Dissociative disorder not otherwise specified

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Dissociative disorder not otherwise specified

Other specified dissociative disorder (OSDD) is exhumed with the DSM-5 (300.15) under the category of dissociative disorders, replacing the now historic term and identification known in the DSM-IV as dissociative disorder not otherwise specified (DDNOS). Other specified dissociative disorder is dependent upon alternating personality states for its interpretation, diagnosis, design, and while it is not a victim of true amnesia, it relates to the DSM-5 category of dissociative amnesia. The general consensus is that other specified dissociative disorder is caused in the early years of childhood by either primary caregivers or important caregivers outside the home but exaggerates adult life in a hostile environment resulting in habitual behavioral abnormalities but at the same time is a defense in a captive situation.

Children lack specific diagnoses due to their environment, but if safe their mental damage is repairable during childhood, however adults presented with overwhelming circumstances that continued from childhood. Obvious design of other specified dissociative disorder leads the afflicted to therapy or self care, and depending on the level of abuse they endured throughout their life, their healing can take weeks or their entire life. While drugs mask symptoms, they are counterproductive because the symptoms must be experienced for an individual to seek help. Other Specified Dissociative Disorder is an environmentally caused disease. According to the International Society for the Study of Trauma and Dissociation (ISSTD), who is the foremost authority on the subject of dissociative disorders, other specified dissociative disorder is prevalent in 3% of the United States populous.

OSDD in the DSM-5

In a 2013 update to the DSM terminology and identification of "Dissociative Disorder Not Otherwise Specified" was changed to Other Specified Dissociative Disorder. Active terminology now includes tortured captives that were idemized through "brain-washing techniques" that according the the DSM-5 were abstained from childhood brain function. In addition to adult torture, the children were damaged to the point of brain damage resulting in mental disease.[1][2][3] To be clear, fMRI imaging distinctly shows that Other Specified Dissociative Disorder as well as the other Dissociative Disorders are indeed brain damage.[4][5][6][7]

Personality

Personality can be defined as a biopsychosocial system that determines an individual's characteristic mental and behavioral actions. This definition highlights the fact that personality includes perception and emotion; that perception, emotion, and thought involve mental actions, including decision making; and that behavior involves combined mental and motor action. Personality constitutes a whole system that has an ongoing tendency toward integration, that is, binding and differentiation of different components of experiences as well as different experiences across time. In dissociation in trauma, personality as a system includes two or more insufficiently integrated subsystems.[8]

Separate personality states are referred to as Distinct Personality States in the DSM-5, but the states in Other Specified Dissociative Disorder are Less-Distinct Personality States, which means they alternate with Dissociative Amnesia instead of switch, as is seen in Distinct Personality States of the more complex of the Dissociative Disorders.[7]

Dissociation

Dissociation is defined as a state of being pathological to the adult human, but innate to a child because fantasy, dream states and other forms of magical play are part of a child's world, but adults don't fall into the category of play, because while they dream and even day-dream, they do not habituate in the avenue of making it a daily life habit. The two leaders on the subject of dissociation, Onno van der Hart and Ellert R. S. Nijenhuis have given a definitive definition of dissociation, and even though the populous of the ISSTD falls behind them, lacking the understanding they have obtained on the subject, the leaders in any field are given the right to define terminology.[9]

Dissociation in trauma entails a division of an individual’s personality, i.e., of the dynamic, biopsychosocial system as a whole that determines his or her characteristic mental and behavioral actions. This division of personality constitutes a core feature of trauma. It evolves when the individual lacks the capacity to integrate adverse experiences in part or in full, can support adaptation in this context, but commonly also implies adaptive limitations. The division involves two or more insufficiently integrated dynamic, that is changeable, but excessively rigid subsystems. These subsystems exert functions, and can encompass any number of different dynamic configurations of brain, body, and environment. These different configurations manifest as dynamic actions and implied dynamic states. The dissociative subsystems can be latent, or activated in a sequence or in parallel. Each dissociative subsystem, i.e., dissociative part of the personality includes its own, at least rudimentary person perspectives, that is, its own epistemic pluralism and epistemic dependency. As each dissociative part, the individual can interact with other dissociative parts and other individuals, at least in principle. Dissociative parts maintain permeable biopsychosocial boundaries that keep them divided, but that they can in principle dissolve. Phenomenologically, this division of the personality manifest in dissociative symptoms that can be categorized as negative or positive, and cognitive-emotional or sensorimotor. [8]

Less-distinct personality state (DPS)

The DSM-5 uses the term Distinct Personality State (DPS) to define another Dissociative Disorder, but in the case of Other Specified Dissociative Disorder it is the Less-Distinct Personality States that are referred to, and when terminology is absolute then the DSM-5 version refers to Other Specified Dissociative Disorder.[3][4][7][10]

