Amnesia, time-loss, memory loss

AmnesiaMemory loss. {{See also| amnesia}} is "partial or total inability to recall past experiences". ^[2]:22 which can have a physical or psychological cause. ^[3]:666 Amnesia is memory loss, but must be significant rather than explained by ordinary forgetfulness. Dissociative amnesiaDissociative amnesia (DA) was previously called psychogenic amnesia is a form of temporary amnesia that presents often in traumatic situations; for example in car accidents or victim or witness of a violent crime. Dissociative Amnesia is described in the DSM as a disorder that causes significant distress or impairment in functioning, such as when a person cannot remember significant events that happened to them. (amnesiaMemory loss. {{See also| amnesia}} with a psychological cause) can sometimes be described as "losing timeIs a period of time where either no state is present, such as the time it takes to switch or is the time where an ANP takes over for an EP or another ANP. This occurs often in otherwise specified dissociative disorder and dissociative identity disorder." or "blackouts" with no obvious physical cause, followed by the experience of "coming to".^[3]:666

Types of amnesia

Several different types of amnesia exist. Amnesia can have a physical cause or be caused by a general medical condition, for example, head trauma or traumatic brain injury (TBITraumatic brain injury (TBI) is "a traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force".Mild TBI is known as mTBI. (Department of Veterans Affairs and Department of Defense (2009)) {{Rp|3}}), substance-induced amnesia (such as carbon monoxide poisoning or chronic alcohol consumption), or electroconvulsive therapy ^{[2]: 60-61}. Amnesia with a psychological cause (e.g., due to traumaThe most fundamental effect of trauma is dissociation, so we define trauma as the event(s) that cause dissociation. {{Rp|75}} The original trauma in those with dissociative identity disorder was failure of secure attachment with a primary attachment figure in early childhood. {{Rp|83}}) is known as dissociative amnesia, and can exist as a single disorder or within another psychiatric diagnosis (e.g., PTSD or dissociative identity disorder). This page refers to amnesia as it relates to mental health, in particular trauma and dissociationDissociation is a compartmentalization of experience, where elements of a trauma are not integrated into a unified sense of the self. {{Rp|4-810, 127}}The lay persons idea of [[dissociation]], that which exists in the normal mind, is not what is referred to in this document. {{Rp|233-234}}.

Amnesia within dissociative disorders may be memory loss of daily events or of events in the past. Amnesia is not always complete. Sometimes, only parts of what happened is forgotten, or the memory is hard to get back. The memory may also feel less real, like a dream. Or only the facts are remembered, but no feelings/emotions. ^{(citation needed)}

Symptoms

The amnesia (or time-loss) itself may not be obvious (due to 'amnesia of amnesia'). But the symptoms of it may be more obvious, once the person is aware what is considered 'normal' forgetfulness. These symptoms indicate amnesia: ^[4]

• Time lossIs a period of time where either no state is present, such as the time it takes to switch or is the time where an ANP takes over for an EP or another ANP. This occurs often in otherwise specified dissociative disorder and dissociative identity disorder.
• Dissociative fugue (sudden loss of personal identity, with travel away from home)
• Being told of doing things but without memory"Memory is not a static thing, but an active set of processes." {{Rp|51}} "Our earliest experiences shape not only what we remember, but also how we remember and how we shape the narrative of our lives. Memory can be seen as the way the mind encodes elements of experience into various forms of representation. As a child develops, the mind begins to create a sense of continuity across time, linking past experiences with present perceptions and anticipations of the future." {{Rp|11}} of doing them
• Finding evidence of doing something without remembering doing it
• Temporary loss of certain skills
• Finding things among one's belongings that one doesn't remember putting there
• Noticing things are suddenly gone
• Childhood amnesia (although a certain degree of amnesia is normal, losing years from childhood or amnesia for major events in childhood is not normal)
• Amnesia for personal identity
• Strangers claiming to know you

Amnesia of Amnesia

Sometimes, amnesia is hidden (like many dissociative symptoms). Then 'amnesia for amnesia' happens, the fact there is a gap in time or there is information missing is forgotten. This is common in individuals with Dissociative Identity Disorder, especially before the start of awareness.^{(citation needed)}

