DSM change justified due to pandemic of AS misdiagnosis
Could you please define "major impairment"? I think you'll find a great many different views on that subject from just those who have posted in this thread alone.
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daydreamer84
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Well, here's the Merriam Webster definition of impair:: "to damage or make worse by or as if by diminishing in some material respect "LINK. Severe is defined in this respect as "of a great degree"
LINK2
So your social interaction should be damaged or diminished to a great degree. It's somewhat sujective exactly what that would translate to in real life. I wouldn't call something like being married for many years (and having a relationship that will probably hold together despite problems and fighting)and having a few friends and holding down a job for many years with occasional problems due to social awkwardness or misunderstanding damaged or diminished to a great degree, for example.
Last edited by daydreamer84 on 15 Jun 2013, 3:06 pm, edited 1 time in total.
Hmmmm, that's still going to cover a great deal of territory.
It would be much easier to base the DX on repeatable indications of communication and processing differences.
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daydreamer84
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Hmmmm, that's still going to cover a great deal of territory.
It would be much easier to base the DX on repeatable indications of communication and processing differences.
No, it is....but those communication and processing differences have to cause major impairment. Flat affect and taking things literally to a degree that these traits cause you major problems at work or in getting a job and with social life/relationships , for example. Otherwise a professor with a bit of a flat voice and face and occasionally takes things literally whose been in a good marriage for 20 years with 3 children who he has good relationships with who has no problem with all the interaction his job requires, for example, could be diagnosed. I don't think someone like that has a disorder and needs to be diagnosed.
Last edited by daydreamer84 on 15 Jun 2013, 3:11 pm, edited 1 time in total.
Hmmmm, that's still going to cover a great deal of territory.
It would be much easier to base the DX on repeatable indications of communication and processing differences.
No, it is....but those communication and processing differences have to cause major impairment. Flat affect and taking things literally to a degree that these traits cause you major problems at work or in getting a job and with social life/relationships , for example. Otherwise a professor with a bi of a flat voice and face and occasionally takes things literally whose been in a good marriage for 20 years with 3 children who he has good relationships with who has no problem with all the interaction his job requires. I don't think someone like that has a disorder and needs to be diagnosed.
Is the professor any less on the spectrum?
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daydreamer84
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Hmmmm, that's still going to cover a great deal of territory.
It would be much easier to base the DX on repeatable indications of communication and processing differences.
No, it is....but those communication and processing differences have to cause major impairment. Flat affect and taking things literally to a degree that these traits cause you major problems at work or in getting a job and with social life/relationships , for example. Otherwise a professor with a bi of a flat voice and face and occasionally takes things literally whose been in a good marriage for 20 years with 3 children who he has good relationships with who has no problem with all the interaction his job requires. I don't think someone like that has a disorder and needs to be diagnosed.
Is the professor any less on the spectrum?
Yes, he's on the very edge of the spectrum fading into normality with some genes and some of the traits. If it's a polygenic disorder then some people will necessarily have some of the genes and manifest some of the phenotype without having the full disorder. He should just be aware that he might have a greater chance of having an autstic child. He may even benifit from some techniques autsitic people use to deal with their issues (like learning some body language and prosody explicitly) but he doesn't need benefits and accommodations -he;s already doing okay and he's IS definitely less autstic than someone who meets the criteria.
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@DayDreamer84: Well you clearly didn't read the content of my posts then. Because you identify with the OP in your specific experience you are agreeing with her wholeheartedly - as if this is some exclusive club that only those as close as possible to rain man can join. Another narrow view, failing to realise that everyone has different life circumstances and supports, different parental approach (such as denial vs proactive) meaning some got a diagnosis some didn't and a whole host of other factors.
Roll on the time when you will be proven wrong by cross-disciplinary, holistic assessment and diagnosis, such as that advocated by the NIMH. Once you see that the same genetics and brain wiring exist in two apparently differently presenting autistic individuals, leading to subjectively different opinions on both from people such as yourself, you will realise how narrow and bigoted your view is.
Hope you have a large cloth for all the egg you will have on your face when that time comes.
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Last edited by whirlingmind on 15 Jun 2013, 5:20 pm, edited 1 time in total.
