Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Dissociative amnesia: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis

Richard J Loewenstein, MD
Section Editor
David Spiegel, MD
Deputy Editor
Richard Hermann, MD


Dissociative amnesia is a potentially reversible memory impairment that primarily affects autobiographical memory [1-3]. In dissociative amnesia, the patient cannot recall important autobiographical information, usually of a traumatic or stressful nature, although more extensive memory loss may be reported.

Dissociative fugue, a subtype of dissociative amnesia in DSM-5 [3], is characterized by sudden unexpected travel or wandering in a dissociated state, with subsequent dissociative amnesia for the fugue episode, and often for some or all of the patient’s life history.

Dissociative amnesia and dissociative fugue (a subtype) are discussed here. Other dissociative disorders, including dissociative identity disorder, depersonalization disorder, and dissociative aspects of posttraumatic stress disorder, are discussed separately. (See "Dissociative identity disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis" and "Depersonalization/derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis" and "Psychotherapy of depersonalization/derealization disorder" and "Dissociative aspects of posttraumatic stress disorder: Epidemiology, clinical manifestations, assessment, and diagnosis".)


Autobiographical memory [1] – Episodes recollected from a person’s life, with a combination of episodic autobiographical memory and semantic autobiographical memory [4]. Autobiographical memory includes recall of cognitive, emotional, and motivational aspects of events.

Semantic memory — Memory of objects, facts, and concepts, including words and their meaning, such as learning the skill of reading

