Preliminary draft DSM-5 released

Post Reply New Topic

Well, no one is arguing that having only one friend means one is autistic. Only that having one friend doesn't mean one isn't autistic.

That does not really make sense. If they mean plural to exclude people on the basis of the age of a single friend or a spouse, then what do different types of relationships have to do with anything? They could easily cover the kind of relationships you refer to by referring to "non-casual, voluntary social relationships". There are any number of ways the information could be conveyed without confusing the issue as this presentation does, if a single friendship or marriage-like relationship were intended to exclude a person from diagnosis.


If they can socialize fine with others (if they therefore choose to not develop and maintain relationships, rather than fail to do so) then they are not who the criteria refers to.

If your interpretation is correct, under this criteria, someone can be Autistic one day, not Autistic for a year, then when the one friend who will put up with them moves away, or dies, or stops putting up with them, they become Autistic again, even though Autism is construed as a stable developmental condition, (or in other words a condition that is not considered to be intermittent). I do not believe APA intends Autism diagnosis to be a potentially intermittent entity, determined by circumstantial factors rather than the functioning of the individual assessed.

There's various types of peer relationships people can have as they age; there's friends and the different types of such and there's romantic partners and the different types of such that come under here, both of which are the big ones and they come under the plural "relationships".

I've been doing some research, seeing how various professionals on the 'net interpret this criterion in the old DSM-IV-TR, and they say that it's a complete lack of social relationships/relations due to the difficulties of the ASD.

The DSM-IV-TR puts it as:

That's its complete description. It's hard to interpret, but I'm seeing an inability to develop such here ("lack of understanding" leads on to the social isolation that it describes elsewhere).

True. I wasn't told what they used to diagnose me with.

Definitely.

I was at my monthly meeting with the psych today. (I have to go once a month if I want the anxiety meds). I asked if I would still be diagnosed under the new criteria seeing that I am married. He said absolutely yes.

He hypothetically pointed out just becuase one is married, it doesn't mean ones relationship is appropriate at the proper developement level. For example, people get married for a whole host of reasons. Marriages of convienence, marriages because someone got pregnant, pre-arranged marriages (I work with someone who is in a pre-arranged marriage), mail-order brides (my brother has one of those), gold-diggers, Countless number of marriages have absolutely no relationship, but they stay together for the kids. His point was just becuase one is married, it doesn't mean it is at the appropriate developement level. People are married for allot of reasons other than relationships.

He also pointed (which I think was directed at me. I wish he'd use my name so I'd know for sure.) That even if you have an appropriate relationship in your marriage, you've never had one male friend in your 41 years of your life and that is developementaly inappropriate. Its not that I haven't tried or desired one, I just can't figure it out.

I think they are talking about Elvis.

OT- but I can't resist it:

someone said "slicing up meatloaf". meatloaf is a singer (who incidentally kinda looks like a meatloaf) it'd be cruel to slice him up.

To return to the other discussion all I can say is that the psychologist and neuropsychiatrist who diagnosed me considered me a clear case even though I've had boyfriends, a few friends when I was younger and now a husband and kids (the husband is hardly age appropriate though). I also have one friend I see on a regular basis but we usually talk mostly about autism.

I trust these diagnosticians, they're at the top of their field, alongside Gillberg, in Sweden.

Yeah, not having a single male friend your whole life, but having a spouse [who's most likely a perfect match], isn't "appropriate" if such is a direct result of your ASD.

When all of the other things are there too (lack of nonverbal cues, problems with communication, lack of social reciprocity and the restricted/repetitive behaviours/interests), bingo, ASD.

I think the objections explained at
AANE Position Paper on DSM-5
by the Aspergers Association of New England (AANE) give a succinct and comprehensive argument as to why it is wrongheaded to drop the Asperger's Syndrome diagnosis.

