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Psychogenic amnesia

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Title: Psychogenic amnesia  
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Subject: Amnesia, Fugue state, Repressed memory, Eyewitness memory, Effects of stress on memory
Collection: Dissociative Disorders, Memory Disorders, Neurotic, Stress-Related and Somatoform Disorders, Psychiatric Diagnosis
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Psychogenic amnesia

Dissociative amnesia/psychogenic amnesia
Classification and external resources
ICD-10 F44.0
ICD-9-CM 300.1
MedlinePlus 003257

Psychogenic amnesia, or dissociative amnesia, is a memory disorder characterized by sudden retrograde autobiographical memory loss, said to occur for a period of time ranging from hours to years.[1] More recently, "dissociative amnesia" has been defined as a dissociative disorder "characterized by retrospectively reported memory gaps. These gaps involve an inability to recall personal information, usually of a traumatic or stressful nature."[2] In a change from the DSM-IV to the DSM-5, dissociative fugue is now subsumed under dissociative amnesia.[3]

The atypical clinical syndrome of the memory disorder (as opposed to organic amnesia) is that a person with psychogenic amnesia is profoundly unable to remember personal information about themselves; there is a lack of conscious self-knowledge which affects even simple self-knowledge, such as who they are.[4] Psychogenic amnesia is distinguished from organic psychological stress should precipitate the amnesia,[5] however psychogenic amnesia as a memory disorder is controversial.[6]

Contents

  • About psychogenic amnesia 1
    • Comparison with organic amnesia 1.1
    • Imaging and brain regions 1.2
    • Treatments 1.3
  • In popular culture 2
  • See also 3
  • References 4

About psychogenic amnesia

Psychogenic amnesia is defined by the presence of retrograde amnesia (the inability to retrieve stored memories leading up to the onset of amnesia), and an absence of anterograde amnesia (the inability to form new long term memories).[7][8][9] Access to episodic memory can be impeded,[1] while the degree of impairment to short term memory, semantic memory and procedural memory is thought to vary among cases.[4] If other memory processes are affected, they are usually much less severely affected than retrograde autobiographical memory, which is taken as the hallmark of psychogenic amnesia.[4] However the wide variability of memory impairment among cases of psychogenic amnesia raises questions as to its true neuropsychological criteria, as despite intense study of a wide range of cases there is little consensus of which memory deficits are specific to psychogenic amnesia.[6]

Past literature[4] has suggested psychogenic amnesia can be ‘situation-specific’ or ‘global-transient’, the former referring to memory loss for a particular incident, and the latter relating to large retrograde amnesic gaps of up to many years in personal identity.[4][10] The most commonly cited examples of global-transient psychogenic amnesia are ‘fugue states', of which there is a sudden retrograde loss of autobiographical memory resulting in impairment of personal identity and usually accompanied by a period of wandering.[6] Suspected cases of psychogenic amnesia have been heavily reported throughout the literature since 1935 where it was reported by Abeles and Schilder.[11] There are many clinical anecdotes of psychogenic or dissociative amnesia attributed to stressor ranging from cases of child sexual abuse[12] to soldiers returning from combat.[13][2]

