Nursing Diagnoses in Psychiatric Nursing Care Plans and Psychotropic Medications

(^192) 1. 4. ● 3. took place during the fugue. Course is typically brief—hours to days, and rarely, months. Recurrences are rare.of detachment from the environment, or a sense of observing Dissociative Identity Disorder (DID). b. in the individual of two or more distinct personalities, each of which is dominant at a particular time. The original person-ality usually is not aware (at least initially) of the existence of subpersonalities. When there are more than two subperson-alities, however, they are usually aware of each other. Transi-tion from one personality to another is usually sudden and often associated with psychosocial stress. The course tends to be more chronic than in the other dissociative disorders. a. Depersonalization Disorder. TO DISSOCIATIVE DISORDERchange in the quality of self-awareness, which often takes the form of feelings of unreality, changes in body image, feelings PREDISPOSING FACTORS oneself from outside the body.Physiological ●Neurobiological.correlation between neurological alterations and dissocia-seen in more than one generation of a family.Genetics.der than in the general population. The disorder is often common in fi^ ALTERATIONS IN PSYCHOSOCIAL ADAPTATION The rst-degree relatives of people with the disor-DSM Some clinicians have suggested a possible -IV-TRCharacterized by a temporary suggests that DID is more The existence with-
2506_Ch10_191-200.indd 0192 2506 Ch 10 191 - 200 .ind 2. d 0 b. Psychosocial a. 192 sociative behaviors occurred when individuals repressed distressing mental contents from conscious awareness. He believed that the unconscious was a dynamic entity in which repressed mental contents were stored and unavail-able to conscious recall. Current psychodynamic explana-it is possible that dissociative amnesia and dissociative fugue tions of dissociation are based on Freud’s concepts.frontal cortex. Some studies have suggested a possible link Psychological Trauma.between DID and certain neurological conditions, such as temporal lobe epilepsy and severe migraine headaches. points to the etiology of DID as a set of traumatic experi-ences that overwhelms the individual’s capacity to cope Electroencephalographic abnormalities have been observed in some clients with DID.tive disorders. Although available information is inadequate, may be related to alterations in certain areas of the brain that have to do with memory. These include the hippocam-Psychodynamic Theory. pus, mammillary bodies, amygdala, fornix, thalamus, and^ Freud (1962) believed that dis-A growing body of evidence 1 10/1/10 9:35:30 AM 0 / 1 / 10 9 : 35 : 30 AM