Abnormal Psychology

Dissociative and Somatoform Disorders 337

Although aspects of both dissociation and neodissociation theories have received

some support from research (Green & Lynn, 1995; Hilgard, 1994; Kirsch & Lynn,

1998), neither theory explains the specifi c mechanisms involved in the dissociation

or reintegration of memories.

Social Factors: Indirect Effects

Many traumatic events are social in nature, such as combat and abuse. These kinds

of social traumas are likely to contribute to dissociative disorders, particularly dis-

sociative amnesia. In fact, people with a dissociative disorder report childhood

physical or sexual abuse almost three times more often than do people without a

dissociative disorder (Foote et al., 2006). However, some researchers point out that

traumatic events can also induce anxiety, which can lead people to have dissociative

symptoms. Thus, traumatic events may not directly cause dissociative symptoms

such as amnesia; rather such events may indirectly lead to such symptoms by trig-

gering anxiety (Cardeña & Spiegel, 1993; Kihlstrom, 2001).

As noted in Table 8.2, some researchers propose that dissociative amnesia is

a disorder of modern times, because there are no written accounts of its occurring

before 1800 in any culture (Pope et al., 2007).

In sum, dissociative amnesia in the absence of physical trauma to the brain

is extremely rare, which makes research on etiology and treatment similarly rare.

Although researchers have proposed theories about why and how dissociative

amnesia arises, these theories address dissociation generally; dissociative amnesia as

a disorder is not well understood. These same defi ciencies—a paucity of research and

broad theories that do not adequately characterize the specifi c mechanisms—also

limit our understanding of the other dissociative disorders.

Dissociative Fugue

The key features of dissociative fugue are sudden, unplanned travel and diffi culty

remembering the past. This combination can lead sufferers to be confused about

who they are and sometimes to take on a new identity.

What Is Dissociative Fugue?

A person with dissociative fugue can have an episode that lasts anywhere from a

few hours to weeks or even months. During a fugue state, an individual generally

seems to function normally. Once the fugue state has subsided, however, the indi-

vidual may not be able to remember what occurred during it (American Psychiatric

Association, 2000). Table 8.3 lists the DSM-IV-TR diagnostic criteria for dissocia-

tive fugue. Table 8.4 provides more facts about this disorder, and Case 8.2 describes

Joe, who had symptoms of dissociative fugue.

P S

N

Dissociative fugue

A dissociative disorder that involves sudden,

unplanned travel and diffi culty remembering

the past, which can lead patients to be

confused about who they are and sometimes

to take on a new identity.

Table 8.3 • DSM-IV-TR Diagnostic Criteria for Dissociative Fugue

A. The predominant disturbance is sudden, unexpected travel away from home or one’s

customary place of work, with inability to recall one’s past.

B. Confusion about personal identity or assumption of a new identity (partial or complete).

C. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder

[discussed later in the chapter] and is not due to the direct physiological effects of a substance

(e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).

D. The symptoms cause clinically signifi cant distress or impairment in social, occupational, or

other important areas of functioning.

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Text Revision,

Fourth Edition, (Copyright 2000) American Psychiatric Association.