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Oct 2017. | This topic last updated: Feb 24, 2014.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
  1. Conway MA, Pleydell-Pearce CW. The construction of autobiographical memories in the self-memory system. Psychol Rev 2000; 107:261.
  2. Spiegel D, Loewenstein RJ, Lewis-Fernández R, et al. Dissociative disorders in DSM-5. Depress Anxiety 2011; 28:824.
  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington 2013.
  4. Kihlstrom JF. ‘So that we might have roses in December’: The functions of autobiographical memory. Appl Cogn Psychol 2009; 23:1179.
  5. Ross CA. Epidemiology of multiple personality disorder and dissociation. Psychiatr Clin North Am 1991; 14:503.
  6. Sar V, Akyüz G, Doğan O. Prevalence of dissociative disorders among women in the general population. Psychiatry Res 2007; 149:169.
  7. Foote B, Smolin Y, Kaplan M, et al. Prevalence of dissociative disorders in psychiatric outpatients. Am J Psychiatry 2006; 163:623.
  8. Ross C, Duffy C, Ellason JW. Prevalence, reliability, and validity of dissociative disorders in an inpatient setting. J Trauma 2002; 3:7.
  9. Waller NG, Ross CA. The prevalence and biometric structure of pathological dissociation in the general population: taxometric and behavior genetic findings. J Abnorm Psychol 1997; 106:499.
  10. Becker-Blease KA, Deater-Deckard K, Eley T, et al. A genetic analysis of individual differences in dissociative behaviors in childhood and adolescence. J Child Psychol Psychiatry 2004; 45:522.
  11. Jang KL, Paris J, Zweig-Frank H, Livesley WJ. Twin study of dissociative experience. J Nerv Ment Dis 1998; 186:345.
  12. Briere J, Elliott DM. Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women. Child Abuse Negl 2003; 27:1205.
  13. Pieper S, Out D, Bakermans-Kranenburg MJ, van Ijzendoorn MH. Behavioral and molecular genetics of dissociation: the role of the serotonin transporter gene promoter polymorphism (5-HTTLPR). J Trauma Stress 2011; 24:373.
  14. Lochner C, Seedat S, Hemmings SM, et al. Investigating the possible effects of trauma experiences and 5-HTT on the dissociative experiences of patients with OCD using path analysis and multiple regression. Neuropsychobiology 2007; 56:6.
  15. Loewenstein RJ. Psychogenic amnesia and psychogenic fugue: A comprehensive review. In: American Psychiatric Press Annual Review of Psychiatry, Tasman A, Goldfinger S (Eds), American Psychiatric Press, Washington, DC 1991. Vol 10, p.189.
  16. Loewenstein RJ. Diagnosis, epidemiology, clinical course, treatment, and cost effectiveness of treatment for dissociative disorders and multiple personality disorder: Report submitted to the Clinton administration task force on health care financing reform. Dissociation 1994; 7:3.
  17. Brown D, Scheflin AW, Hammond DC. Memory, Trauma, Treatment, and the Law, Norton and Company, New York City 1998.
  18. Dalenberg CJ, Palesh OG. Scientific progress and methodological issues in the study of recovered and false memories of trauma. In: The Hidden Epidemic: The Impact of Early Life Trauma on Health and Disease, Lanius RA, Vermetten E, Pain C (Eds), Cambridge University Press, Cambridge, UK 2010. p.225.
  19. Williams LM. Recall of childhood trauma: a prospective study of women's memories of child sexual abuse. J Consult Clin Psychol 1994; 62:1167.
  20. Elliott DM, Briere J. Posttraumatic stress associated with delayed recall of sexual abuse: a general population study. J Trauma Stress 1995; 8:629.
  21. Elliott DM. Traumatic events: prevalence and delayed recall in the general population. J Consult Clin Psychol 1997; 65:811.
  22. Briere J, Conte J. Self-reported amnesia for abuse in adults molested as children. J Trauma Stress 1993; 6:21.
  23. Christianson SA, Engelberg E. Remembering and forgetting traumatic experiences: A matter of survival. In: Recovered Memories and False Memories, Conway MA (Ed), Oxford University Press, Oxford 1997. p.230.
  24. Ross CA, Farley M, Schwartz HL. Dissociation among women in prostitution. Journal of Trauma Practice 2004; 2:199.
  25. Bremner JD, Southwick S, Brett E, et al. Dissociation and posttraumatic stress disorder in Vietnam combat veterans. Am J Psychiatry 1992; 149:328.
  26. Cardeña E, Spiegel D. Dissociative reactions to the San Francisco Bay Area earthquake of 1989. Am J Psychiatry 1993; 150:474.
  27. Koopman C, Classen C, Spiegel D. Predictors of posttraumatic stress symptoms among survivors of the Oakland/Berkeley, Calif., firestorm. Am J Psychiatry 1994; 151:888.
  28. Kuch K, Cox BJ. Symptoms of PTSD in 124 survivors of the Holocaust. Am J Psychiatry 1992; 149:337.