'False Memories'

There have been claims amnesia of childhood trauma do not really exist (or are rare), and that most cases are actually what are called 'false memories': 'memories' of events that did not actually occur. The claim is that the memories are a result of suggestion and are wholly false. Clear evidence exists that trauma memories, especially in young children, are exceptionally resilient to suggestion. ^[5] The terms 'repressed memoryRepressed memory is a term mostly used by the False Memory Syndrome Foundation and their followers, that is meant to refer to when memories are unconsciously, suppressed. This is not a real term and is not the same as dissociation. {{Rp|34-35}}' and 'recovered memories' have also been used to refer to memories of trauma which return after a period of amnesia. Some of those researching "false memories" have been earned a considerable amount of money testifying in the defense"specific, unconscious, intra-psychic adjustment that occurs in order to resole emotional conflict and to reduce an individual's anxiety. A mental mechanism, an ego defense mechanisms, or an adjustive technique."{{Rp|97}} of people accused of child or adult sexual abuse"interactions in which one person behaves in a violent, demeaning or invasive manner towards another person (e.g. child or partner)" and rape, for example Dr Elizabeth Loftus testified at least a hundred times as a defense witness,^[6] including in the defense of Ted Bundy.^[6]

A very small number of patients have claimed their therapists implanted 'false memories', and the individual sues their therapistPyschotherapists are often called a 'therapists'. These professionals may be a psychiatrist, psychologist or other mental health professional who have specialist training in psychotherapy. They are qualified to work with patients in a clinical setting.; however research attempting to create false memories of traumatic experiences by suggestion have been either unsuccessful or heavily criticized,^[7][8][9][1] and do not describe the subjects as experiencing posttraumatic symptoms such as flashbacks as a result of the supposed "traumatic" memories. Pope ⁽¹⁹⁹⁶⁾ asked whether a false memory of "once becoming lost in a shopping mall" was adequate scientific evidence that a therapist could implant a memory of "abusive sexual events". Ethical issues, misrepresentation of study results (including quoting different rates of success in for the same study),^[7][8] the use of undergraduate students to carry out research^[7] and issues with methodology of the research.^[8] The scientific evidence needed to support expert witnesses was increased in the United States in the mid 1990s, and as a result "false memory syndrome" is no longer accepted in legal cases.

These attempts to prove that therapists implant false memories of sex abuse rest on experiments that do not involve therapy or memories of sex abuse circumvent the established scientific procedures for identifying harm caused by therapists and the therapeutic process."^[9]:117

One important task in questioning this link in the chain of reasoning is to examine whether consistent criteria are used in attempting to generalize,in regard both to essentially valid memories that have been lost and recovered and to implanted memories that are completely or essentially false,from the laboratory to therapy, from a mildly traumatic stimulus to child sex abuse, or from a single incident to an incident repeatedly experienced over years.

These attempts to prove that therapists implant false memories of sex abuse rest on experiments that do not involve therapy or memories of sex abuse circumvent the established scientific procedures for identifying harm caused by therapists and the therapeutic process.

Individuals have also sued their abusers, causing a lot controversy, as there was sometimes no other evidence other than their report of what happened.^{(citation needed)} However, in many cases the media was found to ignore corroborating evidence in order to support those who claimed to be "falsely accused", especially in cases of child or adult sexual abuse.

No evidence of a 'False Memory"Memory is not a static thing, but an active set of processes." {{Rp|51}} "Our earliest experiences shape not only what we remember, but also how we remember and how we shape the narrative of our lives. Memory can be seen as the way the mind encodes elements of experience into various forms of representation. As a child develops, the mind begins to create a sense of continuity across time, linking past experiences with present perceptions and anticipations of the future." {{Rp|11}} Syndrome', no diagnostic criteria