It would appear that the DSM-5 may be a useful tool to the shrinks who try to manage cases. However dropping the asperger's syndrome diagnosis matches very well with a point of George Orwell's "Newspeak" in his novel "1984"; namely: "it is very difficult to understand or deal with a topic until it has a name". This was the history of Asperger's prior to 1994 and with DSM 5 it probably will be again. "Asperger's Syndrome" is a very useful term to patients, families and clinicians, teachers etc. as AANE's article points out.

What is to become of organizations like AANE are they going to have to change their name to "DSM-5 blah blah blah blah etc. etc. Association of New England"? As AANE so concisely points out,

Can somebody give specific examples of "Marked deficits in nonverbal and verbal communication used for social interaction"?

i wish they would start thinking a bit less black and white and put it this way:
Marked deficits in nonverbal and/or verbal communication used for social interaction

persistent is good, but it evolves as we learn. it IS persistent i agree, but not fixed and set in stone.
anyway i like that they added the sensory stuff. it's still an NT point of view because the word stereotyped is a bit silly, there are reasons behind everything and we are not mindless robots who adopt silly routines for no reason, it seems they mix up ocd and autism a bit still.( repetitive behaviours).
the : Failure to develop and maintain peer relationships appropriate to developmental level one is good but would benefit the and/or too. i can't develop relationships very well, but my son can. they just never last more than a month ever.
well i still fit it.
but it seems a bit short....

non verbal: forgetting to smile, not looking in people's eyes the appropriate way, forgetting to move your hands to underline what you're speaking of ( i never do that...) , things like that
verbal: not being able to stay engaged in a conversation that is very boring to you ( oh, mh mh, you bought a pair of shoes....ok) in a way that makes the person feel friendly towards you i guess, or going on scripted rants ( about a special interest or just something you really know a lot about) not letting people finish their sentences if you already know what they're going to say next and upsetting them by answering before it's your time to speak,,not knowing what to say if you have never previously thought about the subject a person starts talking about. i suppose i may be wrong about the verbal ones, if they mean "eloquency"or "vocabulary"then i do not fit it, but as they included "social interaction"i might be right.

Thanks, that is helpful.

I sometimes use my hands too much, so that I notice people looking at my hands with a sort of... disgust? Fascination? And then I try to stop using my hands.

I guess that would not be a strictly autistic thing, would it?

I used to do that a lot when I was in kindergarten and I was always trying to lecture other kids about my special interests. Now I rarely give "uninvited" lectures, but when somebody asks me a question about a special interest, my oh my...

I do that a lot, and have to restrain myself to avoid doing it.

Well, then, those who think it's a useful distinction should keep using the name. But it really doesn't belong as a separate diagnosis in DSM when it doesn't have diagnostic criteria that actually distinguish it. Or maybe those (the professionals) who use the diagnosis need to come up with better diagnostic criteria.

There's also, though, the argument so many people with Asperger's make. That it's not a disorder. They are, in essence, arguing that it doesn't belong in DSM. DSM labels disorders. It doesn't label variations that aren't disorders.

Ridiculous. Those that argue that Asperger's is not a disorder are those with Asperger's that are simply less impaired. The very fact that a person is evaluated and diagnosed means SOMETHING brought that person to the attention of parents, school administrators or other people. It's not like categorizing people by eye color. The system, for all its flaws, doesn't randomly snatch people and put them through diagnostics just to slap a label on them. There has to be some indication that an evaluation is even needed before the expense will be incurred.

By insisting it's "not a problem", those with Asperger's that function well enough that a "cure" is not necessary are doing a disservice to those on the spectrum that actually ARE struggling. Just because it's going great for them doesn't make it so for a large number of others. Additionally, how many Aspies would not be doing so great if it were not for the identification of Asperger's, early intervention and the targeted education in life skills.

At least one thing is for certain, ego is intact with Aspies.

Get over it. Asperger's is a neurological variant that causes problems. A sub set of those with Asperger's are able to adapt very well and live very fulfilling lives. And there is a subset of Aspies that struggle every day.