Controversy Associated with Dissociative Disorder
- Explain the controversy that surrounds dissociative disorders.
- Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.(Controversy Associated with Dissociative Disorder Essay Example)
- Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
- Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.
CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS
The DSM-5-TR is a diagnostic tool. It has evolved over the decades, as have the classifications and criteria within its pages. It is used not just for diagnosis, however, but also for billing, access to services, and legal cases. Not all practitioners are in agreement with the content and structure of the DSM-5-TR, and dissociative disorders are one such area. These disorders can be difficult to distinguish and diagnose. There is also controversy in the field over the legitimacy of certain dissociative disorders, such as dissociative identity disorder, which was formerly called multiple personality disorder.(Controversy Associated with Dissociative Disorder Essay Example)
In this Assignment, you will examine the controversy surrounding dissociative disorders. You will also explore clinical, ethical, and legal considerations pertinent to working with patients with these disorders.(Controversy Associated with Dissociative Disorder Essay Example)
Be sure to review the Learning Resources before completing this activity.Click the weekly resources link to access the resources.
· Review this week’s Learning Resources on dissociative disorders.
· Use the Walden Library to investigate the controversy regarding dissociative disorders. Locate at least three scholarly articles that you can use to support your Assignment. (Controversy Associated with Dissociative Disorder Essay Example)
THE ASSIGNMENT (2–3 PAGES)
· Explain the controversy that surrounds dissociative disorders.
· Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.(Controversy Associated with Dissociative Disorder Essay Example)
· Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
· Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.
NRNP_6665_Week9_Assignment_Rubric
NRNP_6665_Week9_Assignment_Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning Outcome In 2–3 pages, address the following:• Explain the controversy that surrounds dissociative disorders.(Controversy Associated with Dissociative Disorder Essay Example)
15 to >13.0 pts
Excellent
The response includes an accurate and concise explanation of the controversy within the field related to dissociative disorders.
13 to >11.0 pts
Good
The response includes an accurate explanation of the controversy within the field related to dissociative disorders.
11 to >10.0 pts
Fair
The response includes a somewhat vague or inaccurate explanation of the controversy within the field related to dissociative disorders.(Controversy Associated with Dissociative Disorder Essay Example)
10 to >0 pts
Poor
The response includes a vague or inaccurate explanation of the controversy within the field related to dissociative disorders. Or the response is missing.
15 pts
This criterion is linked to a Learning Outcome• Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.
25 to >22.0 pts
Excellent
The response includes a thorough and well-organized explanation of the student’s professional beliefs about dissociative disorders. Rationale demonstrates critical thinking and is strongly supported with three scholarly references.
22 to >19.0 pts
Good
The response includes a well-organized explanation of the student’s professional beliefs about dissociative disorders. Rationale is clear and appropriately supported with three scholarly references.
19 to >17.0 pts
Fair
The response includes a somewhat vague explanation of the student’s professional beliefs about dissociative disorders. Rationale is somewhat unclear and references either provide weak support for the rationale or are not scholarly/current.
17 to >0 pts
Poor
The response includes a vague explanation of the student’s professional beliefs about dissociative disorders. Rationale is unclear and references are inappropriate. Or the response is missing.
25 pts
This criterion is linked to a Learning Outcome• Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.(Controversy Associated with Dissociative Disorder Essay Example)
30 to >26.0 pts
Excellent
The response includes an accurate and concise explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
26 to >23.0 pts
Good
The response includes an accurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
23 to >20.0 pts
Fair
The response includes a somewhat vague or incomplete explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.(Controversy Associated with Dissociative Disorder Essay Example)
20 to >0 pts
Poor
The response includes a vague or inaccurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. Or the response is missing.
30 pts
This criterion is linked to a Learning Outcome• Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.
15 to >13.0 pts
Excellent
The response includes an accurate and concise explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important.(Controversy Associated with Dissociative Disorder Essay Example)
13 to >11.0 pts
Good
The response includes an accurate explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important.(Controversy Associated with Dissociative Disorder Essay Example)
11 to >10.0 pts
Fair
The response includes a somewhat vague or incomplete explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important.(Controversy Associated with Dissociative Disorder Essay Example)
10 to >0 pts
Poor
The response includes a vague and inaccurate explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important. Or, response is missing.
15 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.(Controversy Associated with Dissociative Disorder Essay Example)
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4 to >3.5 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.(Controversy Associated with Dissociative Disorder Essay Example)
3.5 to >3.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.
