Johns Hopkins Psychiatry Guide

Dissociative Amnesia

Megan Meah Hosein, M.D., Glenn Treisman, M.D., Ph.D.
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DEFINITION

  • Dissociative amnesia is classified under the Dissociative Disorders section of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) [1].
    • Previously known as psychogenic amnesia, renamed dissociative amnesia in DSM-IV [2]
    • Characterized by an apparent disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior
    • The DSM-5 lists the defining feature as inability to recall important autobiograpical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting.
  • This is a controversial diagnostic entity that incorporates elements of psychogenic fugue states (psychogenic amnesia), repressed memory, traumatic amnesia, and conversion.
    • The concept of repression (repression of memory regarding traumatic events) remains controversial, with scientific studies often being interpreted as supportive of both sides of the argument.
  • May overlap with dissociative fugue, which is apparently purposeful travel or bewildered wandering that is associated with autobiographical amnesia [1]
  • The DSM-5 lists a variety of memory disturbances that can occur in dissociative amnesia [1]:
    • Localized amnesia (the most common form): failure to recall events during a circumscribed period of time
    • Selective amnesia: can recall some, but not all parts of a circumscribed period of time or traumatic event
    • Systematized amnesia: loss of memory for a specific category of information
    • Continuous amnesia: loss of memory for each new event as it occurs
    • Generalized amnesia (rare): acute onset of complete loss of memory for one’s life history
      • May lose semantic knowledge, procedural knowledge, and/or personal identity
  • Some authors feel this disorder is more common in combat veterans, sexual assault victims, and extreme emotional stress or conflict, while others see this as a disorder of vulnerable individuals with comorbid psychiatric conditions, problematic life circumstances, and/or personality vulnerabilities.
  • Controversy exists whether dissociative amnesia should be conceptualized as a dissociative disorder or included in the symptom clusters for PTSD and acute stress disorder, emphasizing its relationship to trauma [3].

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Last updated: October 22, 2014