NRNP 6665 Assignment: Controversy Associated With Dissociative Disorders
NRNP 6665 Assignment: Controversy Associated With Dissociative Disorders
Controversy Associated with Dissociative Disorders
Dissociative disorders are mental health problems that psychiatric mental health nurse practitioners encounter in their practice. Patients with dissociative disorders experience interruption, disruption, or discontinuity of their usual subjective behaviors, memory, emotions, identity, motor control, and consciousness. Dissociative disorders exist in types that include dissociative amnesia, dissociative identity disorder, unspecified dissociative disorder, and depersonalization disorder. Despite being considered mental health issues, controversies surround dissociative disorders. Therefore, this paper focuses on the controversy that surrounds dissociative disorders, my professional beliefs about the disorders, strategies for maintaining a therapeutic relationship with patients with the disorder, and ethical and legal considerations associated with the disorders.
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Controversy That Surrounds Dissociative Disorders
Controversy surrounds dissociative disorders. One of them is the proposition by the iatrogenic model. The iatrogenic model posits that dissociative disorders are conditions seen in hypnotizable and suggestible patients. This means that dissociative disorders have symptoms that are seen in patients with borderline personality disorder (Dalenberg et al., 2022; Dodier et al., 2022). As a result, dissociative disorder diagnosis lacks the specificity of a mental health disorder on its own but a coexisting comorbidity in personality disorders.
The sociocognitive model also provides another view of the controversy associated with dissociative disorders. According to the sociocognitive model, childhood traumatic experiences such as sexual abuse exist as multiple personalities and repressed memories. These forms of traumatic experiences make people believe that they suffer from dissociative disorders, which is false. Instead, they have repressed memories or multiple personalities, which do not meet the stated criteria for diagnosing dissociative disorders. In both models, proponents argue that minimal data supports the correlation between dissociative disorders and traumatic experiences (Lynn et al., 2022). They also assert the lack of psychological processes that explain traumatic experiences that patients remember and those they do not remember as seen in dissociative disorders.
My Professional Beliefs about Dissociative Disorders
I believe that dissociative disorders are mental health problems. I also believe that the controversies surrounding dissociative disorders are largely attributed to the lack of adequate information about them and the stigma associated with the diagnosis. Factors such as social and cultural values and beliefs affect the perception that people have toward mental health problems, including dissociative disorders. Such practices create a false perception of what constitutes a mental health problem and not. In my view, a mental health problem affects one’s social, occupational, academic, and other areas of functioning. Dissociative disorders affect these areas of one’s life, hence, qualifying as mental health disorders. Most of the information about dissociative disorders is subjective (Snyder, 2021). In this case, healthcare providers rely mainly on what patients tell them and not the things they observe. This makes it difficult for healthcare providers to make absolute diagnoses, hence, the controversies.
I also believe that psychiatric mental health nurse practitioners should not let controversies affect the treatment of dissociative disorders in their practice. They should ensure that patients with the disorders access high-quality, evidence-based treatments that improve their mental health, well-being, and functioning. I also support the need for active patient involvement in managing dissociative disorders. Practitioners should educate patients about their diagnoses and dispel any misinformation associated with them (Nester et al., 2022). Strategies such as shared decision-making should be incorporated into the care to empower patients with the knowledge and skills they require for managing dissociative disorders.
Strategies for Maintaining the Therapeutic Relationship
Psychiatric mental health nurse practitioners caring for patients with dissociative disorders should maintain a therapeutic relationship with a client who might present with a dissociative disorder. One of the strategies needed to maintain a therapeutic relationship with such a client is being non-judgmental. The nurse should treat such patients with respect. They should show empathy toward them and acknowledge their experiences. Psychiatric mental health nurse practitioners should also ensure active patient engagement in their care. Strategies such as shared-decision making should be used to ensure patient preferences are incorporated into the treatment plans. Psychiatric nurses should also promote open sharing of information to create a therapeutic relationship with patients diagnosed with dissociative disorders (Marchand et al., 2020). They should ensure that patients are informed about their diagnoses, treatment plans, benefits, and patient roles in the treatment process.
Psychiatric mental health nurse practitioners should also respect patients’ autonomy as a strategy to maintain a therapeutic relationship with those diagnosed with dissociative disorders. Nurses should provide patients with accurate information about their diagnoses and treatments so patients can make informed decisions about their care. Multidisciplinary teams might also be involved in the provision of care as a way of maintaining a therapeutic relationship with the patients. For example, it might be necessary for psychiatric nurses to involve counselors in the care process (Marchand et al., 2020). Such strategies will ensure the provision of patient-centered care that aligns with the actual and potential needs of patients diagnosed with dissociative disorders.