Dalam (2001) states

In 1992, the False Memory Syndrome Foundation (FMSF), an advocacy organization for people claiming to be falsely accused of sexual abuse, announced the discovery of a new syndrome involving iatrogenically [created by mental health professionals' mispractise or bad practise] created false memories of childhood sexual abuse. This article critically examines the assumptions underlying “False Memory Syndrome” to determine whether there is sufficient empirical evidence to support it as a valid diagnostic construct. Epidemiological evidence is also examined to determine whether there is data to support its advocates' claim of a public health crisis or epidemic. A review of the relevant literature demonstrates that the existence of such a syndrome lacks general acceptance in the mental health field, and that the construct is based on a series of faulty assumptions, many of which have been scientifically disproven. There is a similar lack of empirical validation for claims of a “false memory” epidemic. It is concluded that in the absence of any substantive scientific support, “False Memory Syndrome” is best characterized as a pseudoscientific syndrome that was developed to defend against claims of child abuse."

Betrayal trauma theoryBetrayal trauma theory (BTT) reports that a negative event enacted by a primary caregiver will influence how events are processed and remembered. The child is more likely to recall abuse by a stranger than by a caregiver. {{See also| Betrayal trauma theory}}

Sadock ^(2008):293 states that betrayal trauma explains amnesia can be the result of severe trauma which is committed by a trusted, needed person. The betrayal caused by the trauma is thought to influence the way the memory of the trauma is encoded and remembered. The memory of the abuse does not become linked to the attachmentThe communication of emotion between an infant and their primary caregiver(s) is essential to shaping the developing mind. "Emotion serves as a central organizing process within the brain. In this way, an individual's abilities to organize emotions - a product in part, of early attachment relationships directly shapes the ability of the mind to integrate experience and to adapt to future stressors." {{Rp|9}} Interruption in the attachment pattern of young children with their caretaker(s) has been shown to be a primary precursor to Dissociative Disorder pathology. (see etiology) {{Rp|85}} {{Rp|97}}, this survival mechanisms allows the attachment to the needed and trusted person to remain despite the traumatic betrayal. This theory is accepted scientifically and passes the Daubert test, meaning it can be used in United States court cases.

Explicit and Implicit memory

Explicit memories can be recalled directly. A memory of a past event is normally explicit (it is possible to recall voluntarily). Implicit memories can't be remembered directly. These include language, motoric memories, and facts.

It has been suggested that traumatic memories are stored as implicit memories. Young children do not have a fully developed explicit memory(Facts, events and autobiographical consciousness). Explicit Memory is the second layer of encoded memory to be laid down. Both factual and autobiographical memory develop after 18 months of age. The narrative process is one way that the mind attempts to integrate."As a child develops, the mind begins to create a sense of continuity across time, linking past experiences with present perceptions and anticipations of the future. Within these representa­tional processes, generalizations or mental models of the self (see self) and the Self with others are created; these form an essential scaffold for the minds growing interactions with the world." {{Rp|11}} It is late memory - present beginning in the first year of life.■ Semantic : Factual memory. Initial development by one or two years of age.■ Autobiographical : Collections of episodic memory. Progressive development with onset after second year of life.■ Requires conscious awareness for encoding and having the subjective sense of recollection (and, if autobiographical, of self and time).■ Focal attention required for encoding.■ Hippocampal processing required for storage and initial retrieval. Cortical consolidation makes selected events a part of permanent memory and independent of hippocampal involvement for retrieval. {{Rp|57}}, further making it more likely that childhood trauma memories are stored as implicit memories. This is (most likely) the reason there can be full amnesia of childhood trauma, as implicit memories cannot be recalled directly. ^[5]

Dissociative Amnesia

Dissociative amnesia (DA) is amnesia which is caused by dissociation rather than as a result of a physical, organic (biological) or substance useHarmful Use is a pattern of psychoactive substance use that results in damage to physical or mental health, e.g. hepatitis following injecting drugs or depression which is secondary to heavy alcohol intake. Adverse social consequences normally also occur. Previously known as "non-dependent use" in the ICD manual, referred to as "substance use" in the DSM manual. {{Rp|41}}, so amnesia which is caused by alcohol use or a condition such as dementia cannot be diagnosed as dissociative amnesia. Dissociative amnesia is a dissociative disorder which is rare^[3]:xxx and has previously been known as psychogenic amnesiaDissociative amnesia (DA) was previously called psychogenic amnesia is a form of temporary amnesia that presents often in traumatic situations; for example in car accidents or victim or witness of a violent crime. Dissociative Amnesia is described in the DSM as a disorder that causes significant distress or impairment in functioning, such as when a person cannot remember significant events that happened to them. .^[3]:330