Neurological

  1. ^ a b c d e Arzy, S., Collette, S., Wissmeyere, M., Lazeyras, F., Kaplan, P. W. & Blank, O. (2001). "Psychogenic amnesia and self-identity: a multimodal functional investigation". European Journal of Neurology 18: 1422–1425.  
  2. ^ a b c Leong S, Waits W, Diebold C (January 2006). "Dissociative Amnesia and DSM-IV-TR Cluster C Personality Traits". Psychiatry (Edgmont) 3 (1): 51–5.  
  3. ^ American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  4. ^ a b c d e f g h i j k l Serraa, L., Faddaa, L., Buccionea, I., Caltagironea, C. & Carlesimoa, G. A. (2007). "Psychogenic and organic amnesia. A multidimensional assessment of clinical, neuroradiological, neuropsychological and psycopathological features.". Behavioural Neurology 18: 53–64.  
  5. ^  
  6. ^ a b c d e f g h i j k l m Lucchelli, F. & Spinnler, H. (2003). "The "psychogenic" versus "organic" conundrum of pure retrograde amnesia: Is it still worth pursuing?". Cortex: A Journal Devoted to the Study of the Nervous System and Behaviour 38 (4): 665–669.  
  7. ^ a b Markowitsch HJ (2003). "Psychogenic amnesia". Neuroimage. 20 Suppl 1: S132–8.  
  8. ^ Yasuno F, Nishikawa T, Nakagawa Y, et al. (2000). "Functional anatomical study of psychogenic amnesia". Psychiatry Res 99 (1): 43–57.  
  9. ^ Mackenzie Ross S (2000). "Profound retrograde amnesia following mild head injury: organic or functional?". Cortex 36 (4): 521–37.  
  10. ^ Kopelman MD (2002). "Disorders of memory". Brain 125 (Pt 10): 2152–90.  
  11. ^ Abeles, M. & Schilder, P. (1935). "; Psychogenic loss of personal identity". Archives of Neurology and Psychiatry 34: 587–604.  
  12. ^ a b Arrigo, J. M. & Pezdek, K. (1997). "Lessons from the study of psychogenic amnesia". Current Directions in Psychological Science 6 (5): 148–152.  
  13. ^ a b c d e f g Sargant, W. & Slater, E. (1941). "Amnesic syndromes in war". Journal of the Royal Society of Medicine 34 (12): 757–764. 
  14. ^ Kopelman, M. D., Christensen, H., Puffett, A. & Stanhope, N. (1994). "The great escape: A neuropsychological study of psychogenic amnesia". Neuropsychologia 32 (6): 675–691.  
  15. ^ a b c d e f g Renzi, E. D., Lucchelli, F., Muggia, S. & Spinnler, H. (1997). "Is memory loss without anatomical damage tantamount to a psychogenic deficit? The case of pure retrograde amnesia". Neuropsychologia 35 (6): 781–794.  
  16. ^ a b c d Kopelman, M. D. (2000). "Focal retrograde amnesia and the attribution of causality: An exceptionally critical review". Cognitive Neuropsychology 17: 585–621.  
  17. ^ a b c d Kopelman, M. D., Christensen, H., Puffett, A. & Stanhope, N. (1994). "The great escape: A neuropsychological study of psychogenic amnesia". Neuropsychologia 32 (6): 675–691.  
  18. ^ De Renzi, E., Lucchelli, F.,Muggia, S., & Spinnler, H. (1995). "Persistent retrograde amnesia following a minor trauma". Cortex 31: 531–542.  
  19. ^ Lucchelli, F., Muggia, S., & Spinnler, H. (1995). "The "Petites Madeleines" phenomenon in two amnesic patients. Sudden recovery of forgotten memories". Brain 118: 167–183.  
  20. ^ Campodonico, J. R., & Rediess, S. (1996). "Dissociation of implicit and explicit knowledge in a case of psychogenic retrograde amnesia". Journal of the International Neuropsychological Society (19): 191–203. 
  21. ^ Yang JC, Jeong GW, Lee MS, et al. (2005). "Functional MR imaging of psychogenic amnesia: a case report". Korean J Radiol 6 (3): 196–9.  
  22. ^ Freyd, J. (1994). "Betrayal Trauma: Traumatic Amnesia as an Adaptive Response to Childhood Abuse.". Ethics & Behavior 4 (4): 307–330.  
  23. ^ a b c Abeles, M. & Schilder, P. (1935). "Psychogenic loss of personal identity. Archives of Neurology and Psychiatry" 34. pp. 587–604. 
  24. ^ Vattakatuchery, JJ; Chesterman, P (2006). "The use of abreaction to recover memories in psychogenic amnesia: A case report". Journal of Forensic Psychiatry and Psychology 17 (4): 647–653.  
  25. ^ Lyn, S. J., Boycheva, E. & Barnes, S. (2008). "To assess or to not assess hypnotic suggestibility? That is the question". American Journal of Clinical Hypnosis 51 (2): 161–165.  
  26. ^ a b Goldsmith, R.E., Cheit, R.E., and Wood, M.E. (2009) Evidence of Dissociative Amnesia in Science and Literature: Culture-Bound Approaches to Trauma in Pope, Poliakoff, Parker, Boynes, and Hudson (2007). Journal of Trauma & Dissociation, Volume 10, Issue 3 July 2009, pp. 237 – 253,9

