Not all dissociation is structural
Non-Structural Dissociative Disorders
Exploring dissociative disorders without parts.
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Table of Contents
1. UDD
2. DPDR
3. OSDD-3
4. OSDD-4
5. Other
6. Structural Dissociation
7. Sources and Further ReadingIf you came from the structural dissociation carrd, 6 will take you back. If you started here, 6 takes you to a separate carrd with further information on dissociative disorders.
UDD
Unspecified dissociative disorder is a stand-in diagnosis for an individual with observed dissociative symptoms, but without enough available information to make a specified diagnosis. It can also be used as a temporary diagnosis for those with a specified disorder in need of specific treatment but not yet in a place to receive a diagnosis such as that of DID.Unlike other disorders on this carrd, many cases of UDD are structural dissociation. However, not all UDD is structural dissociation, as many dissociative disorders could be initially diagnosed and/or treated under UDD.UDD has no distinct qualifying symptoms other than dissociative features.
DPDR
Warning: this section contains examples of depersonalization and derealization which may cause distress. A second warning will be present prior to the description in order to allow those with easily triggered depersonalization or derealization to read this page.Depersonalization and derealization disorder is characterized by episodes of dissociation including both depersonalization and derealization. Depersonalization is a form of dissociation wherein one struggles to recognize their sense of identity, their body, or what they are feeling, such as to feel that their body does not belong to them or that they are not themself. Derealization is a form of dissociation wherein one struggles to recognize their surroundings and others, such as places they are familiar with, or the concept of other people and the world at large.Many people with DPDR have comorbid cPTSD, which makes for their symptoms to present in a congruent (going together-ness) fashion with their structural dissociation. However, not all cases of DPDR present with comorbid cPTSD, which means DPDR does not necessitate parts-based dissociation. Instead, episodes may be triggered by disturbances to the individual’s perception of reality.
Warning 2: please skip the following section if needed
Disturbances to the individual’s perception may include encountering objects or people which seem “off” to the individual, such as a dimming lightbulb being the “wrong” brightness, or a sick friend’s voice being “wrong.” This causes a feeling of hyperawareness to perceived faults to the individual, making everything seem wrong in or around them. Depersonalization and derealization can co-occur, making the individual feel as though both they and their surroundings are unreal or distorted.
OSDD-3
Other specified dissociative disorder type 3 is characterized by dissociative episodes as a response to trauma and stress without the presence of parts. If parts are present, cPTSD, OSDD-1, or (p)DID may be diagnosed instead.OSDD-3 episodes may feature depersonalization, derealization, dissociative amnesia, altered perception, and even fugue (more on fugue later).In the case of OSDD-3, altered perception is different from parts-based disorders in that perception is primarily based in outside factors, rather than sense of identity. Altered perceptions such as perception of time as passing abnormally or of things and people to seem out of place are common in OSDD-3.
OSDD-4
Other specified dissociative disorder type 4–also referred to as trance disorder—is characterized by recurrent dissociative trance without the presence of parts. If parts are present, cPTSD, OSDD-1, or (p)DID may be diagnosed instead.Dissociative trance presents as a dissociated individual with an impaired set of motor and speech skills, as well as lacking drive or direction. The individual may have no sense of what they need or want to do, including a lack of care to take care of themself or dependents. The individual may also appear fixated on a single goal.Under trance, the individual may rely on simple words or phrases to communicate, as well as repeat these. The individual may avoid complex or unfamiliar motor functions, though they may feel comfortable engaging motor skills which seem complex to an outsider, such as use of a video game controller or neatly folding laundry, if these skills are familiar to them. Similarly, under trance, the individual may engage in non-self-regulatory repetitive motor and/or vocal behaviors, which are distinguished from self-regulatory repetitive motor and/or vocal behaviors often seen in autism or ADHD and referred to as “stimming” (short for self-stimulation), as these behaviors are used as a means to remain in a dissociative state. This behavior is also observed in maladaptive daydreaming (which will be covered later).In some cases of trance disorder, identity disturbance may be experienced as is unrelated to parts, and when congruent with trance episodes, may be diagnosed following the ICD as possession trance disorder or trance disorder with possession. In the DSM, no distinction is made between trance with or without possession in OSDD-4.
Other
This section is dedicated to disorders which feature dissociation but are not dissociative disorders, as well as one case of a proposed disorder not yet recognized.
Autism and ADHD
While ASD and ADHD are not dissociative disorders, those with one or both of these disorders are predisposed to higher rates of dissociative tendencies as a coping mechanism for day-to-day stressors and/or boredom. Those with ADHD are especially prone to low-level dissociation as a response to low threshold stressors and general boredom.
Anxiety disorders
Those with non-dissociative anxiety disorders (in this case excluding cPTSD) may experience infrequent or low intensity episodes of dissociation, especially when under high stress. Simple PTSD may also be specifically diagnosed with dissociative features.
Mood disorders
In cases of major depressive disorder and bipolar disorder, individuals may experience dissociation during severe episodes. Bipolar disorder is especially likely to feature mood-congruent episodes, wherein dissociation occurs linked to (hypo)mania and/or depressive episodes.
Maladaptive daydreaming
Although maladaptive daydreaming is not currently an official disorder, its existence is acknowledged by professionals, and has been proposed to become a newly recognized disorder. MaDD is a form of dissociation used to excessively daydream, fantasize, or otherwise use mental escapism in order to cope with daily stressors and boredom, and features non-self-regulatory repetitive motor behaviors as a means to help trigger and maintain a dissociative state. Those with MaDD intentionally dissociate, and often prefer dissociation to an associated state. MaDD is most common in those with ADHD, anxiety disorders, mood disorders, and OCD.
Sources Used
DPDR as a a non-structural dissociative disorder, DPDR as comorbid with cPTSDTrance disorder case study: interaction of culture and dissociative disorders 1. TW for religious topics and themes.Trance disorder case study: interaction of culture and dissociative disorders 2.Self-stimulation in ASD. Included in this resource for comparison to dissociative non-self-regulatory repetitive behavior.Predisposition of ASD to trauma and subsequent dissociation.Panic disorder with dissociative features.Dissociative subtype simple PTSD, not all dissociative PTSD is cPTSD.Dissociation in unipolar and bipolar depression.Mood-congruence of dissociative symptoms in bipolar disorder.What is maladaptive daydreaming, and is it a disorder or a symptom?Maladaptive daydreaming comorbidity and associationsMaladaptive daydreaming is a real phenomenon.