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1. DISSOCIATIVE AMNESIA & DISSOCIATIVE FUGUE
A. The predominant disturbance is one or more episodes of
inability to recall important personal information, usually of a
traumatic or stressful nature, that is too extensive to be
explained by ordinary forgetfulness.
B. The disturbance does not occur exclusively during the
course of dissociative identity disorder, dissociative fugue,
posttraumatic stress disorder, acute stress disorder, or
somatization disorder and is not due to the direct physiological
effects of a substance (eg, a drug of abuse, a medication) or a
neurological or other general medical condition (eg, amnestic
disorder due to head trauma).
C. The symptoms cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
A. The predominant disturbance is sudden, unexpected travel
away from home or one's customary place of work, with inability
to recall one's past.
B. Confusion about personal identity or assumption of a new
identity (partial or complete).
C. The disturbance does not occur exclusively during the
course of dissociative identity disorder and is not due to the
direct physiological effects of a substance (eg, a drug of
abuse, a medication) or a general medical condition (eg,
temporal lobe epilepsy).
D. The symptoms cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
2. DISSOCIATIVE IDENTITY DISORDER
A. The presence of two or more distinct identities or
personality states (each with its own relatively enduring
pattern of perceiving, relating to and thinking about the
environment and self).
B. At least two of these identities or personality states
recurrently take control of the person's behavior.
C. Inability to recall important personal information that is
too extensive to be explained by ordinary forgetfulness.
D. The disturbance is not due to the direct physiological
effects of a substance (eg, blackouts or chaotic behavior during
alcohol intoxication) or a general medical condition (eg,
complex partial seizures).
3. DEPERSONALIZATION DISORDER
A. Persistent or recurrent experiences of feeling detached
from, and as if one is an outside observer of, one's mental
processes or body (eg, feeling like one is in a dream).
B. During the depersonalization experience, reality testing
remains intact.
C. The depersonalization causes clinically significant
distress or impairment in social, occupational, or other
important areas of functioning.
D. The depersonalization experience does not occur
exclusively during the course of another mental disorder, such
as schizophrenia, panic disorder, acute stress disorder, or
another dissociative disorder, and is not due to the direct
physiological effects of a substance (eg, a drug of abuse, a
medication) or a general medical condition (eg, temporal lobe
epilepsy).
4. DISSOCIATIVE DISORDER NOT OTHERWISE SPECIFIED
A. Includes dissociative symptomatology that does not fit all
the criteria for the other four types of dissociative disorder.
B. Includes dissociative hallucinosis, dissociative states
following torture or political indoctrination,
somnambulism,"out-of-body" experiences, dissociative
trances that are part of culturally sanctioned rituals,
culture-bound "possession" states (eg, amok), and the
Ganser syndrome (hysterical pseudodementia).
5. DISSOCIATION FOLLOWING ACUTE TRAUMA
Following acute trauma, such as that associated with a
civilian catastrophe or criminal assault, dissociation is
commonly encountered as a part of a posttraumatic stress
disorder (see Chapter 23). Treatment involves a safe
environment, individual psychotherapy, and when required, group
therapy. When children are involved, following a civilian
catastrophe, preventive intervention can be provided in schools.
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