  29. Carlson EB, Rosser-Hogan R. Trauma experiences, posttraumatic stress, dissociation, and depression in Cambodian refugees. Am J Psychiatry 1991; 148:1548.
  30. Carlson EB, Rosser-Hogan R. Mental health status of Cambodian refugees ten years after leaving their homes. Am J Orthopsychiatry 1993; 63:223.
  31. van der Kolk BA, Fisler R. Dissociation and the fragmentary nature of traumatic memories: overview and exploratory study. J Trauma Stress 1995; 8:505.
  32. Sivers H, Schooler JW, Freyd JJ. Recovered memories. In: Encyclopedia of the Human Brain, Ramachandran VS (Ed), Elsevier Science, New York City 2002. p.169.
  33. Putnam FW, Helmers K, Horowitz LA, Trickett PK. Hypnotizability and dissociativity in sexually abused girls. Child Abuse Negl 1995; 19:645.
  34. Brewin CR. Remembering and forgetting. In: Handbook of PTSD: Science and Practice, Friedman MJ, Keane TM, Resick PA (Eds), Guilford Press, New York City 2007. p.116.
  35. Widom CS, Shepard RL. Accuracy of adult recollections of childhood victimization: Part 1. Childhood physical abuse. J Psychiatr Res 1996; 9:34.
  36. Widom CS, Morris S. Accuracy of adult recollections of childhood victimization: Part 2. Childhood sexual abuse. J Psychiatr Res 1997; 8:412.
  37. Sargant W, Slater E. Amnesic Syndromes in War: (Section of Psychiatry). Proc R Soc Med 1941; 34:757.
  38. Henderson JL, Moore M. The psychoneuroses of war. N Engl J Med 1944; 230:273.
  39. Trickett PK, McBride-Chang C, Putnam FW. The classroom performance and behavior of sexually abused females. Dev Psychopathol 1994; 6:183.
  40. FISHER C. Amnesic states in war neuroses; the psychogenesis of fugues. Psychoanal Q 1945; 14:437.
  41. Herman JL, Schatzow E. Recovery and verification of memories of childhood sexual trauma. Psychoanal Psychol 1987; 4:1.
  42. Edwards VJ, Fivush R, Anda RF, et al. Autobiographical memory disturbances in childhood abuse survivors. In: Trauma and Cognitive Science: A Meeting of Minds, Science, and Human Experience, Freyd JJ, DePrince AP (Eds), Howarth Press, Binghamton, NY 2001.
  43. Chu JA, Frey LM, Ganzel BL, Matthews JA. Memories of childhood abuse: dissociation, amnesia, and corroboration. Am J Psychiatry 1999; 156:749.
  44. Loftus EF. The reality of repressed memories. Am Psychol 1993; 48:518.
  45. Geraerts E, Schooler JW, Merckelbach H, et al. The reality of recovered memories: corroborating continuous and discontinuous memories of childhood sexual abuse. Psychol Sci 2007; 18:564.
  46. Myers CS. Contributions to the study of shell-shock. Lancet 1916; 65.
  47. Rivers HR. The repression of war experience. Lancet 1918; 173.
  48. Jung CG. The question of the therapeutic value of "abreaction". Br J Med Psychol 1921-1922; 2:15.
  49. Waelde LC, Silvern L, Fairbank JA. A taxometric investigation of dissociation in Vietnam veterans. J Trauma Stress 2005; 18:359.
  50. Futterman S, Pumpian-Mindlin E. Traumatic war neuroses five years later. Am J Psychiatry 1951; 107:401.
  51. Geraerts E, Schooler JW, Merckelbach H, et al. The reality of recovered memories: corroborating continuous and discontinuous memories of childhood sexual abuse. Psychol Sci 2007; 18:564.
  52. Kardiner A. The Traumatic Neuroses of War, Paul B. Hoeber, Inc, New York City 1941.
  53. Simeon D, Loewenstein RJ. Dissociative disorders. In: Comprehensive Textbook of Psychiatry, 9th ed, Sadock BJ, Sadock VA, Ruiz P (Eds), Kluwer/Lippincott Williams and Wilkens, Philadelphia 2009. p.1965.
  54. Barlow MR, Freyd JJ. Adaptive dissociation: Information processing and response to betrayal. In: Dissociation and the Dissociative Disorders: DSM-V and Beyond, Dell PF, O'Neil JA (Eds), Routledge Mental Health, New York City 2009. p.93.
  55. Freyd JJ. Betrayal Trauma: The Logic of Forgetting Childhood Abuse, Harvard University Press, Cambridge 1996.
  56. Stanilou A, Vitcu I, Markowitsch HJ. Neuroimaging and dissociative disorders. In: Advances in Brain Imaging, Chaudary V (Ed), InTech, Rijeka 2012.
  57. Markowitsch HJ, Kessler J, Weber-Luxenburger G, et al. Neuroimaging and behavioral correlates of recovery from mnestic block syndrome and other cognitive deteriorations. Neuropsychiatry Neuropsychol Behav Neurol 2000; 13:60.
  58. Kikuchi H, Fujii T, Abe N, et al. Memory repression: brain mechanisms underlying dissociative amnesia. J Cogn Neurosci 2010; 22:602.
  59. Hennig-Fast K, Meister F, Frodl T, et al. A case of persistent retrograde amnesia following a dissociative fugue: neuropsychological and neurofunctional underpinnings of loss of autobiographical memory and self-awareness. Neuropsychologia 2008; 46:2993.