Ethical and Legal Considerations
Psychiatric mental health nurse practitioners bring some ethical and legal considerations related to dissociative disorders to their practice. One of them is ensuring non-maleficence and benevolence. Psychiatric nurses should ensure that the care that patients with dissociative disorders receive does not predispose them to any harm. They must also make care decisions in the best interests of their patients. Psychiatric nurses should also seek informed consent from their patients (Rocchio, 2020). Informed consent should be obtained to demonstrate that patients with dissociative disorders understand the nature of their conditions and the treatment options.
Psychiatric nurses should also educate patients about the diagnosis and management. Patients should understand their conditions for them to make sound decisions about whether they will accept the treatments or not. Psychiatric nurses should also be aware that patients have a right to accept or decline the available treatments for dissociative disorders. They must respect the decisions that patients make related to the uptake or not of the available treatments. This will ensure that nurses uphold the right of the patients to autonomy in the care process. Lastly, psychiatric nurses should ensure data integrity when caring for patients with dissociative disorders. They should ensure data privacy and confidentiality (Rocchio, 2020). Nurses should obtain consent from their patients before sharing information with other parties.
Conclusion
In summary, controversy surrounds dissociative disorders. Psychiatric nurses should explore evidence-based strategies for creating a therapeutic relationship with their patients. I believe that dissociative disorders are mental health problems. Controversies surrounding dissociative disorders should not alter treatment approaches that psychiatric nurses consider for their patients. Psychiatric nurses should consider ethical and legal issues that influence care delivery to patients with dissociative disorders.
References
Dalenberg, C., Naish, B., & Abu-Rus, A. (2022). Dissociation, Dissociative Disorder, and Their Treatment. In R. Geffner, J. W. White, L. K. Hamberger, A. Rosenbaum, V. Vaughan-Eden, & V. I. Vieth (Eds.), Handbook of Interpersonal Violence and Abuse Across the Lifespan: A project of the National Partnership to End Interpersonal Violence Across the Lifespan (NPEIV) (pp. 4383–4408). Springer International Publishing. https://doi.org/10.1007/978-3-319-89999-2_177
Dodier, O., Otgaar, H., & Lynn, S. J. (2022). A Critical Analysis of Myths About Dissociative Identity Disorder. Annales Médico-Psychologiques, Revue Psychiatrique, 180(9), 855–861. https://doi.org/10.1016/j.amp.2021.10.007
Lynn, S. J., Polizzi, C., Merckelbach, H., Chiu, C.-D., Maxwell, R., Heugten, D. van, & Lilienfeld, S. O. (2022). Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework. Annual Review of Clinical Psychology, 18(Volume 18, 2022), 259–289. https://doi.org/10.1146/annurev-clinpsy-081219-102424
Marchand, K., Foreman, J., MacDonald, S., Harrison, S., Schechter, M. T., & Oviedo-Joekes, E. (2020). Building healthcare provider relationships for patient-centered care: A qualitative study of the experiences of people receiving injectable opioid agonist treatment. Substance Abuse Treatment, Prevention, and Policy, 15(1), 7. https://doi.org/10.1186/s13011-020-0253-y
Nester, M. S., Hawkins, S. L., & Brand, B. L. (2022). Barriers to accessing and continuing mental health treatment among individuals with dissociative symptoms. European Journal of Psychotraumatology, 13(1), 2031594. https://doi.org/10.1080/20008198.2022.2031594
Rocchio, L. M. (2020). Ethical and Professional Considerations in the Forensic Assessment of Complex Trauma and Dissociation. Psychological Injury and Law, 13(2), 124–134. https://doi.org/10.1007/s12207-020-09384-9
Snyder, B. L. (2021). Recognizing and treating dissociative disorders: The nurse’s role in supporting patients and their families. American Nurse Journal, 16(9), 15–19.
Controversy Associated With Dissociative Disorders
The DSM-5-TR is a diagnostic tool. It has evolved over the decades, as have the classifications and criteria within its pages. It is used not just for diagnosis, however, but also for billing, access to services, and legal cases. Not all practitioners are in agreement with the content and structure of the DSM-5-TR, and dissociative disorders are one such area. These disorders can be difficult to distinguish and diagnose. There is also controversy in the field over the legitimacy of certain dissociative disorders, such as dissociative identity disorder, which was formerly called multiple personality disorder.
