NRNP 6665 Week 9 Assignment: Controversy Associated With Dissociative Disorders Essay

NRNP 6665 Week 9 Assignment: Controversy Associated With Dissociative Disorders Essay

Week 9 Assignment: Controversy Associated With Dissociative Disorders

Dissociative disorders are a group of mental disorders that present with disruption in the normally integrated functions of memory, consciousness, sensations, identity, and control of body movements. Individuals have an impaired ability to effect a conscious and selective control over their symptoms, to a varying extent. The purpose of this paper is to explore the controversy on dissociative disorders and the clinical, ethical, and legal concerns when working with patients with dissociative disorders.

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Controversy That Surrounds Dissociative Disorders

Dissociative disorders are controversial, with numerous arguments for and against these conditions. Questions arise on whether Dissociative disorders are real, with some healthcare professionals believing it does not exist despite being listed in the DSM-V. Dissociative disorders have been linked to past trauma, especially in childhood abuse. However, there is no evidence that they result from childhood trauma, and cases of Dissociative disorders in children are rarely reported (Reinders & Veltman, 2021). There is a debate that the diagnosis and treatment of Dissociative disorders cause the memories of childhood trauma (blatant iatrogenesis), and thus trying to diagnose causes more harm to the patient. Furthermore, diagnosis of Dissociative disorders has been blamed for misdiagnosis of other psychiatric conditions, mismanagement of patient, and under-treatment of depression.

Professional Beliefs about Dissociative Disorders

I believe that dissociative disorders mostly form in individuals with a history of long-term exposure to physical, emotional, and sexual abuse. Besides, natural disasters and combat can contribute to dissociative disorders as individuals suppress traumatic memories. Rafiq et al. (2018) found that exposure to childhood trauma was connected with increased dissociation across individuals with severe mental illness. Besides, significant positive associations were identified between particular childhood adversities and dissociation. Fang et al. (2021) assert that dissociative disorders are associated with antecedent stressors such as adverse life events, social or family issues, and traumas like violence and abuse. Furthermore, Reinders and Veltman (2021) explain that Dissociative identity disorder (DID) is not likely to be a neurodevelopmental disorder but an outcome of environmental factors, such as early childhood trauma, which affect brain morphology.

Strategies for Maintaining a Therapeutic Relationship

Establishing a therapeutic relationship with a patient with a history of abuse and trauma is often challenging due to mistrust. Strategies to create and maintain a therapeutic relationship include focusing on the patient’s needs and making them a priority, which builds more trust. The therapist should work with the patient and agree on the therapy goals and the tasks needed to meet the goals. An optimal therapeutic relationship is achieved when the therapist and patient share beliefs on the therapy goals and perceive the interventions used to achieve them as effective and relevant (Bolsinger et al., 2020). In addition, the therapists should demonstrate empathy and unconditional positive regard.

Ethical and Legal Considerations with Dissociative Disorders

The therapist should respect the client’s autonomy by accepting that the client has a right to self-determination and independence. Beneficence and nonmaleficence should be upheld by ensuring that the therapy provided will be good for the client and not cause harm, to avoid legal consequences. Privacy and confidentiality should be maintained, and this includes obtaining consent before sharing patient information.

Conclusion

The controversy on Dissociative disorders surrounds whether they are real if childhood trauma is the primary cause and whether it is associated with blatant iatrogenesis. My professional beliefs about dissociative disorders are that they develop as a coping mechanism to deal with past trauma. Therapists should prioritize the patients’ needs and agree on goals and interventions to maintain a therapeutic relationship.

References

Bolsinger, J., Jaeger, M., Hoff, P., & Theodoridou, A. (2020). Challenges and Opportunities in Building and Maintaining a Good Therapeutic Relationship in Acute Psychiatric Settings: A Narrative Review. Frontiers in psychiatry, 10, 965. https://doi.org/10.3389/fpsyt.2019.00965

Fang, Z., Li, Y., Xie, L., Cheng, M., Ma, J., Li, T., … & Jiang, L. (2021). Characteristics and outcomes of children with dissociative (conversion) disorders in western China: a retrospective study. BMC psychiatry, 21(1), 1-9. https://doi.org/10.1186/s12888-021-03045-0

Rafiq, S., Campodonico, C., & Varese, F. (2018). The relationship between childhood adversities and dissociation in severe mental illness: a meta-analytic review. Acta Psychiatrica Scandinavica, 138(6), 509–525. https://doi.org/10.1111/acps.12969

Reinders, A., & Veltman, D. (2021). Dissociative identity disorder: Out of the shadows at last? The British Journal of Psychiatry, 219(2), 413-414. https://doi.org/10.1192/bjp.2020.168

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Week 9: Dissociative Disorders
Have you ever been driving and realized you don’t remember the last few minutes of driving? Or have you gotten so wrapped up in a book or movie that you lose some awareness of your surroundings? These are examples of common and very mild dissociation, or a disconnect or lack of continuity between thoughts, feelings, actions, and sense of self.

