Dissociative amnesia

The essential feature of dissociative amnesia is a sudden inability to recall important personal information that can’t be explained by ordinary forgetfulness. The patient typically is unable to recall all events that occurred during a specific period, but other types of recall disturbance are also possible.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, recognizes five types of amnesia, based on the time period and amount of information lost to recall:

❑ localized amnesia — failure to recall all events that occurred during a circumscribed time period

❑ selective amnesia — failure to recall some of the events that occurred during a circumscribed time period

❑ generalized amnesia — failure to recall all events over the entire life span

❑ continuous amnesia — failure to recall events subsequent to a specific time up to and including the present

❑ systematized amnesia — failure to recall certain categories of information.

This disorder commonly occurs during war and natural disasters. Although it’s more common in adolescents and young adult women, it’s also seen in young men after combat experience. The amnesic event typically ends abruptly, and recovery is complete, with rare recurrences.

Causes

Dissociative amnesia follows severe psychosocial stress, commonly involving a threat of physical injury or death. Amnesia may also occur after thinking about or engaging in unacceptable behavior such as an extramarital affair.

Signs and symptoms

During the assessment interview, the amnesic patient may appear perplexed and disoriented, wandering aimlessly. He won’t be able to remember the event that precipitated the episode and probably won’t recognize his inability to recall information.

After the episode has ended, the patient is usually unaware that he has suffered what’s known as a recall disturbance.

Diagnosis

For characteristic findings in patients with this condition, see Diagnosing dissociative amnesia.

Treatment

Psychotherapy aims to help the patient recognize the traumatic event that triggered the amnesia and the anxiety it produced. A trusting, therapeutic relationship is essential to achieving this goal. The therapist subsequently attempts to teach the patient reality-based coping strategies.

Special considerations

❑ When providing care in this disorder, teach the patient effective coping strategies to use in stressful situations rather than those strategies that distort reality.

❑ Help the patient with dissociative amnesia recognize and deal with experiences that produce anxiety.

❑ Establish a therapeutic, nonjudgmental relationship with the patient.

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Book Source Details

• Book Title: Professional Guide to Diseases (Eighth Edition)
• Author(s): Springhouse
• Year of Publication: 2005
• Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.

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