DSM-5 categories for other specified and unspecified dissociative disorders

Category 300.15 (F44.89)

In the DSM-IV this category was called Dissociative Disorder Not Otherwise Described (DDNOS), but the DSM-5 has changed the information used to diagnose this mental disorder enough that that term is now obsolete, and the new term Other Specified Dissociative Disorder defines this section in ways that make it so the labels are not interchangeable, and so using the name DDNOS as of May 2013 is improper.[5] It's important for diagnosticians to understand that there are not any Distinct Personality States within this disorder,[4] but instead there are states that alternate.[4] The ultimate criteria that begets the difference between Dissociative Identity Disorder and Other Specified Dissociative Disorder is the lack of True Amnesia [5] between two or more Distinct Personality States.[4] This can only be defined by a skilled and practiced trauma expert, and when not it leads to a confusion within the health care community as a whole, and even among the afflicted.[4][5] [7]

  1. Symptoms do not fit the criteria for any other Dissociative Disorder, and are said to be mixed, confused and don't follow a certain pattern as is seen in Dissociative Identity Disorder.[4][5][8]
  2. Significant impairment due to symptoms.[8]
  3. Lacking drug affects, direct trauma to the skull or other neurological condition.
  4. Lacking a "temporary state" created purposefully by cultural practice, which is a common addition to any DSM category like this.
  5. The defined symptoms are not attributed to Dissociative Identity Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder, Somatic Symptoms Disorder or any other neurological disorder.

Category 300.15 (F44.9)

Unspecified Dissociative Disorder is used in a setting where a clinician is not qualified to diagnose this complicated mental disorder.[2][5][7][8]

Category 300.12 (F44.0)

Dissociative Amnesia is the primary action prevalent in Other Specified Dissociation Disorder, but the DSM-5 does not list it because it's not one of the minimum criteria needed to diagnosis the mental disorder, but the following criteria are. It's important to understand that Dissociation Amnesia is shared between Other Specified Dissociative Disorder and Dissociative Identity Disorder, but True Amnesia is lacking in Other Specified Dissociation Disorder.

  1. Amnesia, which is not to be confused with True Amnesia which is only found in Dissociative Identity Disorder.[4][5][8]
  2. Significant impairment due to symptoms.[8]
  3. Lacking drug affects, direct trauma to the skull or other neurological condition.[8]
  4. Lacking a "temporary state" created purposefully by cultural practice, which is a common addition to any DSM category like this.
  5. The defined symptoms are not attributed to Dissociative Identity Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder, Somatic Symptoms Disorder or any other neurological disorder.

Dissociative amnesia

Dissociative amnesia in Other Specified Dissociative Disorder is a complex function of absolute control between the different Less-Distinct Personality States that make up the whole of this functional form of brain damage. Dissociative amnesia functions to prevent the whole of the individual from realizing what different damaged parts of the brain are doing at any given time, but caution is needed because the ill informed will confused this with True Amnesia which is only found in the most complex of the Dissociative Disorders.

Cause

Childhood trauma is attributed to all of the Dissociative Disorders, and although not all trauma is inclusive to follow the lines of overt child abuse, it is isolation, lack of attachment with a primary caregiver and terror that cannot be calmed in the mind during the entirety of childhood, which the primary leaders in the field of Dissociative Disorders identify as the cause of Other Specified Dissociative Disorder. Identification of primary abuse is not limited to innate birth parents or even primary care, but can be attributed to both in home and abuse outside the home. While this idea has been bantered about for years, the team of Ulrich F.Lanius, Sandra L. Paulsen and Frank M. Corrigan in their 2014 book, Neurobiology and Treatment of Traumatic Dissociation Toward an Embodied Self, revealed that intense isolation is not required to encapsulate the brain in a way that causes Other Specified Dissociative Disorder as it does Dissociation Identity Disorder.[2][4][11][12][13]

Children

Neurobiology has shown that all the Dissociative Disorders like Other Specified Dissociative Disorder are caused by environmental influence during the earliest years of childhood, rather than being an innate disease. Various factors revolve around childhood abuse, including attachment and isolation that attribute to this disorder, and it's thought that this disorder begins and is fully formed prior to the age natural integration of the organs of the brain take place, because it's impossible for it to occur in any other fashion.[2][4][5][8][13]

