Dissociative Identity Disorder

We learned about dissociative identity disorder this week. We defined it as previously known as multiple personality disorder - having 2 more distinct identities that control the person's behavior. We talked about how it's very controversial, similar to how hypnosis was.

I read an article (sorry Rachel, I know that's your thing) about whether or not dissociative identity disorder is real or not. Someone asked the question we did "is it real or not?" A mental health expert, Dr. Charles Raison, answered the question.

He first summed up the opinion of those who are opposed to it: they think that the condition doesn't exist, or that if it is, it's 'iatrogenic' -- it's caused by therapists training their patients to interpret their symptoms as if they have a whole set of distinct personalities.

Then he tells about those who agree with it: therapists will hold separate meetings with each of the patients other personalities (how weird?).

He then tells his own opinion: he says "The dictionary defines dissociation as "an unexpected partial or complete disruption of the normal integration of a person's conscious or psychological functioning that cannot be easily explained by the person." I don't think anyone could doubt that this phenomenon exists." 
He hold up his claim by saying that dissociation is when you're doing something important, then you lose track of the part of yourself that's doing it.  He says that he doesn't believe that they're actually present, but that they are convinced that this is actually happening.  

It's a weird concept - that a single person could have multiple personalities in their head. It's hard to imagine as well. I would like to think that dissociation to this degree is impossible and that dissociative identity disorder doesn't exist. What do you think? 

Anxiety

A psychological disorder is when abnormal behavior persists over time and becomes a deviant, distressful, and dysfunctional pattern of thoughts, feelings, or behaviors. One of the psychological disorders is anxiety. There are many different types of anxieties that we learned in class, many of which I did not know qualified as anxieties. Anxiety is when the sympathetic nervous system is aroused when there is nothing that should arouse it. Sometimes anxiety could be good, because it triggers your fight-or-flight response. When your sympathetic nervous system is continuously aroused and your body is in constant activation, then it becomes detrimental, like when it occurs in the absence of normal stimulation.

General Anxiety Disorder: The person is always worried and they feel physiological symptoms over everything. They make huge situations when there is nothing there.

Phobias:
    Full Fledged Panic - when a fear begins to take over your life, thoughts, dreams, etc. then it is considered a phobia.
   Agoraphobia - the fear of going outside, the person stays shuttered in their home, this could             happen because of any reason.
  Social Phobia - Feel anxious to be in social situations. It is considered a phobia when it is                    actually impeding you functioning.

Obsessive-Compulsive Disorder:
Have obsessive thoughts, which then develops anxiety. You then develop compulsive actions to          relieve anxiety. You are so worried that something is not right that you constantly check it even if        you know it's right. You do these actions to cope with your anxiety.

PTSD:
Anyone who had major trauma. Can't function in life because of it. Flashbacks f the trauma. Most         found in veterans.

Panic Disorder:
Anxiety on steroids. A person will feel like they're going to die. Sometimes caused by something       specific and sometimes not. Sometimes someone will have a fear of having a panic attack, so they will have the panic attack.

Depression Help.

Depression is something that many Americans unfortunately have. Luckily there are a lot of treatments that help some through depression. There are medication, therapy and meditations that are used to help treat someone with depression. Unfortunately there are a few people with depression that none of the current treatments work for them.
Rectly the Los Angeles Times put out an article about people with depression that cannot get cured thought he current treatments. They were informing the public about a few new treatments that are just starting to emerge to help people with depression.
I thought it was very interesting to hear what treatments where just coming out or currently under study.
Vortioxetine- Is a new drug that was recently approved. It is known to help depression and even boost the person's memory.
Ketamine- This drug is not approved to help depression. Although it has helped with people who do not respond to antidepressant. It is also really good in helping those with suicidal thoughts.
Transcranial Magnetic Stimulation- This is something to consider if drugs do not work. They attach electromagnetic coil to a person's scalp. They then send magnetic impulses to specific parts of the brain knows to trigger depression. The impulses are know to help revert it.
Cranial Electrotherapy Stimulation- Is a regular thing that you can buy and use at home. You place it on your head and it sends electronic impulses to the brain. It is known to help smaller problems like insomnia but it can also help with depression.
Deep Brain Stimulation- This is something new that is till being tested. They place a small neurostimulator into the brain- similar to a pacemaker. It is known to help with many problems.

Hopefully these new treatments will help more people with depression. Do you think these new treatments will work? Or is some depression a lost case and nothing can be done?
Look out for these names, one of them might be the #1 breakthrough with helping cure depression.

