300 Dissociative Disorders
cedents. Dissociative amnesia is more likely to  occur with 1) a greater number of adverse
childhood experiences, particularly physical and/or sexual abuse, 2) interpersonal vio-
lence; and 3) increased severity, frequency, and violence of the trauma. 
Genetic and physiological. There are no genetic studies of  dissociative amnesia. Stud-
ies of dissociation report significant genetic an d environmental factors in both clinical and
nonclinical samples. 
Course modifiers. Removal from the traumatic circumstances underlying the dissociative
amnesia (e.g., combat) may bring about a rapid re turn of memory. The memory loss of indi-
viduals with dissociative fugue may be particularly refractory. Onset of PTSD symptoms may
decrease localized, selective, or systematized amnesia. The returning memory, however, may
be experienced as flashbacks that alternate wi th amnesia for the content of the flashbacks. 
Culture-Related Diagnostic Issues
In Asia, the Middle East, and Latin America, non-epileptic seizures and other functional
neurological symptoms may accompany dissociat ive amnesia. In cultur es with highly re-
strictive social traditions, th e precipitants of dissociative  amnesia often do not involve
frank trauma. Instead, the amnesia is preceded by severe psychological stresses or con-
flicts (e.g., marital conflict, other family d isturbances, attachment problems, conflicts due
to restriction or oppression). 
Suicide Risk
Suicidal and other self-destructive behavior s are common in individuals with dissociative
amnesia. Suicidal behavior may be a particular risk when the amnesia remits suddenly
and overwhelms the individual  with intolerable memories.
Functional Consequences of Dissociative Amnesia