291Dissociative
 Disorders
Dissociative disorders  are characterized by a disrup tion of and/or discontinuity
in the normal integration of consciousness, memory, identity, emotion, perception, body
representation, motor control, and behavior. Dissociative symptoms can potentially dis-
rupt every area of psychological functioning.  This chapter includes dissociative identity
disorder, dissociative amnesia, depersonalization/derealization disorder, other specified
dissociative disorder, and unspecified dissociative disorder.
Dissociative symptoms are experienced as a)  unbidden intrusions into awareness and
behavior, with accompanying losses of continuity  in subjective experience (i.e., ‘‘positive’’
dissociative symptoms such as fragmentation of identity, depersonalization, and dereal-
ization) and/or b) inability to access inform ation or to control ment al functions that nor-
mally are readily amenable to access or contro l (i.e., “negative’’ dissociative symptoms such
as amnesia).
The dissociative disorders are frequently found in the af termath of trauma, and many
of the symptoms, including embarrassment an d confusion about the symptoms or a desire
to hide them, are influenced by the proximity to trauma. In DSM-5, the dissociative disor-
ders are placed next to, but are not part of, the trauma- and stressor-r elated disorders, re-
flecting the close relationship between these di agnostic classes. Both  acute stress disorder
and posttraumatic stress disorder contain di ssociative symptoms, such as amnesia, flash-
backs, numbing, and depersonalization/derealization.
Depersonalization/derealization disorder is characterized by clinically significant persis-
tent or recurrent depersonalizat ion (i.e., experiences of unreality or detachment from one’s