1699 – Long Lasting Personality Changes After The Onset Of Dissociative Amnesia

Abstract

Introduction

Across various cultures, dissociative amnesia is triggered by psychological stress or trauma. Its hallmark is a severe (usually retrograde) memory impairment, occurring without evidence of significant brain damage (as detected by conventional structural brain imaging). In a substantial number of cases, the memory impairment follows a chronic course. Sometimes dissociative amnesia occurs on a background of a personality disorder (narcissistic or borderline). Other times, amnesia itself triggers long lasting personality changes.

Objectives

This work’s objectives are establishing greater recognition among health care providers of the spectrum of the personality changes that may accompany chronic forms of dissociative amnesia.

Aims

We review data from own patients with chronic forms of dissociative amnesia.

Methods

Patients were investigated medically, psychiatrically, neuropsychologically and and neuroradiologically.

Results

Changes in personality dimensions occur after the onset of amnesia. These may involve affectivity, perception (e.g. impaired self face or face-emotion processing), cognition (e.g. social cognition) and behaviour (e.g. changing in eating, smoking, drinking or working habits).

Conclusions

The observed personality changes may represent a consequence of amnesia. Functional imaging studies show metabolic changes in dissociative amnesia in brain areas involved in conscious mnemonic processing. Several structures engaged in processing within episodic-autobiographical memory system were also implicated in self and reward-related processing. Alternatively, the personality changes may be viewed as being pivotal in the development and maintenance of dissociative amnesia; this personality shift may subsequently lead to enduring changes in ways of cognitive processing, self-processing, perception and affect.