Adults

While someone eighteen-years old or younger is still in their formative years they are likely to naturally heal from Other Specified Dissociative Disorder if they are taken from an abusive situation and put in a safe environment and they will never remember they even had the mental disorder.[4][5][13] This is possible not only because this mental disease lacks the identification for an innate disorder, but because it is a mild form of brain damage unless it continues into the adult years.[4][5][13] In that case it becomes pervasive, destroying an individuals life through the overt symptoms which cause the subject to act child-like, angry, impulsive, and as a whole abusive to the people in their lives, therefore Other Specified Dissociative Disorder is obvious to the afflicted as well as to those that are around them causing them to seek treatment as early in life as possible.[2] Like all Dissociative Disorders, Other Specified Dissociative Disorder is drowned in the actions of Dissociative Amnesia, and because of this, those afflicted with it are often confused as to what has occurred in their life, even though they have successfully healed.[2]

Captive situations (per DSM-5)

When a child was in a situation throughout childhood where they obtained enough brain damage that they could be diagnosed with Other Specified Dissociation Disorder, then as an adult they have retained the mental skills needed to survive situations that the DSM-5 identify as "brainwashing, thought reform, indoctrination while captive, torture, long-term political imprisonment, recruitment by sects/cults or by terror organization." [4][5][5][7][13][13] Without these learned skills it's highly possible that when in these DSM defined situations an individual will die.[4][5][13]

Treatment

Treatment is a three step process starting with acknowledgement of the disorder and obtaining proper treatment or self care. The three steps overlap, with the second step focusing on trauma processing.[11][14] Trauma processing is a confusing term, but it simply means there are harmful events stuck that need to be moved from one part of the brain to another.[2] In the third step harmful events that terrify a person, and keep them from moving their accumulated history of abuse to its final resting place, become integrated into memory within the brain itself.[15] EMDR is one of the more popular ways that trauma is integrated with the whole of the brain.[16][17][18]

Psycho-pharmacology

Medication is counter production when used for the treatment with any Dissociative Disorder because while it does aid in reducing symptoms of depression and anxiety the drugs mask the feelings needed to heal the disease.[13][14][19]

Prevalence

According to the ISSTD Other Specified Dissociative Disorder is thought to exist in over 3% of the United States population.[14]

History

The Dissociative Disorders have a broken history due to intervention by the popular media. The media takes what they think they know and they make movies, books and other forms of entertainment out of it and they mix up Other Specified Dissociative Disorder and Dissociative Identity Disorder, because while the medical field is vastly ignorant of the two different Dissociative Disorders, the media is more so and in many ways they are the ones that affect the way the population views a mental disorder. Pierre Janet was the first to identify a Dissociative Disorder while Charles Myers was the first to separate Posttraumatic Stress Disorder into a Distinct Personality State and a Less-Distinct Personality State. Research was lacking hard evidence until [10] Ellert R.S. Nijenhuis and Onno van Der Hart [8] used fMRI data to support their theory of Structural Dissociation of the Personality that combines psychology, neurology and psychoneurology. Kathy Steele joined the former in authoring a book called "Structural Dissociation of the Personality" and in doing so the threesome continued to further the idea of separate personality states.[20] Other top researchers agree with the basics of Structural Dissociation including some of the best in the field today: Frank M. Corrigan, Ulrich F. Lanius, Sandra L. Paulsen,[4] Alan Schore,[5] Bessel vanderKolk [12] and Daniel Siegal.[13][14]

ISSTD

The International Society for the Study of Trauma and Dissociation is considered to be the foremost expert on the subject of Other Specified Dissociative Disorders as well as all of the Dissociative Disorders, psychological trauma and they are by default the organization that should be referenced in bulk.[14]