Let's Sleep In!

Ever wish that the school day started a little later? How annoying is it to drag yourself out of bed to get to school by 7:50? Imagine if school started at 7:00 or 7:20. Oh, the horror! So, what if I told you that there is an ongoing push to get schools to have later start times. Does this sound like a good or bad idea to you? Remove yourself from your day-school mindset, and imagine you would normally get out at 2 or 3 normally. The later school starts, the later school will have to end. How will this cut in with extracurricular activities? I know.. you're probably laughing because we already end really late and somehow manage. And you're also probably thinking that if we started any later that would mean we would never get home. But I told you--- try to be unbiased! Now, read Jan Hoffman's article entitled "To Keep Teenagers Alert, Schools Let Them Sleep In" by clicking here. It's pretty interesting, dontcha think? 

So, now that you've read the article, what do you all think? Do you think it makes sense for schools to be going toward these later start times, or do you think that it's too much of a hassle? By the way- note how one of the 'later start time' options was 8 a.m. That's not so late compared to our school, but it's an extra hour to 40 minutes for other students.

There are some interesting points that the article brought up that I thought I'd discuss for those of you who didn't necessarily read the article. Apparently teenagers are developmentally driven to be late to bed and late to rise. As in, there is a biological aspect to why we (sorry if you don't fall under this 'we'.. I know I do) seem to be okay going to sleep late and then feel terrible in the morning. Is this another case of the "blame it on biology" (oy.. now that song is going to be stuck in my head again..)? Recent results show that the later a school's start time, the better off the students were on many measures, including mental health, car crash rates, attendance, and, in some cases, grades and standardizes tests. What do you think about this correlation? I think those results make a lot of logical sense. Why do you think, though, that there's not a greater push to get teens to go to bed earlier? Wouldn't this solve the same problems?

I am all for this later start time in theory, but I don't know what it's long lasting impacts will be. If teens get home later, and have a later start time, don't you think they will just develop a new schedule? Let's say they used to go to bed at 12 every night and get up at 6:40- what's to stop them from going to bed at 1 and getting up at 7:40? I guess what I'm trying to say-do you think these positive results will be lasting in the long-term, or do you think that kids will eventually adjust to these new times, and find other ways to be lacking sleep? 

I think the main objective for all concerned parties is for kids to be healthy and get enough sleep. Researchers have found that sleeping can help moderate teenagers' tendency toward impulsive or risky decision making. We also know that sleep is important in information processing. Is later a later start time the solution to all this? I think we have to think about what exactly is causing teenagers to go to sleep so late in the first place. During puberty, teenagers have a later release of melatonin, which makes most teenagers not feel drowsy until 11pm. This is a biological factor that will cause teenagers to go to sleep late. But what about social factors? What about the fact that electronic devices trick the brain into sensing wakeful daylight, slowing the release of melatonin and the onset of sleep? What about facebook, twitter, and other social networking sites? Teens waste so much time on those sites. If they actually did what they were supposed to do, maybe they wouldn't be tired. 

I'm interested to see where this will take us. Will more schools lean towards later start times? Will the students in the schools with later starts score significantly higher and do better? Will they be happier? What about the athletes and other kids participating in extracurricular activities? So many questions.  It's not as simple as it might sound. Final thoughts? 

Affluenza isn't actually a thing. Sorry.

In December 2013, a Texas teenager was put on probation with no jail time after killing four people while driving under the influence. How could this be? The judge cited "affluenza," meaning the teen could not have taken responsibility for his actions because he grew up wealthy. I know what you're probably thinking- really?!

Yes. A psychologist testified on behalf of the teen, claiming he suffered from affluenza, a condition in which wealthy young people have a sense of entitlement, are irresponsible, and make excuses for poor behavior because their parents have not set proper boundaries. The kid may have gotten off easy, but many critique the psychology behind the affluenza diagnosis.

Clinical psychologist Robin Rosenberg believes that the affluenza diagnosis is a a distortion of psychology. The psychology of affluenza does not hold up for two reasons. Firstly, even if the teenager was not disciplined or given boundaries at home, he certainly would have been able to learn lessons in other areas of his life. People are sensitive to context and accurately distinguish between consequences that will occur in one situation but not in another. We see this in preschoolers. They are sensitive to context. They know when to push the boundaries and how much they can get away with. Even rats are known to understand and make discriminations based on context. In a study, rats learned that if a light is on when they press a lever, they’ll receive a food pellet, but when the light is off they won’t. It's that simple.

