Tuesday, October 21, 2014

Dissociative Disorder; A psychological disorder



PSY/450 Diversity and Cultural Factors in Psychology

     Psychologists have typically defined “psychological disorders… by some form of abnormal behavior or thought process, [however,] abnormality can be difficult to define, especially since it varies from culture to culture” (Psychological Disorder, 2001, p. 518).  With that in mind, it is important to consider that abnormal behavior is the subjective experiences of one’s culture, the idioms of a person’s distress, the diagnoses, and treatment provided, and finally the outcome of that treatment.  Although, according to Shiraev and Levy (2010), “Human beings develop ideas, establish behavioral norms, and learn emotional responses according to a set of cultural prescriptions” (p. 223).      It is within those cultural prescriptions that the parameters of psychopathology are defined as adaptive or maladaptive, normal or abnormal.  Psychologists such as Wilhelm Wundt (1832-1920) were instrumental in the early introspective and structuralism perspectives of psychology, helping to establish psychological research on memory and the conscious experience.  Thus focus on psychological disorders, such as dissociative disorder that involve memory, consciousness, and identity itself could be explored as to the affects human development and socialization have on this type of disorder and the cultural impacts of such a disorder. 
Dissociative Disorder
     Seemingly triggered as a response to trauma or intolerable situations (e.g., abuse) dissociative disorders are an interruption or dissociation of a person’s consciousness (e.g., memory, identity, personal history, or perception) and can take on many forms of such disruption (Spiegel, Loewenstein, Lewis-Fernández, Sar, Simeon, Vermetten, Cardeña, & Dell, 2011): 
     Depersonalization disorder is a recurrent feeling of detachment or distance from one’s own body as though watching one’s self in a dream-like or intoxicated state (DeepDriveAdmin, 2011).  In some individuals severe stress and trauma (e.g., motor vehicle accidents, verbal, emotional, or sexual abuse) engage the human psychobiological survival system, flooding the body with stress hormones causing adaptive depersonalization behaviors as a result of the acute or chronic stress, thus the physical and emotional sensations are avoided (Charney, 2004).
     Dissociative amnesia, unlike amnesia resulting from a blow to the head, can be localized, selective, systematized, or generalized (DeepDriveAdmin, 2011).  Localized amnesia involves a specific event (e.g., car accident).  Selective amnesia, on the-other-hand, blocks only portions of an event; whereas, systematized amnesia memory is lost for an entire category of information (e.g., an object, or a person).  As for generalized amnesia, an entire lifetime is forgotten.
     Dissociative fugue is characterized by an unexpected physical leave of one’s surroundings to an unknown destination lasting for several hours, days, or months (DeepDriveAdmin, 2011).  People in a fugue state are able to function and carry on normal conversations it is only when he or she are trying to identify who or where he or she comes from the psychological disorder is apparent.  According to Shiraev and Levy (2010) natural disasters, ethnic, or religious strife involving violence could be a trigger of dissociative fugue.
     Dissociative identity disorder (DID) is “the presence of two or more distinct identities,” more commonly known as multiple personalities (Spiegel, et. al., 2011, p. E32).  However, with the exception of Dr. Corneila Wilbur who witnessed 16 different personalities within one Sybil Dorsette (made popular in the 1976 movie Sybil), “the frequency of discernable personality ‘switching’ in a clinical setting is too infrequent to allow for adequate diagnostic criterion” (Spiegel, et. al., 2011, p. E32).  Although, testing of identified personalities confirms the reliability of a DID diagnosis without observing the actual personality switch or shift itself.
The Affects of Human Development and Socialization on Dissociative Disorder
     From birth to death human development and socialization shape how each person thinks, feels, and behaves.  From what is known of dissociative disorder trauma, fear, and stress overload the amygdala flooding the body with stress hormones causing a disruption in normal processes and consciousness; a physiological response to stress.  “Socialization is the process by which an individual… takes on [his or her cultures,] values and behaviors,” thus it would be expected that dissociative behaviors would also fall within these cultural boundaries (Shiraev & Levy, 2010, p. 196).  To fully understand how someone’s development and socialization affect his or her mental health it is important to understand the idioms of a person’s distress.  In some instances dissociative disorder (DID) is explained culturally as a person experiencing possession-related symptoms, thus diagnostic criterion allows for such cultural considerations.  Regardless, the way in which someone describes his or her symptoms and subjective experiences provide clinicians with the culture-based explanations upon which to diagnosis one’s mental disorders. 
Cultural Implications of Dissociative Disorder
     Because different cultural groups hold different views on accepted and unaccepted behaviors, some dissociative symptoms may not be recognized as a psychological disorder.  As an example, reincarnation is a central tenet of many religions, thus DID may be seen as a manifestation of past life experiences and not a psychological disorder of concern to be treated.  In addition, there are some cultural ceremonies that intentionally inflict pain to induce out of body experiences such as those experienced in a depersonalized state.  On the-other-hand, individuals in the U. S. with symptoms of dissociative disorder are considered to have suffered some form of severe trauma; therefore, her or she are thought to be at risk of additional complications to themselves and possible others if intervention is not provided.
Conclusion
     Psychological disorders that involve memory, consciousness, and identity can impact an individual’s ability to affectively function within his or her social structure, in most of these cases trauma or intolerable stress is the cause.  However, the idioms of a person’s distress manifest based on “specific environmental, social, and cultural contexts” in which he or she are raised (Shiraev & Levy, 2011, p. 225).  As such the cultural impact of psychological disorders, although symptomatically similar cross-culturally, must be diagnosed and treated appropriately within an individual’s own cultural context.  Although, as cross-cultural psychology expands throughout the world that context is becoming much broader.  



 

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