There are three major dissociative disorders defined in the DSM-5: dissociative identity disorder, dissociative amnesia, and depersonalization-derealization disorder. Dissociative disorders may be associated with traumatic events in order to help manage difficult memories or experiences. Patients with these types of disorders are likely to also exhibit symptoms of a variety of other dysfunctions, such as depression, alcoholism, or self-harm and may also be more susceptible to personality, sleeping, and eating disorders.

This week, you will analyze issues related to the diagnosis and treatment of dissociative disorders as well as associated legal and ethical considerations.

Learning Objectives
Students will:

Analyze issues related to the diagnosis and treatment of dissociative disorders
Analyze legal and ethical considerations related to dissociative disorders
Learning Resources
Required Readings (click to expand/reduce)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

Chapter 12, “Dissociative Disorders”
Required Media (click to expand/reduce)

Osmosis. (2017, November 20). Dissociative disorders – causes, symptoms, diagnosis, treatment, pathology [Video]. YouTube. https://youtu.be/XF2zeOdE5GY

Mad Medicine. (2019, August 18). Dissociative disorders (Psychiatry) – USMLE Step 1 [Video]. YouTube. https://youtu.be/Iz03M9pwhs0

Grande, T. (2018, October 22). The dissociative identity disorder controversy (Trauma vs. Iatrogenic). [Video]. YouTube. https://www.youtube.com/watch?v=zqTP0CP9aDk

Assignment: Controversy Associated With Dissociative Disorders
The DSM-5 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, 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.

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.

Photo Credit: Getty Images/Wavebreak Media

To Prepare
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.
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.
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.
By Day 7 of Week 9
Submit your Assignment.

Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK9Assgn+last name+first initial.(extension)” as the name.
Click the Week 9 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 9 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:

Week 9 Assignment Rubric

Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:

Submit your Week 9 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 9
To participate in this Assignment:

Week 9 Assignment
Name: NRNP_6665_Week9_Assignment_Rubric
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Novice Competent Proficient New Column4
In 2–3 pages, address the following:

• Explain the controversy that surrounds dissociative disorders.
14 (14%) – 15 (15%)
The response includes an accurate and concise explanation of the controversy within the field related to dissociative disorders.
12 (12%) – 13 (13%)
The response includes an accurate explanation of the controversy within the field related to dissociative disorders.
11 (11%) – 11 (11%)
The response includes a somewhat vague or inaccurate explanation of the controversy within the field related to dissociative disorders.
0 (0%) – 10 (10%)
The response includes a vague or inaccurate explanation of the controversy within the field related to dissociative disorders. Or the response is missing.
• Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.
23 (23%) – 25 (25%)
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.
20 (20%) – 22 (22%)
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.
18 (18%) – 19 (19%)
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.
0 (0%) – 17 (17%)
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.
• Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
27 (27%) – 30 (30%)
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.
24 (24%) – 26 (26%)
The response includes an accurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
21 (21%) – 23 (23%)
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.
0 (0%) – 20 (20%)
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.
• Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.
14 (14%) – 15 (15%)
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.
12 (12%) – 13 (13%)
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.
11 (11%) – 11 (11%)
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.
0 (0%) – 10 (10%)
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.
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.
5 (5%) – 5 (5%)
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 (4%) – 4 (4%)
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.
3.5 (3.5%) – 3.5 (3.5%)
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.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
4 (4%) – 4 (4%)
Contains one or two grammar, spelling, and punctuation errors
3.5 (3.5%) – 3.5 (3.5%)
Contains three or four grammar, spelling, and punctuation errors
0 (0%) – 3 (3%)
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
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 (5%) – 5 (5%)
Uses correct APA format with no errors
4 (4%) – 4 (4%)
Contains one or two APA format errors
3.5 (3.5%) – 3.5 (3.5%)
Contains three or four APA format errors
0 (0%) – 3 (3%)
Contains many (five or more) APA format errors
Total Points: 100
Name: NRNP_6665_Week9_Assignment_Rubric