Secondly, the teenager seemed to feel a sense of responsibility in other areas of his life. He remained in school instead of dropping out because he understood the consequences such actions might bring. If he understood this, he certainly would have understood the consequences of driving under the influence.

So, it seems that affluenza is NOT a valid psychological diagnosis. Everyone has at least some sense of responsibility and knows that certain actions lead to unpleasant consequences, no matter how much money their parents may have.

PTSD

Learning about PTSD reminded me of an episode of Criminal Minds, "Distress", that I watched awhile back. In the episode, the Behavioral Analysis Unit travels to an area of Houston which is undergoing construction to search for a man that has been snapping the necks of innocent people - a construction worker, a security guard, and a homeless man. They profile this man to be a war veteran with PTSD. This man is basically reliving the war zone he had been in. His distorted perception of reality was causing him to kill people who were, in reality, no danger to him. The BAU has to go about the situation very carefully because the veteran has special training and can be very dangerous. SPOILER: in the end, the man is shot by a SWAT team member. Everyone is sad. I cried. 

Does this kind of violence really occur in PTSD victims? When Sgt. Robert Bales was arrested for killing 16 civilians in Afghanistan last year, many were quick to connect his violent rampage to his PTSD like symptoms. However, there is no evidence that suggests PTSD can be a cause of violent crimes. Anger, hostility, and aggression are less common symptoms than depression, hypervigilance, and disturbing memories or nightmares. If anything, some PTSD victims show aggression towards themselves or their spouses and families. 

Dissociative Fugue

Dissociative fugue is such a crazy concept so I needed to find some more information on it. A person is diagnosed with this dissociative disorder when they experience a loss of memory of their identity. Symptoms of this disorder include sudden travel away from home, the inability to recall important information about themselves or past events, and extreme distress. A person could wake up in a completely different city with absolutely zero memory of who they are. Can you imagine? That's insane!

The cause of this disorder appears to be linked to traumatic or stressful events in a person's life. This fugue state can last from less than a day to many months. While this disorder can usually go away on its own, treatment varies from psychotherapy to medication to clinical hypnosis (I <3 hypnosis). 

I can think of multiple occurrences of what seems to be dissociative fugue in TV shows I've watched. But just how common is this disorder in real life? The prevalence rate of dissociative fugue is a mere 0.2% of the population (American Psychiatric Association, 2000; Maldonado et al., 2002). So don't worry, friends. Chances are you'll wake up tomorrow morning and still know who you are. 

Brothers: A Manifestation of PTSD

As you all may know, I enjoy reading television more than I like watching it. If you were unaware of this, let me explain. I keep myself updated on the shows I typically watch or am fascinated with by reading the once-a-week recaps that are published after an episode premieres, due to either a lack of time to watch or disinterest in that particular plot or episode. And one of the greatest moments that can occur while perusing these articles on the world-wide interweb, is finding a reference to something we have learned in psychology! The "reading T.V." is just a fun fact, and doesn't have much to do with my blog. I just thought I'd throw it in in there. However, finding a reference to psychology is the subject of my blog post.  Since psychological disorders are something the producers on every major television network/movie corporation incorporate at least once in the history of their programs, and it just so happens to be the chapter we are learning in psychology, it was my lucky day (check my Megillot blog title for that joke).

One of the most startling disorders to learn about was post-traumatic stress disorder, or PTSD, as it completely consumes your thoughts and actions. Our memories exist in part to protect us in the future. However, sometimes, for some of us, the unforgettable takes over our lives in what is called post-traumatic stress disorder (PTSD), an anxiety disorder characterized by hauntings, memories, nightmares, social withdrawal, flashbacks, jumpy anxiety, and/or insomnia that linger for four weeks or more after a traumatic experience. PTSD symptoms have been reported by survivors of accidents, disasters, and violent and sexual assaults, along with many war veterans. Research indicates that the greater one’s emotional distress during a trauma, the higher the risk for post-traumatic symptoms. And the more frequent an assault experience, the more adverse the long-term outcomes tend to be. A sensitive limbic system seems to increase vulnerability, by flooding the body with stress hormones again and again as images of the traumatic experience erupt into consciousness. Genes may also play a role, as some combat-exposed men have identical twins who did not experience combat, yet these non-exposed co-twins tend to share their brother’s risk for cognitive difficulties, such as unfocused attention. Such findings suggest that some PTSD symptoms may actually be genetically predisposed.

