, PTSD, or acute stress disorder, schizophrenia, or another
dissociative disorder. A thorough medical and neurological evaluation is essential,
including standard laboratory studies, an EEG, and any indicated drug screens.
Drug-related depersonalization is typically transient, but persistent
depersonalization can follow an episode of intoxication with a variety of
substances, including marijuana, cocaine, and other psychostimulants. A range of
neurological conditions, including seizure disorders, brain tumors, postconcussive
syndrome, metabolic abnormalities, migraine, vertigo, and Ménière's disease,
,have been reported as causes. Depersonalization caused by organic conditions
tends to be primarily sensory without the elaborated descriptions and
personalized meanings common to psychiatric etiologies.
What are the common comorbid conditions in individuals with
depersonalization/derealization disorder? Page 306 DSM-5 - ANSWERS-Lifetime
commodities were high for unipolar depressive disorder and for any anxiety
disorders, with a significant proportion of the sample having both disorders.
Comorbidity with post-traumatic stress disorder was low. The three most
commonly co-occurring personality disorders were avoidant borderline and
obsessive compulsive.
What are the treatment options for depersonalization/derealization disorder?
(Sadock, pg. 454) - ANSWERS-Clinicians working with patients with
depersonalization/derealization disorder often find them to be a singularly
clinically refractory group. Some systematic evidence indicates that SSRI
antidepressants, such as fluoxetine (Prozac), may be helpful to patients with
depersonalization disorder. Two recent, double-blind, placebo-controlled studies,
however, found no efficacy for fluvoxamine (Luvox) and lamotrigine (Lamictal),
respectively, for depersonalization disorder. Some patients with
depersonalization disorder respond at best sporadically and partially to the usual
groups of psychiatric medications, singly or in combination: antidepressants,
mood stabilizers, typical and atypical neuroleptics, anticonvulsants, and so forth.
Many different types of psychotherapy have been used to treat depersonalization
disorder: psychodynamic, cognitive, cognitive-behavioral, hypnotherapeutic, and
supportive. Many such patients do not have a robust response to these specific
types of standard psychotherapy. Stress management strategies, distraction
techniques, reduction of sensory stimulation, relaxation training, and physical
exercise may be somewhat helpful in some patients.
,How is Dissociative Identity Disorder (DID) characterized in relation to distinct
identities or personality states?
(Sadock, pg. 458) - ANSWERS-It is characterized by the presence of two or more
distinct identities or personality states. The identities or personality states,
sometimes called alters, self-states, alter identities, or parts, among other terms,
differ from one another in that each presents as having its own pattern of
perceiving, relating to, and thinking about the environment and self, in short, its
own personality.
Dissociative Identity Disorder is a disruption of identity characterized by two or
more distinct personality states, which may be described in some cultures an
experience of possession.
What are the prevalence rates for DID? (Sadock, P. 458) - ANSWERS-Few
epidemiological data exist fo DID however, studies report female to male ratios
between 5 to 1 and 9 to 1 for diagnosed cases. (Found on google-NIH-
approximately 0.5-1% of population
What are the etiological factors for the development of DID? (Sadock, P. 458) -
ANSWERS-DID is strongly linked to severe experiences of early childhood trauma,
usually maltreatment. The rates of reported severe childhood trauma for child
and adult patients with DID range from 85 to 97 percent of cases.
Physical and sexual abuse are the most frequently reported sources of childhood
trauma
What are the risk factors for the development of DID? - ANSWERS-Strongly linked
to severe experiences of early childhood trauma, usually maltreatment. The rates
of reported severe childhood trauma for child and adult patients with dissociative
, identity disorder range from 85 to 97 percent of cases. Physical and sexual abuse
are the most frequently reported sources of childhood trauma
Preliminary studies have found no significant genetic contribution.
Environmental: interpersonal physical and sexual abuse is associated with an
increased risk of DID. Prevalence of childhood abuse and neglect in the US,
Canada and Europe are about 90%. Other forms of traumatization include
childhood medical and surgical procedures, war, childhood prostitution, and
terrorism.
What are the diagnostic, clinical, and associated features for DID? - ANSWERS-The
key feature in diagnosing this disorder is the presence of two or more distinct
personality states. There are many other signs and symptoms, however, that
define the disorder, and because of great diversity, this make the diagnosis
difficult. These are listed in Table 12-6, which describes the many other associated
symptoms commonly found in patients with dissociative personality disorder
As part of the general mental status examination, clinicians should routinely
inquire about experiences of losing time, blackout spells, and major gaps in the
continuity of recall for personal information
Patients with dissociative disorder often report significant gaps in
autobiographical memory, especially for childhood events
Clinically, dissociative alterations in identity may first be manifested by odd first-
person plural or third-person singular or plural self-references. In addition,
patients may refer to themselves using their own first names or make
depersonalized self-references, such as "the body," when describing themselves
and others. Patients often describe a profound sense of concretized internal
division or personified internal conflicts between parts of themselves. In some
instances, these parts may have proper names or may be designated by their
predominant affect or function, for example, "the angry one" or "the wife."
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