Dissociative Disorders [Professor Name] - PowerPoint Presentation

1. Dissociative Disorders[Professor Name][Class and Section Number]

2. Learning Objectives1. Define the basic terminology and historical origins of dissociative symptoms and dissociative disorders.2. Describe the posttraumatic model of dissociation and the sleep-dissociation model, and the controversies and debate between these competing theories.3. What is the innovative angle of the sleep-dissociation model?4. How can the two models be combined into one conceptual scheme?

3. Warm Up ActivityOn a sheet of paper, write about the last time you were daydreaming. Describe the place were you imagining. Describe how you were you feeling. What snapped you out of this fantasy?What if you couldn’t snap out of it?

4. Warm Up ActivityDiscussion:Were there similarities across your stories?In particular, how did your partner feel about the idea of not being able to end their fantasy?

5. OverviewHistory of Dissociative DisordersDefining Dissociative DisordersMeasuring Dissociation Dissociation and TraumaCausality and EvidenceDissociation and SleepSleep ProblemsStudying the Relationship between Dissociation and SleepInducing and Reducing Sleep ProblemsImplications and Conclusions

6. History of Dissociative DisordersAn array of symptomsFormerly known as Multiple Personality Disorder.Rarely diagnosed until the 1980s.

7. OverviewHistory of Dissociative DisordersDefining Dissociative DisordersMeasuring Dissociation Dissociation and TraumaCausality and EvidenceDissociation and SleepSleep ProblemsStudying the Relationship between Dissociation and SleepInducing and Reducing Sleep ProblemsImplications and Conclusions

8. Defining Dissociative DisordersThe DSM-5 definition of dissociation Differences between “trait” and “state”, and the continuumTypes of dissociative disordersDissociative symptom clusters

9. “The Woman with 7 Personalities”

10. OverviewHistory of Dissociative DisordersDefining Dissociative DisordersMeasuring Dissociation Dissociation and TraumaCausality and EvidenceDissociation and SleepSleep ProblemsStudying the Relationship between Dissociation and SleepInducing and Reducing Sleep ProblemsImplications and Conclusions

11. Measuring Dissociation The Dissociative Experiences Scale (DES)Example of itemsSuitable only for screeningStructured Clinical Interview for DSM-5

12. Measurement Approaches TPSIdentify and write down three strengths of the Dissociation Scale (Bernstein & Putnam, 1986) questions (2 mins)Identify and write down three weaknesses of the Dissociation Scale (2 mins)Share with class or with partner (3 mins)Consider why the Dissociation Scale alone cannot be used to diagnose dissociative disorder.

13. Measurement Approaches TPS1. Some people have the experience of driving a car and suddenly realizing that they don't remember what has happened during all or part of the trip. Mark the line to show what percentage of the time this happens to you. 0%-----------100% 2. Some people find that sometimes they are listening to someone talk and they suddenly realize that they did not hear part or all of what was just said. Mark the line to show what percentage of the time this happens to you. 0%----------100% 3. Some people have the experience of finding themselves in a place and having no idea how they got there. Mark the line to show what percentage of the time this happens to you. 4. Some people have the experience of finding themselves dressed in clothes that they don't remember putting on. Mark the line to show what percentage of the time this happens to you. 0% ---------- 100%

14. Measurement Approaches TPS5. Some people have the experience of finding new things among their belongings that they do not remember buying. Mark the line to show what percentage of the time this happens to you. 0% ---------- 100%6. Some people sometimes find that they are approached by people that they do not know who call them by another name or insist that they have met them before. Mark the line to show what percentage of the time this happens to you. 0% ---------- 100%7. Some people sometimes have the experience of feeling as though they are standing next to themselves or watching themselves do something and they actually see themselves as if they were looking at another person. Mark the line to show what percentage of the time this happens to you. 0% ---------- 100%

15. Measurement Approaches TPS8. Some people are told that they sometimes do not recognize friends or family members. Mark the line to show what percentage of the time this happens to you. 0% ---------- 100%9. Some people find that they have no memory for some important events in their lives (for example, a wedding or graduation). Mark the line to show what percentage of the important events in your life you have no memory for. 0% ---------- 100% 10. Some people have the experience of being accused of lying when they do not think that they have lied. Mark the line to show what percentage of the time this happens to you. 0% ---------- 100%

16. CAT: The Muddiest PointWhat was the muddiest point in today’s class? Write down what concept you are still struggling to understand.

17. Revisiting The Muddiest PointMany of you seemed to struggle with…How would you respond to this muddiest point?

18. OverviewHistory of Dissociative DisordersDefining Dissociative DisordersMeasuring Dissociation Dissociation and TraumaCausality and EvidenceDissociation and SleepSleep ProblemsStudying the Relationship between Dissociation and SleepInducing and Reducing Sleep ProblemsImplications and Conclusions

19. Dissociation and TraumaThe Posttraumatic Model (PTM)The most widely held perspective on dissociative symptomsSymptoms are defensive response to highly aversive events

20. The Posttraumatic Model (PTM)Symptoms are a reflection of strategies to cope with highly aversive experiences.Dissociation as a means of escape from painful memories.Vermetten and colleagues (2006) example

21. Causality and EvidenceThree main limitations:based on cross-sectional designsself-report measurecognitive failures/high dissociationTraumaDissociative Symptoms