In this Assignment, you will examine the controversy surrounding dissociative disorders. You will also explore clinical, ethical, and legal considerations pertinent to working with patients with these disorders.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
Learning Resources
Required Readings
Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
Chapter 11, “Dissociative Disorders”
Required Media
Osmosis. (2017, November 20). Dissociative disorders – causes, symptoms, diagnosis, treatment, pathology
Links to an external site. [Video]. YouTube. https://youtu.be/XF2zeOdE5GYLinks to an external site.
Mad Medicine. (2019, August 18). Dissociative disorders (Psychiatry) – USMLE Step 1
Links to an external site. [Video]. YouTube. https://youtu.be/Iz03M9pwhs0Links to an external site.
Grande, T. (2018, October 22). The dissociative identity disorder controversy (Trauma vs. Iatrogenic)
Links to an external site.. [Video]. YouTube. https://www.youtube.com/watch?v=zqTP0CP9aDk
To Prepare
Review this week’s Learning Resources on dissociative disorders.
Use the Walden Library to investigate the controversy regarding dissociative disorders. Locate at least three scholarly articles that you can use to support your Assignment.
The Assignment (2–3 pages)
Explain the controversy that surrounds dissociative disorders.
Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.
Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.
By Day 7 of Week 9
Submit your Assignment
submission information
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Rubric
NRNP_6665_Week9_Assignment_Rubric
NRNP_6665_Week9_Assignment_Rubric
| Criteria |
Ratings |
Pts |
| This criterion is linked to a Learning Outcome In 2–3 pages, address the following:• Explain the controversy that surrounds dissociative disorders. |
| 15 to >13.0 ptsExcellent
The response includes an accurate and concise explanation of the controversy within the field related to dissociative disorders. |
13 to >11.0 ptsGood
The response includes an accurate explanation of the controversy within the field related to dissociative disorders. |
11 to >10.0 ptsFair
The response includes a somewhat vague or inaccurate explanation of the controversy within the field related to dissociative disorders. |
10 to >0 ptsPoor
The response includes a vague or inaccurate explanation of the controversy within the field related to dissociative disorders. Or the response is missing. |
|
15 pts |
| This criterion is linked to a Learning Outcome • Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature. |
| 25 to >22.0 ptsExcellent
The response includes a thorough and well-organized explanation of the student’s professional beliefs about dissociative disorders. Rationale demonstrates critical thinking and is strongly supported with three scholarly references. |
22 to >19.0 ptsGood
The response includes a well-organized explanation of the student’s professional beliefs about dissociative disorders. Rationale is clear and appropriately supported with three scholarly references. |
19 to >17.0 ptsFair
The response includes a somewhat vague explanation of the student’s professional beliefs about dissociative disorders. Rationale is somewhat unclear and references either provide weak support for the rationale or are not scholarly/current. |
17 to >0 ptsPoor
The response includes a vague explanation of the student’s professional beliefs about dissociative disorders. Rationale is unclear and references are inappropriate. Or the response is missing. |
|
25 pts |
| This criterion is linked to a Learning Outcome • Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. |
| 30 to >26.0 ptsExcellent
The response includes an accurate and concise explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. |
26 to >23.0 ptsGood
The response includes an accurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. |
23 to >20.0 ptsFair
The response includes a somewhat vague or incomplete explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. |
20 to >0 ptsPoor
The response includes a vague or inaccurate explanation of strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder. Or the response is missing. |
|
30 pts |
| This criterion is linked to a Learning Outcome • Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important. |
| 15 to >13.0 ptsExcellent
The response includes an accurate and concise explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important. |
13 to >11.0 ptsGood
The response includes an accurate explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important. |
11 to >10.0 ptsFair
The response includes a somewhat vague or incomplete explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important. |
10 to >0 ptsPoor
The response includes a vague and inaccurate explanation of ethical and legal considerations related to dissociative disorders that are important to clinical practice and why they are important. Or, response is missing. |
|
15 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
| 5 to >4.0 ptsExcellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. |
4 to >3.5 ptsGood
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. |
3.5 to >3.0 ptsFair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. |
3 to >0 ptsPoor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. |
|
5 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
| 5 to >4.0 ptsExcellent
Uses correct grammar, spelling, and punctuation with no errors |
4 to >3.5 ptsGood
Contains one or two grammar, spelling, and punctuation errors |
3.5 to >3.0 ptsFair
Contains three or four grammar, spelling, and punctuation errors |
3 to >0 ptsPoor
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding |
|
5 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. |
| 5 to >4.0 ptsExcellent
Uses correct APA format with no errors |
4 to >3.5 ptsGood
Contains one or two APA format errors |
3.5 to >3.0 ptsFair
Contains three or four APA format errors |
3 to >0 ptsPoor
Contains many (five or more) APA format errors |
|
5 pts |
| Total Points: 100 |