See also

References

<references>

  1. ^ Dell, Paul (2008). Dissociation and the dissociative disorders: DSM-V and beyond. London: Routledge. ISBN 978-0-415-95785-4.
  2. ^ a b c d e f g Empirical Reference, 2014; Loewenstein, Richard J.; Spiegel, David; Brand, Bethany L. (June 2014). "Dispelling Myths About Dissociative Identity Disorder Treatment: An Empirically Based Approach". Psychiatry: Interpersonal and Biological Processes. 77 (2): 169–189. doi:10.1521/psyc.2014.77.2.169. {{cite journal}}: |first1= has numeric name (help)
  3. ^ a b Reinders, Antje A.T.S.; Willemsen, Antoon T.M.; den Boer, Johan A.; Vos, Herry P.J.; Veltman, Dick J.; Loewenstein, Richard J. (September 2014). "Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: A PET study and neurobiological model". Psychiatry Research: Neuroimaging. 223 (3): 236–243. doi:10.1016/j.pscychresns.2014.05.005.
  4. ^ a b c d e f g h i j k l m n o Lanius, Ulrich F; Paulsen, Sandra L.; Corrigan, Frank M. (2012). Neurobiology and treatment of traumatic dissociation: towards an embodied self. New York: Springer. ISBN 0-8261-0631-5.
  5. ^ a b c d e f g h i j k l m n Schore, Alan N. (2014). Neuroscience and Psychoanalysis. ISBN 88-97479-06-5.
  6. ^ Nijenhuis, Ellert R. S.; van der Hart, Onno (July 2011). "Dissociation in Trauma: A New Definition and Comparison with Previous Formulations". Journal of Trauma & Dissociation. 12 (4): 416–445. doi:10.1080/15299732.2011.570592.
  7. ^ a b c d e f APA (2013). Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). Washington [etc.]: American Psychiatric Publishing. ISBN 0-89042-555-8.
  8. ^ a b c d e f g h i j Dissociation, 2011; van der Hart, Onno; Nijenhuis, Ellert R. S. (July 2011). "Dissociation in Trauma: A New Definition and Comparison with Previous Formulations". Journal of Trauma & Dissociation. 12 (4): 416–445. doi:10.1080/15299732.2011.570592. {{cite journal}}: |first1= has numeric name (help)
  9. ^ Nijenhuis, Ellert R. S.; van der Hart, Onno (July 2011). "Defining Dissociation in Trauma". Journal of Trauma & Dissociation. 12 (4): 469–473. doi:10.1080/15299732.2011.570599.
  10. ^ a b Schlumpf, Yolanda R.; Reinders, Antje A. T. S.; Nijenhuis, Ellert R. S.; Luechinger, Roger; van Osch, Matthias J. P.; Jäncke, Lutz; Chao, Linda (12 June 2014). "Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study". PLoS ONE. 9 (6): e98795. doi:10.1371/journal.pone.0098795.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  11. ^ a b Empirical Overview, 2014; Brand, B. L.; ar, V.; Kruger, C.; Stavropoulos, P.; Martinez-Taboas, A.; Lewis-Fernandez, R.; Middleton, W.; Dorahy, M.J. (1 May 2014). "Dissociative identity disorder: An empirical overview". Australian & New Zealand Journal of Psychiatry. 48 (5): 402–417. doi:10.1177/0004867414527523. {{cite journal}}: |first1= has numeric name (help)
  12. ^ a b vanderKolk, Bessel (2014). Body keeps the score: brain, mind, and body in the healing of trauma. Viking. ISBN 0-670-78593-8.
  13. ^ a b c d e f g h i Siegel, Daniel J. (2012). The developing mind : how relationships and the brain interact to shape who we are (2nd ed.). New York: Guilford Press. ISBN 978-1-4625-0390-2.
  14. ^ a b c d e International Society for the Study (28 February 2011). "Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision". Journal of Trauma & Dissociation. 12 (2): 115–187. doi:10.1080/15299732.2011.537247.
  15. ^ Courtois, Christine A.; Ford, Julian D. (2013). Treatment of complex trauma: a sequenced, relationship-based approach. New York: Guilford Press. ISBN 1-4625-0658-5.
  16. ^ van der Hart, Onno; Nijenhuis, Ellert R. S.; Solomon, Roger (1 May 2010). "Dissociation of the Personality in Complex Trauma-Related Disorders and EMDR: Theoretical Considerations". Journal of EMDR Practice and Research. 4 (2): 76–92. doi:10.1891/1933-3196.4.2.76.
  17. ^ Empirical study, 2014; Brand, B. L.; Şar, V.; Krüger, C.; Stavropoulos, P.; Martínez-Taboas, A.; Lewis-Fernández, R.; Middleton, W.; Dorahy, M. J. (1 May 2014). "Dissociative identity disorder: An empirical overview". Australian & New Zealand Journal of Psychiatry. 48 (5): 402–417. doi:10.1177/0004867414527523. {{cite journal}}: |first1= has numeric name (help)
  18. ^ Review study, 2009; Classen, Catherine C.; McNary, Scot W.; Zaveri, Parin; Brand, Bethany L. (September 2009). "A Review of Dissociative Disorders Treatment Studies". The Journal of Nervous and Mental Disease. 197 (9): 646–654. doi:10.1097/NMD.0b013e3181b3afaa. {{cite journal}}: |first1= has numeric name (help)
  19. ^ Gentile, Julie (Feb 2012). "Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder". Innov Clin Neurosci. 2 (10). PMC 3615506. PMID 23556139.
  20. ^ van der Hart; Nijenhuis, Ellert; Steele, Kathy (2006). The Haunted self: structural dissociation and the treatment of chronic traumatization (1st ed.). New York: W.W. Norton. ISBN 978-0-393-70401-3.
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