3 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.(Controversy Associated with Dissociative Disorder Essay Example)
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation(Controversy Associated with Dissociative Disorder Essay Example)
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good
Contains one or two grammar, spelling, and punctuation errors
3.5 to >3.0 pts
Fair
Contains three or four grammar, spelling, and punctuation errors
3 to >0 pts
Poor
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent
Uses correct APA format with no errors
4 to >3.5 pts
Good
Contains one or two APA format errors
3.5 to >3.0 pts
Fair
Contains three or four APA format errors
3 to >0 pts
Poor
Contains many (five or more) APA format errors
5 pts
Total Points: 100
Controversy Associated with Dissociative Disorder Essay Example
Dissociative disorders disrupt or impair memory, identity, emotion, perception, conduct, and sense of self. Dissociative symptoms include a sense of detachment or a sensation of being beyond one’s body, as well as memory loss or amnesia. Previous trauma experience is also linked to dissociative disorders. However, the nature of dissociative disorders and the implications of observed symptoms raises concerns over whether they are real. This paper will discuss the controversy surrounding dissociative disorders, professional beliefs about dissociative disorders, strategies to maintain a therapeutic relationship with a client suffering from a dissociative disorder, and ethical and legal considerations when working with such a client.(Controversy Associated with Dissociative Disorder Essay Example)
The controversy that surrounds dissociative disorders
Dissociative disorders (DD) have been debated since the development of contemporary psychiatry and psychology. Even among professionals, DD views are frequently not supported by the scientific literature. Multiple lines of research point to a strong connection between psychological trauma, particularly cumulative and early-life trauma, and DD (Loewenstein, 2019). The argument presented by skeptics is that DDs are artifactual states caused by iatrogenic or sociocultural influences where dissociation causes trauma fantasies. However, almost no clinical or research data lend weight to this assertion.(Controversy Associated with Dissociative Disorder Essay Example)
Dissociative identity disorder (DID) is the most common and controversial DD. It is founded on the argument that the development of existing diagnostic measures renders first-person claims of dissociation based on those scales unreliable (Loewenstein, 2019). According to this argument, how these scales are made causes more false positives. The misinterpretation of other conditions, poor patient care, and insufficient treatment of depression have all been attributed to DID diagnoses (Loewenstein, 2019).(Controversy Associated with Dissociative Disorder Essay Example)
Even when DID is treated with the best intentions, psychotherapy may have unintended adverse effects, where some patients report worsening symptoms and declining functionality. On understanding if DID is fake, some medical professionals question whether those who advocate the diagnosis of dissociative identity disorder have any financial or other conflicts of interest. According to Loewenstein (2019), physicians or organizations can generate an income of up to $20,000 per patient from the long-term intensive psychotherapy care that people with DID typically get, giving doctors a strong incentive to identify DID. It implies doctors can continue diagnosing people with DID wrongfully because its treatment is a significant revenue stream.(Controversy Associated with Dissociative Disorder Essay Example)
My professional beliefs about dissociative disorders
Besides the controversy, I believe dissociative disorders are real and impact a significant part of the population. The disease is often misdiagnosed as Schizophrenia due to the unjustified belief that the individual might be delusional (Mitra & Jain, 2021). Dissociative disorders are widespread in general and clinical populations and constitute a significant underserved group with a high risk of self-harm and suicide (Pietkiewicz et al., 2021). Research shows that severe DD patients’ symptoms, including suicidal and self-destructive tendencies, significantly improved after treatment (Loewenstein, 2019). However, a significant public health initiative is required to promote understanding of DD, including educational initiatives in all programs for mental health professionals and more financing for research.(Controversy Associated with Dissociative Disorder Essay Example)
Strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder
The initial treatment phase’s primary goals are building rapport and fostering trust in the therapeutic process. The therapist informs the client that they will not be required to confront any topics they do not feel comfortable facing and emphasizes that symptoms are a byproduct of identified factors during the assessment (Thayyil & Rani, 2020). The therapist empowers the client’s capacity for self-regulation and willingness to effect change within themselves while establishing a solid therapeutic alliance and retaining professional neutrality. The therapeutic relationship is reinforced by establishing and maintaining clear boundaries, developing reliable strategies to deal with emotions during therapy, establishing appropriate ways to assert oneself and deal with interpersonal conflict, acting mindfully, acknowledging changes, and appreciating the significance of the client’s efforts towards change and recovery.(Controversy Associated with Dissociative Disorder Essay Example)
