Dissociative Amnesia
Dissociative Amnesia
Potentially reversible memory impairment
that primarily affects autobiographical
memory/information.
Dissociative amnesia cannot be explained by
ordinary forgetfulness – and while the patient is
aware that they are having trouble remembering,
they are not bothered by it.
Types of Memory
Autobiographical memory
• Episodes recollected from a person’s life, with a combination of episode autobiographical memory and semantic
autobiographical memory.
• Ex: recall of cognitive, emotional, and motivational aspects of events
Semantic memory
• Memory of objects, facts, and concepts, including words and their meaning
• Ex: learning the skill of reading
Episodic memory
• Memory of specific events and their context
• Ex: the first day of school when I tried to read a book
Procedural memory
• Memory of how to perform different actions and skills
• Ex: riding a bike or tying shoes
Prevalence
Reported around 2 – 6% of general population
Onset in late adolescent and adulthood
Females are more affected than males
Increased incidence of comorbid major depression and
anxiety disorders
Pathogenesis
Environmental
Trauma (physical or sexual
abuse in childhood, sexual Genetic
assault, military combat, 50% of variance in
natural disaster, torture) dissociative disorders could
be accounted for by genetic
factors
Neurobiological
Temporal-/hippocampal-
and occipital areas
associated with
autobiographical memory
are affected
Clinical Manifestation
Large groups of memories, Symptoms of memory loss
perceptions, and associated affects • Fragmentary recall of life history
• Unrecalled behaviour
have become unavailable, usually
• Unexplained possessions
relate to autobiographical information, • Inexplicable changes in relationships
for example: • Fluctuations in skills/habits/knowledge
• Who a person is • Not remembering people who describe
• What he or she did significant interactions with him/her
• Where he or she went • Brief lapses of memory during clinical
interview or other interactions
• With whom he or she spoke
• What was said
• What he or she thought and felt at the
time
Types of Amnesia
Localized amnesia
• Inability to recall events related to a circumscribed period of time
Selective amnesia
• Ability to remember some, but not all, of the events occurring during a circumscribed period
of time
Generalized amnesia
• Failure to recall one’s entire life
Continuous amnesia
• Failure to recall successive events as they occur
Systemic amnesia
• Failure to remember a category of information, such as all memories relating to one’s family ft
to a particular person
DSM-5 Diagnostic Criteria
A. An inability to recall important autobiographical information, usually of a traumatic or
stressful nature, that is inconsistent with ordinary forgetting
B. The symptoms cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning.
C. The disturbance is not attributable to the physiological effects of a substance (e.g., alcohol
or other drug of abuse, a medication) or a neurological or other medical condition (e.g.,
partial complex seizures, transient global amnesia, sequelae of a closed head
injury/traumatic brain injury, other neurological condition).
D. The disturbance is not better explained by dissociative identity disorder, posttraumatic
stress disorder, acute stress disorder, somatic symptom disorder, or major or mild
neurocognitive disorder.
Differential Diagnosis
1. Neurocognitive disorders
• Dementia and delirum
• Impairment involving other domains
• Unable to learn new cognitive informations
2. Acute and posttraumatic stress disorder
• May have dissociation
• Characteristic symptoms of hyperarousal and avoidance
3. Other dissociative disorder
• Dissociative identity disorder (DID) – two or more distinct identity states with
differences in memory, affect, or clinical presentation among identities
• Depersonalization disorder (DPD) – intact memory for life history
4. Substance use disorder
• result from intoxication or chronic use of alcolhol, benzodiazepines and
marijuana
• History of memory impairment and periods of intoxication may be correlated
5. Factitious disorder or malingering
6. Ordinary forgetfulness/Normal autobiographical memory
Treatment
Cognitive Therapy
identify and correct specific cognitive distortions based in trauma that provides
entry into autobiographical memory
Hypnosis
contain, modulate and titrate the intensity of symptoms, to facilitate recall,
provide support and ego strengthening
Group psychotherapy
Stress management
