Dissociative Disorders involve some degree of temporary or permanent disruption or discontinuity in the normal integration of consciousness, perception, identity, memory, behaviour, motor control and body representation. There is a degree of break with reality and/or normal human functioning, as can be seen in symptoms such as depersonalization (sense of unreality or detachment from oneself), derealization (sense of unreality or detachment from one’s surroundings), fragmentation of identity, or the inability to access or control normal cognitive functions.
The diagnostic categories within Dissociative Disorders include Dissociative Identity Disorder, Dissociative Amnesia, Depersonalization/Derealization Disorder, Other Specified Dissociative Disorder and Unspecified Dissociative Disorder.
Dissociative Identity Disorder
Dissociative Identity Disorder involves a disruption of identity and used to be called Multiple Personality Disorder. It is a disorder where a person has two or more distinct personality states or identities. The disruption or shifting of identity includes a marked discontinuity in sense of self and sense of agency, together with resultant changes in mood, consciousness, perception, memory,
cognition, sensory-motor functioning and/or behaviour. In a particular personality state, there are also gaps in memory that are inconsistent with ordinary forgetting.
Dissociative Amnesia is frequently connected to a severe traumatic event or events and involves an inability to recall important autobiographical information, generally linked to the experienced trauma or traumas, that is inconsistent with ordinary forgetting and outside of any dementia process.
In some cases, dissociative amnesia is linked to a dissociative fugue state (where someone might travel to and live in a new location, develop an amnesia of their previous identity or other vital autobiographical information and assume a new identity).
Depersonalization / Derealization Disorder
Depersonalization / Derealization Disorder is characterised by persistent symptoms of depersonalization or derealization. It needs to be noted that many people experience temporary symptoms of depersonalization or derealization, but that symptoms need to be severe and chronic and not better explained by another diagnosis for Depersonalization / Derealization Disorder to be diagnosed. Depersonalization is characterised by experiences of unreality or detachment from the mind, body or self and derealization is characterised by an experience of unreality or detachment from surroundings.
Other Specified Dissociative Disorder and Unspecified Dissociative Disorder are diagnostic categories for people who do not fit cleanly into one of the above dissociative disorder categories, or where the dissociative symptoms are not better explained by another psychological or medical diagnosis such as Schizophrenia, severe Major Depressive Disorder or Borderline Personality Disorder or a drug use disorder.