In 2009, the movie Brothers was released, and it dealt with the effects of PTSD. Sam Cahill (played by Tobey Maguire) is a Marine captain taken captive along with his hometown friend, Private Joe Willis. Sam and Joe are abused and tortured by their captors, and in a segment of the film, Sam is forced, at gunpoint, to beat Joe to death with a lead pipe. Upon returning home, Sam is stuck in a state of haunting paranoia, and refuses to reveal the source of his pain and what he endured in Afghanistan. At one point, Sam becomes so completely enraged that he leaves a path of physical destruction, destroying the family's newly remodeled kitchen with a crowbar. Things escalate rapidly, to the point where Sam nearly commits suicide. At the end of the movie (SPOILER), Sam is put into a mental institution and finally opens himself up to his grieving wife, and contemplates whether he will ever be able to resume his life normally.

Brothers was a manifestation of PTSD. Throughout the movie, you see that PTSD not only affects the individual plagued by it, but the family as well. There is some truly magnificent acting in the movie, and I highly recommend watching it.

What are some movies you have seen that dealt with a psychological disorder? If you saw them after taking this course, would you look at them differently? What are some examples? 

7 Common Myth About Dissociative Identity Disorder (DID)

1. It is Rare - Only about 1-3% of the population actually have full DID. This disorder has about the same commonality as Bipolar and Schizophrenia. We just don't know a lot about this disorder because we haven't put enough time and money into the research of it. 
2. It's Obvious When someone has DID - Because DID is portrayed in a more exaggerated way in Hollywood movies, we have a skewed perception of what DID actually is. It is much more subtle than we think, and people, on average, spend more than 7 years in a behavioral health system before actually being diagnosed with DID. 
3. People With DID Have Distinct Personalities - People with DID do not have distinct personalities, but different states of behavior. Dr. Bethany Brand describes it as having different ways of being themselves. We all have this in someway, but people with DID don't remember what they do in the different states. 
4. Treatment Makes DID Worse - This can only happen if therapists use outdated practices to try and treat a DID patient. 
5. Therapists Further Develop and “Reify” (regard them as real or concrete) the Self-states - Therapists actually try to create communication between the inner self-states. This teaches the person how to handle all the self-states when a threatening situation arises. 
6. Only People with DID Dissociate - Anyone can dissociate in response to trauma or bad memories. Anyone with an anxiety disorder can dissociate. 
7. Hypnosis Helps - Some therapists think that by using hypnosis they can dig up old memories that caused the DID in the first place. 
These 7 myths show us that DID is not what society perceives it to be. 

Alex Rover's Agoraphobia

Do y'all remember the movie "Nim's Island" from 2008? I definitely remember it. It was my favorite movie for more than a year. I was legit obsessed with it. Honestly, I had forgotten about it, until we learned about Agoraphobia in Psych the other day. Here's the trailer:

One of the principle characters in the movie is Alex Rover, both the hero of a series of great adventure novels and the author of these novels. The author has agoraphobia. One of the big plot point in the movie (SPOILERS!) is that Nim's father goes missing and Alex Rover (the author) starts emailing her and ultimately decides to venture to Nim's island to help her. The problem is that she doesn't want to leave her house. In fact, she's terrified of leaving her house. That's agoraphobia. On a side note, Alex Rover also has arachnophobia and an obsessive personality, kind of.

Here's the main question: was this movie even remotely close to realistic about how to treat Agoraphobia? Would you even be surprised if I said no? Well, no. In the movie, with much nagging from the adventure hero Alex Rover, the author Alex Rover forces herself out of the house and flies to Tonga to get on a helicopter to land on a cruise ship to take a lifeboat to Nim's island. That's not exactly the behavior you would expect of an agoraphobe.

Let's put this in the perspective of psychology. Agoraphobia is an anxiety disorder. Being presented with the fear would make the person more anxious. Depending on the severity of the phobia, going outside will cause some serious anxiety to the point where the person may not be able to function properly. Basically, this movie is completely unrealistic, or Alex Rover never actually had agoraphobia. She just walks out of her house and functions like a normal person, mostly. She had very little anxiety compared to what could have happened. So maybe she had agoraphobia for the first half of the movie and magically got rid of it for the second half. Is that possible?

In summary, nice try, Hollywood, but no cigar.