Other Specified Dissociative Disorder
This disorder is characterized by a loss of awareness or orientation to their surroundings and/or identity. The functions of consciousness, memory, identity, or perception of one’s environment is disrupted.
In a dissociative trance, a person may be completely unresponsive to outside, surrounding stimuli (for instance, someone trying to talk to them may be ignored). This person may perceive that things around them are “surreal,” “blurred,” or moving around them while they remain paralyzed and unable to gain control over their environment.
The person may experience periods during which they question, reject, or detach from their awareness of who they are. These symptoms are rare and usually occur in those who have experienced prolonged stress of torture, abuse, or captivity.
These symptoms cannot be part of a culturally-accepted practice or religious ritual.
Others chronically or recurrently experience a combination of these states, termed syndrome of mixed dissociative symptoms.
Dissociative experiences that are of transient or brief nature most often occur as an acute reaction to an intensely stressful experience or traumatic event. Some common dissociative symptoms in these instances include:
- The feeling that time is slowing down
- Amnesia (recognized following the stressor as an inability to recall important parts of the event)
- A narrowing of consciousness or “tunnel vision”
- Feeling as if one were on chemical anesthetics or analgesics to some degree
Unspecified Dissociative Disorder
Sometimes, one may show signs of a noteworthy dissociative condition or an event that does not fit neatly into the typical presentation of a known dissociative disorder. At other times, the source of dissociative symptoms may be unclear. For example, in the ER after a car accident when the person has experienced a head trauma — here symptoms may be due to a medical injury.
Sometimes, even in non-emergency settings, a patient may require an ongoing assessment of their symptoms in order for a clinician to gather sufficient evidence to confirm the existence of a dissociative disorder.
In these situations, the unspecified dissociative disorder may be used (often as a “working diagnosis”). Specifically, the unspecified category applies to a dissociative episode or experience that significantly distresses a person and/or impacts ability to function in daily life, yet does not meet all the criteria for one of the established, known dissociative disorders. For example, if a person had met all but one symptom criteria for a particular dissociative disorder, this diagnosis would be appropriate.
This criteria has been adapted for the 2013 DSM-5. Other specified dissociative disorder and unspecified dissociative disorder (diagnostic code 300.15) are new additions to the DSM-5.