Dissociative fuguepsychogenic fugueA temporary loss of personal identity due to trauma, reclassified as dissociative amnesia within the DSM-5. Dissociative amnesia includes dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia, but does not always include confused wandering or loss of personality identity. was a separate clinical diagnosis before the DSM-5 psychiatric manual was published, but is now combined with dissociative amnesia since it cannot occur without amnesia.^[3]:431

Diagnostic criteria from the DSMPublished by the American Psychiatric Association as the standard classification of mental disorders used by US mental health professionals. It consists of diagnostic classification, the diagnostic criteria sets, and descriptive text. The DSM-II listed multiple personality disorder as a symptom of hysterical neurosis, dissociative type. The DSM-III (1980) moved Multiple Personality Disorder from a symptom to its own disorder. The DSM-IV changed the name to dissociative identity disorder (1994) and the DSM-5 (May 2013) updated the listing to current standards. {{Rp|384}}-5

The DSM-5 (Diagnostic and Statistical Manual of Mental DisordersPublished by the American Psychiatric Association as the standard classification of mental disorders used by US mental health professionals. It consists of diagnostic classification, the diagnostic criteria sets, and descriptive text. The DSM-II listed multiple personality disorder as a symptom of hysterical neurosis, dissociative type. The DSM-III (1980) moved Multiple Personality Disorder from a symptom to its own disorder. The DSM-IV changed the name to dissociative identity disorder (1994) and the DSM-5 (May 2013) updated the listing to current standards. {{Rp|384}}) includes the following for Dissociative Amnesia(DA) with or without Dissociative Fugue (DF)

A. An individual is unable to recall autobiographic memory associated with a traumatic event. Usually the individual is unconsciously selective in their recall of trauma. ^[10]:156B. An individual must feel distress by the inability to recall events. ^[10]:156:156C. The cause is not physiological, nor is it Dissociative Identity Disorder. ^[10]:156

Dissociative Fugue

A dissociative fuguepsychogenic fugueA temporary loss of personal identity due to trauma, reclassified as dissociative amnesia within the DSM-5. Dissociative amnesia includes dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia, but does not always include confused wandering or loss of personality identity. Dissociative amnesia (DA) was previously called psychogenic amnesia is a form of temporary amnesia that presents often in traumatic situations; for example in car accidents or victim or witness of a violent crime. Dissociative Amnesia is described in the DSM as a disorder that causes significant distress or impairment in functioning, such as when a person cannot remember significant events that happened to them. , also known as psychogenic fugue or fugue statepsychogenic fugueA temporary loss of personal identity due to trauma, reclassified as dissociative amnesia within the DSM-5. Dissociative amnesia includes dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia, but does not always include confused wandering or loss of personality identity. involves both travel and either loss of a identity (e.g., not knowing your name or where you live) or development of a new identity. There is always amnesia for the recent past, for example not knowing how or why the travel took place,^[3]:232,431 the amnesia is generalized rather than selective amnesia.^[3]:431

The DSM-5 also states that a fugue can be noted within a dissociative amnesia diagnosis:

Dissociative Fugue is no longer in a separate category, and is now subsumed under the dissociative amnesia category. If an individual experienced fugue, it is noted here. ^[10]:156

• Topic: Sleep-Wake Disorders
• Disorder: non-rapid eye movement sleep arousal disorders

Under differential diagnosis it mentions that dissociative fugue may be difficult to distinguish from sleepwalking, but unlike all other parasomnias, noctural dissociative fugue arised from a period of wakefulness during sleep, rather than precipitously from sleep without intervening wakefulness.

