Characterized by a lack of consistency in sense of self and sense of agency, the patient exhibits disruption in consciousness, memory, perception, cognition, normal behavior as well as their sensory-motor functioning. Dissociative disorder's symptoms are mostly experienced after occurrence of trauma. Individuals experience either embarrassment or confusion about these symptoms and often attempt to hide them from their peers or associates. They are, therefore, fully aware of the change in attitude and normality in their activity.
DSM-5 defines Dissociative disorders apart from trauma and stressor-related disorders because they are long-term as opposed to the immediate symptoms that define trauma and stressor-related disorders (such as post-traumatic stress disorders and acute stress disorders). Elwood's case involves a ten-year span of experiencing symptoms of discontinuity in normal activity and the urge to focus and improve his life. Contrary to widely acceptable myths in society, these long-term symptoms are not a normal disruption. Some religions and cultures tend to accommodate this disturbance asserting that it is a normal phenomenon. Moreover, the symptoms are not due to physiological effects such as drug use and black-outs or any other medical condition such as seizures.
Patients with Dissociative disorders exhibit a lack of discontinuity in their normal routines and acceptable sense of consciousness to their immediate environment. The disruption of their consistency to engage and integrate with their normal lives as before affects their emotion, perception and body representation. Elwood fails to completely work efficiently as a normal taxi-driver. According to Donna, her 6 year old girlfriend, he has shown (and admits) to laziness and lack of focus in his work. Although he works late, he does not seem to have enough rest from his long hours of sleep. DSM-5 reveals that a lack of awareness to the vitality of situations (such as Elwood's job) leads to in-activeness in an individual's behavior and activities in their normal routines.
According the DSM-5, patients experiencing detachment from their mind, self or body fail to accept and address the reality around them appropriately. This leads to straining relationships with family, spouses and business associates or customers. Individuals either exhibit depersonalization or de-realization of their environment or company consequently affecting their social lives. Elwood is not interested in attending social events and participating actively in public activities. Instead, he prefers to stay in his house and watch TV for long hours. When at times he attends social events with a few friends, he acts normally and participates in the interactive activities such as drinking and smoking. However, he is careful and neither ready nor interested in completely getting involved to the extreme or intoxicate himself. According to Donna, staying alone to watch TV is his favorite activity and more important than going public and associating with friends.
Elwood's life is at danger of stagnation as he has put his ambitions at rest. Donna's fears are justified since Elwood may no longer make any more use of his life despite his potential and talents. He exhibits lack of energy and self-drive leading to his lazy habits and preferences such as watching TV. The Dissociative identity disorder is characterized by this impairment in social and occupational functioning. Although Elwood fails to acknowledge that he is a moody person, the 39-year old is not in full control of his emotions.
Criteria A focuses on the identification of the presence of either multiple distinct personality states or experiences of possession that affect the normal functioning of an individual. This is the most reliable criteria in DSM-5 determination or a Dissociative disorder. Other criterion is based on religious and cultural practices.