22. Causality and EvidenceThree main limitations:based on cross-sectional designsself-report measurecognitive failures/high dissociationDiscussion Activity: Now take turns with the person next to you and share your explanations

23. Limitations of PTM continuedPTM does not tell us how trauma produces dissociative symptoms The relation between highly aversive events and dissociative symptoms

24. OverviewHistory of Dissociative DisordersDefining Dissociative DisordersMeasuring Dissociation Dissociation and TraumaCausality and EvidenceDissociation and SleepSleep ProblemsStudying the Relationship between Dissociation and SleepInducing and Reducing Sleep ProblemsImplications and Conclusions

25. Dissociation and SleepConnections noted as early as 19th centuryExperiencing self and observing self AmnesiaDream characters and alter personalities

26. Sleep ProblemsAnecdotal evidence links sleep problems and dissociationPatients often exhibit sleep abnormalities

27. Dissociation and SleepHigh prevalence of dissociative symptoms and sleep problems in American adultsWatson’s (2001) pioneering study

28. Inducing and Reducing Sleep ProblemsDissociative symptoms increase with sleep deprivationDecrease in symptoms when sleep patterns improveCautious optimism regarding sleep deprivation and dissociative symptoms

29. OverviewHistory of Dissociative DisordersDefining Dissociative DisordersMeasuring Dissociation Dissociation and TraumaCausality and EvidenceDissociation and SleepSleep ProblemsStudying the Relationship between Dissociation and SleepInducing and Reducing Sleep ProblemsImplications and Conclusions

30. Implications and Conclusions

31. Debate Activity Does DID really exist?Write down what you think are 3 strongest arguments for you positionYou have 2-minutes to introduce your main arguments And a 2-minute rebuttalNow write on a piece of paper: Vote which side you think “won” the debateReflect - what made you vote this way?

32. CAT: The One-Minute PaperWhat was the most important thing you learned during this class?What important question remains unanswered?

33. Photo AttributionSlide 1Photo Credit: Blow Your Mind Camilo Rueda López https://www.flickr.com/photos/kozumel/4918575268 https://creativecommons.org/licenses/by-nd/2.0/Slides 3 & 4 Photo Credit: Daydreaming Kristaps Bergfelds https://www.flickr.com/photos/narciss/2758571483 https://creativecommons.org/licenses/by/2.0/Slide 6Photo Credit: Depersonallization disorder Janine https://www.flickr.com/photos/pinkcotton/6091633858 https://creativecommons.org/licenses/by-nc-nd/2.0/Slide 8Photo Credit: Psychosis Dave Emmett https://www.flickr.com/photos/davemmett/342959835 https://creativecommons.org/licenses/by-nc-sa/2.0/Slide 9Photo Credit: dissociative identity disorder 1 hunnnterrr https://www.flickr.com/photos/hunter-m/3561409383 https://creativecommons.org/licenses/by/2.0/Slide 11Photo Credit: Dissociation Phil Kreniske NOBA Images https://creativecommons.org/licenses/by-nc-sa/4.0/Slide 12Photo Credit: Ruler ClkerFreeVectorImages https://pixabay.com/en/ruler-straight-edge-maths-tool-307475/ https://creativecommons.org/publicdomain/zero/1.0/deed.enSlides 16 & 32Photo Credit: Photo Credit: Illustrated silhouette of a black cat nehtaeh79 http://www.freestockphotos.biz/stockphoto/16624 http://creativecommons.org/publicdomain/zero/1.0/Slide 17Photo Credit: bordeaux JanDix https://pixabay.com/en/bordeaux-dog-de-dogue-water-muddy-895827/ https://creativecommons.org/publicdomain/zero/1.0/deed.enSlide 19Photo Credit: Lack of sleep. Angela Quitoriano. https://www.flickr.com/photos/angehphotos/6774645159 https://creativecommons.org/licenses/by/2.0/Slide 20Photo Credit: experimenting Alessandra Celauro https://www.flickr.com/photos/35794811@N06/6804106610/ https://creativecommons.org/licenses/by-nc/2.0/

34. Photo AttributionSlide 22Photo Credit: Questions1 Grisel D´An https://www.flickr.com/photos/128454566@N06/15893429463 https://creativecommons.org/licenses/by-nc/2.0/Slide 23Photo Credit: Sad man holding pillow Vic https://www.flickr.com/photos/59632563@N04/6480297645 https://creativecommons.org/licenses/by/2.0/Slide 25Photo Credit: Sleep Mislav Marohnić https://www.flickr.com/photos/mislav-marohnic/3406902041 https://creativecommons.org/licenses/by/2.0/Slide 26Photo Credit: RER D Mooglio https://www.flickr.com/photos/59016395@N00/5305648637/ https://creativecommons.org/licenses/by-nc-nd/2.0/Slide 27Photo Credit: Craig Mayhew and Robert Simmon, NASA GSFC. Visible Earth NASA http://visibleearth.nasa.gov/view.php?id=55167Slide 28Photo Credit: Sleep Sano Rin https://www.flickr.com/photos/112361276@N07/19951907861/ https://creativecommons.org/licenses/by-nc/2.0/Slide 30Photo Credit: Man walking on the water - silent conversation Heidi & Matt https://www.flickr.com/photos/heidiandmatt/183973465/ https://creativecommons.org/licenses/by-nc-sa/2.0/