There are more than nine parts of lore and less than one part of the law in the entire legal situation pertaining to dissociation and pathological dissociation. In regards to all facets of the putative “special status” that dissociation phenomena, whether normal or sick, purportedly deserve, there is a great deal more communal (and contradictory) tradition than statutory or judicial law (Kabene et al., 2022). The objective of the present examination is to determine if a person with DID is legally accountable for the offense they committed and whether they are capable of facing trial.(Controversy Associated with Dissociative Disorder Essay Example)
There is no agreement within the legal system as to whether DID patients should be held accountable for their conduct, although the disease is fundamentally defined by dissociative amnesia, and the host personality may only have minimal or no contact with the alters. Additionally, courts typically reject the accusations of insanity made by individuals suffering from DID (Kabene et al., 2022). The excessive dependence on secondary data requires people to accept the inferences that have already been formed. Nonetheless, there is no chance to independently confirm those results, hence the need for additional studies in the field to integrate primary data into this study.(Controversy Associated with Dissociative Disorder Essay Example)
Conclusion
Dissociation is generally an escape from reality, and it is sometimes confused with delusion, making dissociative disorders controversial. Research evidence on dissociative disorders demonstrates the authenticity of diagnosis and treatment regimens. Still, it does not fill the gap surrounding the lack of awareness among the public of such conditions, which raises skeptics. Treating dissociative disorders and working with patients with DD is challenging and requires a strong therapeutic relationship between the provider and the client, which can be enhanced through establishing clear boundaries, common goals, positive reinforcement and acknowledgment of effort, and mindfulness. Additionally, legal and ethical issues arise when working with DD patients, including their ability to harm others and the implications of symptoms in a court case. To address these, primary studies on symptoms associated with DD and their implications are fundamental.(Controversy Associated with Dissociative Disorder Essay Example)
References
Kabene, S. M., Neftci, N. B., & Papatzikis, E. (2022). Dissociative identity disorder and the law: guilty or not guilty? Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.891941
Loewenstein R. J. (2019). Dissociation debates: everything you know is wrong. Dialogues in clinical neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2019.20.3/rloewenstein
Mitra, P., & Jain, A. (2021). Dissociative identity disorder. Statpearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK568768/
Pietkiewicz, I. J., Bańbura-Nowak, A., Tomalski, R., & Boon, S. (2021). Revisiting false-positive and imitated dissociative identity disorder. Frontiers in Psychology, 12, 637929. https://doi.org/10.3389/fpsyg.2021.637929
Thayyil, M. M., & Rani, A. (2020). Structural family therapy with a client diagnosed with dissociative disorder. Indian Journal of Psychological Medicine, 43(6), 549-554. https://doi.org/10.1177/0253717620969067
Frequently Asked Questions
What is the controversy of dissociative disorder?
The controversy surrounding dissociative disorders revolves around the diagnosis, validity, and causative factors of these conditions. Some critics argue that the disorders, particularly Dissociative Identity Disorder (DID), are overdiagnosed and may result from suggestibility and therapeutic practices. Others contend that dissociative disorders are genuine and stem from traumatic experiences, emphasizing the need for accurate diagnosis and appropriate treatment approaches.(Controversy Associated with Dissociative Disorder Essay Example)
What is a controversial disorder involving the development of additional personalities called alters?
The controversial disorder involving the development of additional personalities is known as Dissociative Identity Disorder (DID). It is characterized by the presence of two or more distinct personality states or “alters” within an individual, often accompanied by gaps in memory and identity confusion. The diagnosis and treatment of DID have been subjects of debate and controversy within the mental health field.(Controversy Associated with Dissociative Disorder Essay Example)
What are some ethical concerns with treating dissociative identity disorder?
Treating Dissociative Identity Disorder (DID) raises ethical concerns related to therapist-patient boundaries, misdiagnosis, and the potential for iatrogenic harm. Establishing appropriate boundaries between therapist and alters (different identities within the patient) is challenging, as fostering relationships with specific alters could inadvertently reinforce their dissociation. Misdiagnosis may occur due to the complexity of DID symptoms, leading to inappropriate treatment. Additionally, overly suggestive therapeutic approaches might inadvertently create or reinforce alters, risking iatrogenic harm by exacerbating dissociation.(Controversy Associated with Dissociative Disorder Essay Example)
What is rare and controversial dissociative disorder in which an individual experiences two or more distinct and alternating personalities?
The rare and controversial dissociative disorder you are referring to is Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder. In this condition, an individual exhibits the presence of two or more distinct and separate identities or personality states that control their behavior and consciousness, often accompanied by memory gaps for significant periods of time. The origins and diagnosis of DID have been debated within the psychiatric community, contributing to its controversial nature.(Controversy Associated with Dissociative Disorder Essay Example)
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