References

See also

Psychogenic amnesia is a common fictional plot device in many films and books and other media. Examples include Shakespeare’s King Lear, who experienced amnesia and madness following a betrayal by his daughters;[26] the title character Nina in Nicolas Dalayrac's 1786 opera;[26] Jackie Chan in Who Am I?; the character Teri Bauer in 24; Leroy Jethro Gibbs in NCIS; the character Victoria Lord in One Life to Live; the character Brian in Mysterious Skin; and the character Jason Bourne in The Bourne Trilogy.

In popular culture

Treatment attempts often have revolved around trying to discover what traumatic event had caused the amnesia, and drugs such as intravenously administered barbiturates (often thought of as 'truth serum') were popular as treatment for psychogenic amnesia during World War II; benzodiazepines may have been substituted later.[13] 'Truth serum' drugs were thought to work by making a painful memory more tolerable when expressed through relieving the strength of an emotion attached to a memory.[24] Under the influence of these 'truth' drugs the patient would more readily talk about what had occurred to them.[13] However, information elicited from patients under the influence of drugs such as barbiturates would be a mixture of truth and fantasy, and was thus not regarded as scientific in gathering accurate evidence for past events.[13] Often treatment was aimed at treating the patient as a whole, and probably varied in practice in different places.[13] Hypnosis was also popular as a means for gaining information from people about their past experiences, but like 'truth' drugs really only served to lower the threshold of suggestibility so that the patient would speak easily but not necessarily truthfully.[25] If no motive for the amnesia was immediately apparent, deeper motives were usually sought by questioning the patient more intensely, often in conjunction with hypnosis and 'truth' drugs.[23] In many cases, however, patients were found to spontaneously recover from their amnesia on their own accord so no treatment was required.[23][13]

Because psychogenic amnesia is defined by its lack of physical damage to the brain,[15] treatment by physical methods is difficult.[6] Nonetheless, distinguishing between organic and dissociative memory loss has been described as an essential first-step in effective treatments.[2]Treatments in the past have attempted to alleve psychogenic amnesia by treating the mind itself, as guided by theories which range from notions such as 'betrayal theory' to account for memory loss attributed to protracted abuse by caregivers[22] to the amnesia as a form of self-punishment in a Freudian sense, with the obliteration of personal identity as an alternative to suicide.[23]

Treatments

[15] reasoning about the aetiology of psychogenic amnesia is possible, which means cause and consequence can be unfeasible to untangle.ad hoc To reiterate however, care must be taken when attempting to define causation as only [1].posterior parietal cortex deficits have been suggested as attributable to functional changes related to the self-identity while [21],limbic system It has been suggested that deficits in episodic memory may be attributable to dysfunction in the [7] Functional assessment of

Imaging and brain regions

[20][19][18] and often context of precipitating experiences are considered (for example, if there has been [16] defining between organic and psychogenic amnesia is not easy[17] Due to organic amnesia often being difficult to detect,[15] but such an argument runs the risk of psychogenic amnesia becoming an umbrella term for any amnesia of which there is no apparent organic cause.[1] Lack of psychological evidence precipitating amnesia doesn’t mean there isn’t any, for example trauma during childhood has even been cited as triggering amnesia later in life,[4] Often, but not necessarily, a premorbid history of psychiatric illness such as depression is thought to be present in conjunction to triggers of psychological stress.[6] (see above paragraph), and both elements of psychological stress and organic amnesia may be present among cases.[17] as causation is not always clear[4] As aforementioned however, aetiology of psychogenic amnesia is controversial[13] such as World War II.[12] and indeed many anecdotal case studies which are cited as evidence of psychogenic amnesia hail from traumatic experiences[16] Psychological triggers are instead considered as preceding psychogenic amnesia,[17] Psychogenic amnesia is supposed to differ from organic amnesia in a number of ways; one being that unlike organic amnesia, psychogenic amnesia is thought to occur when no structural damage to the brain or brain lesion is evident.

Comparison with organic amnesia

[6]

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