Verdandi
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[opinion=mine]
The change may be partly due to the multitude of poseurs who self-diagnose.
[/opinion]
Pretty sure these "poseurs" don't actually exist, especially not as a multitude.
Seriously, what would people get out of pretending to be autistic that would be so appealing?
What an interesting thread. People diagnosed with Aspergers wanting to exclude others from being diagnosed because they are not suffering enough. I don't get it.
whirlingmind - Your point above is very valid. I think there are a variety of things that can help Aspies more successfully cope in the world. And, perhaps, ultimately, this is what this discussion is all about. Why have some Aspies failed completely to cope in the world. If you read Dr. Temple Grandin’s books, it seems like this is a major theme. That HFAs/Aspies need to learn how to cope in the world. After all, what is the alternative?
Perhaps...
[opinion=mine]
A sense of belonging to a community of like-minded individuals.
An excuse to (sometimes*) get away with behaving like arrogant, ignorant jackasses.
The ability to (sometimes*) inspire "normals" to leave them alone.
Preferential treatment (sometimes*) and concessions in hiring, education, and social situations.
*By "sometimes", I mean that it may occur more often for those who've come out as autistic, than if they'd not come out at all.
[/opinion]
Let’s say the self-diagnosed person has some symptoms, but does not have Aspergers/HFA. Then, what? Maybe they have an Axis 2 personality disorder (say, Schizoid, Avoidant, OCPD, whatever).
By claiming they have Aspergers (a non-treatable neurological disorder), said person does not need to take any action. It’s almost like “the easy way out”. When, in fact, said person probably should be doing something to treat the situation (medication, therapy, etc.).
Please note, I do realize that there are a number of people with Aspergers/HFA who are on medication and undergo therapy. I am also not talking about children here.
I don't understand why Asperger's or autism is so cool. As Temple Grandin wrote, people should focus on the issues a person has, not the label. If someone can identify with AS because they share the same issues we have, why does it need to be Asperger's? If they happen to not have it and they had something else, why must it be Asperger's? Isn't another label good enough? This is what it seems like to me from over the years I have been here.
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Leaving aside DSM-5 for a moment, are you advocating a position where if someone is "doing okay", they are "not autistic"?
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Asperger's was or is not a mild disorder that shouldn't always need diagnosing, there will be more or less severity on either end of the spectrum, to me anyway.
When I was diagnosed, I never realised I was significantly affected to begin with, but I was, the diagnosis wasn't a simple tick box by any means but a long 6 months of discussions.
There still has to be a significant impairment with life I do agree. It just can't just be social interaction, but also the ability and function for independence. With my diagnosis, I'm classed as a dependent and vulnerable adult that could need care for the rest of my life.
Just opinions, but sensory problems should need to be bad enough to cause physical and psychological inabilities, Im perhaps basing a little bit too much on my own diagnosis though...
Best of advice... Avoid Tumblr's "Coming of of my Asperger self diagnosis/no one believes me" etc type rants, a lot of those are non-sense at best.
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daydreamer84
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Leaving aside DSM-5 for a moment, are you advocating a position where if someone is "doing okay", they are "not autistic"?
Well "doing okay" could mean many things. I would never advocate that an autistic person who lives at home and is supported by his parents as an adult and has no friends or relationship but is happy and enjoying his time pursuing his special interests and is okay financially because his parents have a lot of money is not autistic because he's okay. What I meant by saying that my hypothetical professor is "doing okay" is that he is maintaining a marriage , relationships with his children and professional relationships with co-workers enough to keep a job for many many years. My hypothetical prof has some issues with socializing with his peers but not enough to put his job or marriage in any serious danger and this is WITHOUT any support or accommodation. That is not a severe impairment in social interaction. Without a severe impairment in social interaction he (hypothetical prof) is not autistic although he may have some autistic traits.
If a person can maintain relationships up to the level expected in this society for their age/developmental level and a job WITHOUT support or accommodation of any kind, he or she is not autistic. Autism is defined by a severe impairment in social interaction and RRB's causing severe impairment in a person's life. Without that impairment a person is not autistic.