^[11]:403

Diagnostic criteria in the ICD-10

In the ICD-10 dissociative fugue is a separate diagnosis, rather than included in dissociative amnesia.

F44.0 Dissociative amnesia

"The main feature is loss of memory, usually of important recent events, that is not due to organic mental disorderThe DSM-5 psychiatric manual defines this as "a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expected or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."{{Rp|20}}, and is too great to be explained by ordinary forgetfulness or fatigue. The amnesia is usually centred on traumatic events, such as accidents or unexpected bereavements, and is usually partial and selective. Complete and generalized amnesia is rare, and is usually part of a fugue (F44.1). If this is the case, the disorder should be classified as such. The diagnosis should not be made in the presence of organic brainThe brain is a approximately a 1300-gram organ containing 100-billion neurons. It is the control center of the central nervous system. The mind and brain are not the same thing. (see mind) The mind emerges out of interactions between the brain and relationships during the earliest years of childhood. Different child-parent attachment relationships form differing physiological responses, patterns for interpersonal relationship and how an individual views the world. {{Rp|9}} (see attachment) disorders, intoxication, or excessive fatigue."^[12]

Dissociative amnesia can not be diagnosed if it is caused by alcohol (or another psychoactive"A psychoactive drug or substance affects mental processes, e.g. cognition or affect. " This includes both legal and illegal substances or drugs, but does not necessarily mean only those which produce dependence.The ICD diagnostic manual uses the term psychoactive substance use disorders to defined being clinically relevant use (for example intoxication, harmful use, the cause of a psychotic disorder). Examples include alcohol, cannabis and stimulants. {{Rp|53-54}} substance-induced amnesic disorder), it also cannot be diagnosed if the person meet the diagnosis of amnesia not otherwise specified, anterograde or retrograde amnesia"Loss of memory for events preceding the onset of amnesia." {{Rp|30}}, or nonalcoholic organic amnesic syndrome, or for postictal amnesia in epilepsy.^[12]

References

1. ^ a b Pope, K.. Memory, Abuse, and Science: Questioning Claims About the False Memory Syndrome Epidemic. American Psychologist, volume 51, issue 957. (doi:10.1037/0003-066X.51.9.957)
2. ^ a b c Sadock, Benjamin James (2008) (coauthors: Sadock, Virginia Alcott). . Lippincott Williams & Wilkins..
3. ^ a b c d e f g Dell, Paul F. (ed) (2009) (coauthors: O'Neil, John A.). . New York: Routledge..
4. ^ Dell, Paul F.. A New Model of Dissociative Identity Disorder. Psychiatric Clinics of North America, volume 29, issue 1, 28 February 2006, page 1–26. (doi:10.1016/j.psc.)
5. ^ a b Bremner, JD; Krystal, JH; Charney, DS; Southwick, SM (1996). Neural mechanisms in dissociative amnesia for childhood abuse: relevance to the current controversy surrounding the "false memory syndrome".. The American journal of psychiatry, volume 153, issue 7 Suppl, 1996 Jul, page 71-82.
6. ^ a b Loftus, Elizabeth (1991) (coauthors: Ketcham, Katherine). Witness for the Defense: The Accused, the Eyewitness and the Expert who puts memory on trial. 0-312-08455-2.
7. ^ a b c Crook, L. S.; Dean, M. (1999). Ethics & Behavior, volume 9, issue 1, page 39-50. (doi:10.1207/s15327019eb0901_3)
8. ^ a b c Crook, L. S.; Dean, M. (1999). Ethics & Behavior, volume 9, issue 1, page 61-68. (doi:10.1207/s15327019eb0901_5)
9. ^ a b Pope, Kenneth S.. Pseudoscience, Cross-Examination, and Scientific Evidence in the Recovered Memory Controversy. Psychology, Public Policy, and Law, volume 4, issue 4, page 1160-1181. (doi:1076-8971/98/$3.00)
10. ^ a b c d APA, (2013). . APA.
11. ^ American Psychiatric Association, (2013). . APA..
12. ^ a b World Health Organisation, (2010). ICD-10 Classification of Mental and Behavioural Reaction to severe stress, and adjustment disorders.