Tuesday, June 21, 2011

Questions and Answers Regarding Dissociative Amnesia


" Scientific evidence shows that it is not rare for traumatized people to experience amnesia or delayed recall for the trauma.

Amnesia has been reported in combat, for crimes, and for concentration camp experiences and torture. The more severe the trauma, the more likely it is to be forgotten.

Overall, a recovered memory is just as likely to be accurate as a continuously remembered one."

The sociocognitive model of dissociative identity disorder: a reexamination of the evidence.
" No reason exists to doubt the connection between DID and childhood trauma."


Questions and Answers Regarding Dissociative Amnesia
by Stephanie Dallam RN, MS, FNP

....there is near-universal scientific acceptance of the fact that the mind is capable of avoiding conscious recall of traumatic experiences.

....Is dissociation a rare phenomenon?
No. Scientific evidence shows that it is not rare for traumatized people to experience amnesia or delayed recall for the trauma. Amnesia has been reported in combat, for crimes, and for concentration camp experiences and torture. Evidence of this process can be found in the early literature on World War I and World War II.

....Carlson, E., & Rosser-Hogan, R. (April, 1993). Mental health status of Cambodian refugees ten years after leaving their homes. American Journal of Orthopsychiatry, 63 (2), 223-231.

Dissociation is also a frequent finding in survivors extreme terror. Between 1975 and 1979, an estimated one to three million of a population of seven million Cambodians were killed or died of starvation. Carlson, E., & Rosser-Hogan selected 50 subjects at random from a list of all refugees (~500) resettled by nonprofit organization between 1983 and 1985. None had any formal education and had lived in the US for a mean of 5 years. 86% met the criteria for PTSD. The mean number of traumatic experiences the refugees endorsed was 14 and "90% reported amnesia for upsetting events."

....Krell, R. (1993). Child survivors of the Holocaust: Strategies of adaptation. Canadian Journal of Psychiatry, 38 , 384-389.

Krell reported on 22 Holocaust survivors who, as children, hid from the Nazis.
"As children they were encouraged not to tell, but to lead normal lives and forget the past . . ."
"The most pervasive preoccupation of child survivors is the continuing struggle with memory, whether there is too much or too little . . ."
"For a child survivor today, an even more vexing problem is the intrusion of fragments of memory - most are emotionally powerful and painful but make no sense. They seem to become more frequent with time and are triggered by thousands of subtle or not so subtle events . . ."

Marks, J. (1995). The hidden children: The secret survivors of the Holocaust. Toronto : Bantam Books.

One holocaust survivor, Ava Landy, describes her amnesia:
"So much of my childhood between the ages of four and nine is blank....It's almost as if my life was smashed into little pieces . . .
The trouble is, when I try to remember, I come up with so little. This ability to forget was probably my way of surviving emotionally as a child. Even now, whenever anything unpleasant happens to me, I have a mental garbage can in which I can put all the bad stuff and forget it . . . .
I'm still afraid of being hungry. . . . I never leave my house without some food....Again, I don't remember being hungry. I asked my sister and she said that we were hungry. So I must have been! I just don't remember." (p. 188).

What types of traumas result in dissociative amnesia?
A review of 50 studies revealed that amnesia rates tend to increase with severity of trauma and is particularly high in victims of sex crimes....

What is the relation of memory recovery to psychotherapy?
Albach et al. studied 97 adult victims of extreme sexual abuse and a control group of 65 women, matched for age and education who reported on their memories of "ordinary unpleasant childhood experiences." The abuse survivors were broken into two groups. One group had participated in psychotherapy while the other group had not. There was no significant differences in amnesia, memory recovery, or other memory phenomena between the survivors who participated in psychotherapy and those who did not.

...How accurate are recovered memories?
Dalenberg, C. J. (1996). Accuracy, timing and circumstances of disclosure in therapy of recovered and continuous memories of abuse. Journal of Psychiatry & Law,24 (2), 229-75.

Accuracy for Continuous Versus Recovered Memories
Percent with evidence supporting memory
Continuous 75%
Recovered 75%

Conclusion
Scientific evidence shows that it is not rare for traumatized people to experience amnesia or delayed recall for the trauma. Amnesia has been reported in combat, for crimes, and for concentration camp experiences and torture.
The more severe the trauma, the more likely it is to be forgotten.
Overall, a recovered memory is just as likely to be accurate as a continuously remembered one. However, recovered memories have a prominence of emotional and sensory-perceptual elements vs. declarative (verbal) elements. They are often fragmentary and incomplete and thus hard to make into coherent story.
http://www.leadershipcouncil.org/1/tm/amnesia.html


The sociocognitive model of dissociative identity disorder: a reexamination of the evidence.
Gleaves DH.

According to the sociocognitive model of dissociative identity disorder (DID; formerly, multiple personality disorder), DID is not a valid psychiatric disorder of posttraumatic origin; rather, it is a creation of psychotherapy and the media. Support for the model was recently presented by N.P. Spanos (1994).

In this article, the author reexamines the evidence for the model and concludes that it is based on numerous false assumptions about the psychopathology, assessment, and treatment of DID. Most recent research on the dissociative disorders does not support (and in fact disconfirms) the sociocognitive model, and many inferences drawn from previous research appear unwarranted.

No reason exists to doubt the connection between DID and childhood trauma. Treatment recommendations that follow from the sociocognitive model may be harmful because they involve ignoring the posttraumatic symptomatology of persons with DID.

Psychol Bull. 1994 Jul;116(1):143-65.
http://www.ncbi.nlm.nih.gov/pubmed/8711016

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