Dissociative Trance Disorder (PowerPoint Presentation)

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Dissociative Trance Disorder

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Dissociative Trance Disorder

My name

Institution

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DSM 5 definition of the Disorder:

-It is a condition characterized by a complete loss or acute narrowing of awareness of one’s immediate surrounding that manifests as either insensitivity to environmental stimuli or profound unresponsiveness (DSM 5, 2013. p.307).

-The unresponsiveness occurs simultaneously with minor stereotyped behaviors (such as finger movements). However, the individual is unaware of such movements or even if the individual is aware, he or she cannot control. Accompanying this is also the loss of consciousness or transient paralysis (DSM 5, 2013. p.307; Bressert, 2016).

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Prevalence Rate

-data difficult to get

-in 28 articles reporting 402 cases of patients with DTD

-an equal proportion of male and female patients (50% male, 50%female)

-the predominance of possession (69%)

-Predominance of trance (31%)

-20% patients reported amnesia

-34% patients reported somatic complaints (During et al., 2011)

-in a sample of 28 women in 500 households in Sivas, Turkey: Pure DTD was relatively rare (0.6%) (Sar, Akyuz, & Dorgan, 2007).

-in an 8^th year period (1990-1998) in the Sultanate of Oman, patients with DD comprised 0.3% of a total 41465. Of all the DD patients, 19 (or 17.11%) comprised DTD (Chand et al., 200).

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Diagnostic Criteria

-Diagnostic criteria not included

-assessment of symptoms and ruling out any medical condition that might have triggered the symptoms, testing, and diagnosis that involve referral to a mental health professional to determine a diagnosis

-evaluation:

Diagnostic criteria in the DSM-5: No diagnostic criteria for DTD. Mental health professional may compare symptoms to the criteria for diagnosis of various categories of DD as specified in DSM-5 (Mayo Clinic)

A temporary change in state of consciousness as evidenced in any two:

• Loss of one’s usual sense of personal identity
• Narrowing of awareness of immediate surroundings, or unusually narrow
• Limited or restricted speech, movements, and to reappearance of a small repertoire (World Health Organization, 1993)

Physical exam: doctor examines patient, ask in-depth questions, reviews patient’s symptoms and personal history. Some tests might eliminate physical conditions (such as certain brain disease, intoxication, head injury, sleep deprivation, and so forth that can trigger loss of memory and a sense of unreality) (Mayo Clinic)

Psychiatric exam: mental health professional asks about feelings, thoughts, and behavior and further discusses symptoms. Information from others or family members might be helpful (Mayo Clinic)

Differential diagnostic: some disorders have similar symptoms. The clinician has to differentiate against various disorders: dementia, delirium, major depression, post-traumatic stress disorder, head trauma, schizophrenia, alcoholism, epilepsy, dissociative amnesia, Tourette syndrome, and malingering (PsychNet-UK).

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Causes of the Disorder

-traumatic experiences such as accidents, crime victimization, or disaster (APA, 2017)

-past traumatic events such as sexual, torture, war, natural disasters, or emotional abuse suffered during childhood, kidnapping or invasive medical procedure (NHS, 2014; Mayo Clinic, 2017).

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Treatment of the Disorder

Counseling and Psychotherapy or Pharmacotherapy may be used (PsychNet-UK)

– A consideration in the treatment of Trance and Possession Disorder is defining whether the individual is suffering from related mental disorders or having a spiritual problem.

-Therefore treatment currently revolves around assistance to cope with the physical aspects of possession.

Counseling and Psychotherapy: Supportive therapy and psychotherapy may be helpful in certain situations. Family therapy is often helpful in assisting family members or relatives in coping with the affected individual. Behavioral techniques used at home or in a therapeutic setting can help a person learn behaviors that will lead to social acceptance.

Pharmacotherapy: Antipsychotics (typical).

Chlorpromazine (Thorazine).

Thioridazine (Mellaril).

Trifluoperazine (Stelazine).

Thiothixene (Navane).

Fluphenazine (Prolixin).

Haloperidol (Haldol).

Antipsychotics (atypical).

Risperidone (Risperdal).

Olanzapine (Zyprexa).

Clozapine (Clozaril).

References

American Psychiatric Association (APA). (2016). What Are Dissociative Disorders? Retrieved from: https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders

Bressert, S. (2016). Dissociative Disorder: Not Otherwise Specified (NOS). Psych Central. Retrieved on April 27, 2017, from https://psychcentral.com/disorders/dissociative-disorder-not-otherwise-specified-nos/

Chand, S. P., Al‐Hussaini, A. A., Martin, R., Mustapha, S., Zaidan, Z., Viernes, N., & Al‐Adawi, S. (2000). Dissociative disorders in the Sultanate of Oman. Acta Psychiatrica Scandinavica, 102(3), 185-187.

During, E. H., Elahi, F. M., Taieb, O., Moro, M. R., & Baubet, T. (2011). A critical review of dissociative trance and possession disorders: etiological, diagnostic, therapeutic, and nosological issues. The Canadian Journal of Psychiatry, 56(4), 235-242. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/21507280

Mayo Clinic. (2017). Dissociative Disorders. Retrieved from: http://www.mayoclinic.org/diagnosis-treatment/diagnosis/dxc-20269606

Mayo Clinic. (2017). Dissociative Disorders: Symptoms and causes. Retrieved from: http://www.mayoclinic.org/diseases-conditions/dissociative-disorders/symptoms-causes/dxc-20269565

National Health Service (NHS). (2014). Dissociative disorders. Retrieved from: http://www.nhs.uk/Conditions/dissociative-disorders/Pages/Introduction.aspx

PsychNet-UK. (n.d.). Trance and Possession Disorder. Retrieved from: http://www.psychnet-uk.com/x_new_site/DSM_IV/trance_possession_disorder.html

Şar, V., Akyüz, G., & Doğan, O. (2007). Prevalence of dissociative disorders among women in the general population. Psychiatry Research, 149(1), 169-176.

World Health Organization (WHO). (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic criteria for research. Retrieved from: http://www.who.int/classifications/icd/en/GRNBOOK.pdf