  60. Mendelsohn A, Chalamish Y, Solomonovich A, Dudai Y. Mesmerizing memories: brain substrates of episodic memory suppression in posthypnotic amnesia. Neuron 2008; 57:159.
  61. Anderson MC, Ochsner KN, Kuhl B, et al. Neural systems underlying the suppression of unwanted memories. Science 2004; 303:232.
  62. Rapaport D. Emotions and memory, Lippincott Williams and Wilkins, Baltimore 1942.
  63. van der Hart O, Nijenhuis E. Generalized dissociative amnesia: episodic, semantic and procedural memories lost and found. Aust N Z J Psychiatry 2001; 35:589.
  64. Rubin DC, Wetzler SE, Nebes RD. Autobiographical memory across the lifespan. In: Autobiographical Memory, Rubin DC (Ed), Cambridge University Press, Cambridge 1986. p.202.
  65. Dalenberg C. Recovered memory and the Daubert criteria: recovered memory as professionally tested, peer reviewed, and accepted in the relevant scientific community. Trauma Violence Abuse 2006; 7:274.
  66. Coons PM, Millstein V. Psychogenic amnesia: A clinical investigation of 25 cases. Dissociation 1992; 5:73.
  67. Kritchevsky M, Chang J, Squire LR. Functional amnesia: clinical description and neuropsychological profile of 10 cases. Learn Mem 2004; 11:213.
  68. van der Kolk BA, Pelcovitz D, Roth S, et al. Dissociation, somatization, and affect dysregulation: the complexity of adaptation of trauma. Am J Psychiatry 1996; 153:83.
  69. Treating Complex Traumatic Stress Disorders: An Evidence-Based Guide, Courtois CA, Ford JD (Eds), Guilford Press, New York City Vol 2009.
  70. Kessler RC, Demler O, Frank RG, et al. Prevalence and treatment of mental disorders, 1990 to 2003. N Engl J Med 2005; 352:2515.
  71. Green JG, McLaughlin KA, Berglund PA, et al. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry 2010; 67:113.
  72. McLaughlin KA, Green JG, Gruber MJ, et al. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders. Arch Gen Psychiatry 2010; 67:124.
  73. Kessler RC. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry 2000; 61 Suppl 5:4.
  74. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998; 14:245.
  75. Felitti VJ, Anda RF. The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders and sexual behavior. In: The Hidden Epidemic: The Impact of Early Life Trauma on Health and Disease, Lanius RA, Vermetten E, Pain C (Eds), Cambridge University Press, Cambridge, UK 2010. p.77.
  76. Brown DW, Anda RF, Edwards VJ, et al. Adverse childhood experiences and childhood autobiographical memory disturbance. Child Abuse Negl 2007; 31:961.
  77. Edwards VJ, Fivush R, Anda RF. Autobiographical memory disturbances in dhildhood abuse survivors. J Aggress Maltreat Trauma 2001; 4:247.
  78. Frankel AS, Dalenberg C. The forensic evaluation of dissociation and persons diagnosed with dissociative identity disorder: searching for convergence. Psychiatr Clin North Am 2006; 29:169.
  79. Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis 1986; 174:727.
  80. Dalenberg C & Carlson E. New versions of the Dissociative Experiences Scale: The DES-R (Revised) and the DES-B (Brief). Paper presented at Annual Meeting of the International Society, November 2010.
  81. Putnam FW. Dissociation in Children and Adolescents: A Developmental Model, Guilford Press, New York City 1997.
  82. Loewenstein RJ. Dissociative amnesia and dissociative fugue. In: Handbook of Dissociation, 2nd ed, Michaelson W, Ray HR (Eds), Plenum Press, New York City 1996. p.307.
  83. Loewenstein RJ.. Treatment of Dissociative Amnesia. In: Gabbard's Treatment of Psychiatric Disorders, 5th ed, Gabbard GO (Ed), American Psychiatric Publishing, Washington DC 2013.
  84. Cloitre M, Stovall-McClough KC, Nooner K, et al. Treatment for PTSD related to childhood abuse: a randomized controlled trial. Am J Psychiatry 2010; 167:915.
  85. International Society for the Study of Trauma and Dissociation. Guidelines for treating dissociative identity disorder in adults, third revision. J Trauma Dissociation 2011; 12:115.
  86. Loewenstein RJ. An office mental status examination for complex chronic dissociative symptoms and multiple personality disorder. Psychiatr Clin North Am 1991; 14:567.
  87. Simeon D, Guralnik O, Schmeidler J, et al. The role of childhood interpersonal trauma in depersonalization disorder. Am J Psychiatry 2001; 158:1027.
  88. Ruedrich SL, Chu CC, Wadle CV. The amytal interview in the treatment of psychogenic amnesia. Hosp Community Psychiatry 1985; 36:1045.
  89. Kopelman MD. Crime and amnesia: A review. Behav Sci Law 1987; 5:323.
  90. Wiggins E, Brandt J. The detection of simulated amnesia. Law Hum Behav 1988; 12:57.
  91. KIERSCH TA. Amnesia: a clinical study of ninety-eight cases. Am J Psychiatry 1962; 119:57.