Whoops, wrong diagnosis. Autism vs Schizotypal

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06 May 2010, 7:40 pm

Hey, everybody. So, since I have a deep and abiding love for psychology, I was doing my usually bi-monthly rounds of attempting to memorize the DSM-IV (buckets! The new one is coming out. Every time I get a new toy it becomes obsolete. Stupid technology) and (re)found "Schizotypal Disorder." I was only diagnosed with AS this past November, and, well, I think it's wrong. I mean, I went to the psychiatrist specifically for my diagnosis of AS after my older brother had be diagnosed only a couple of months before, and I convinced him easily enough that I was an aspie, and he diagnosed me the same day (peculiar, eh?).

I'm not going to go through all of the list of symptoms and bore everyone to death, but after a lot of research and a lengthy discussion with my aspie brother, we both came to the conclusion that I fit the criteria of Schizotypal much closer than any autism spectrum disorder. It is also believe that "schizo" disorders are also on a spectrum, much like autism--schizophrenia being the "Kanner's" and schizotypal being the "Asperger's" of the schizophrenia spectrum. It is believed that autism and schizophrenia not only share the same genetic pre-disposition, but also are on opposite ends of a single spectrum (Kanners--HFA--Asperger's--NVLD--Nuerotypical--Schizotypal--Schizophrenia, etc.).

My brother claims that as he gets older, he gets more normal, whereas the older I get, the weirder I get (more paranoia, intense illusions, peculiar beliefs). Researching this and coming to terms with it over the past 36 hours or so has really cleared up a lot of the inconsistencies of my AS diagnosis. What I always couldn't understand was the ways of thinking according to Temple Grandin. I didn't relate to any of the ones she has listed, and all I could think was, I think psychically, which is more often seen in schizotypals than autists due to "magical thinking." It also turns out that hallucinations are not normal (why didn't anyone tell me?).

So, I guess what I'm saying is, well, it was nice pretending to be an aspie, and to float around on these forums, but the truth is I'm not one, at least I don't think so anymore. I'm just flat-out nuts.

But, thanks for everything, and good luck!


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Chronos
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06 May 2010, 8:19 pm

Usually schizophrenia is associated with certain structural changes in the brain. I don't believe these same changes have been observed in AS or ASD.

Having schiozophrenia excludes one for a diagnosis of AS, however, because the prodrome of schizophrenia can very much resemble AS.

I do have a friend who was initially diagnosed as having AS and turned out to have schizophrenia unfortunately.



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06 May 2010, 8:33 pm

Sounds like you're on the right track now. Good luck to you too.


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06 May 2010, 8:40 pm

Pretty much everything you said here confirms my own thoughts about Schizotypal PD. I have been Dx-ed with it myself on four out the five neuropsych evals i've had. I was told I fit the general NVLD pattern and thus (since NVLD is not a formal Dx) was Dx-ed with LD-NOS or Mathematics Disorder on Axis-I and Schizotypal on Axis-II.

I have to wonder if I would've been Dx-ed with schizotypal had I received an official Asperger's Dx though.

Considering what is said about the diagnostic criteria for schizotypal in the DSM-IV, I suspect not.

"Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder and is not due to the direct physiological effects of a general medical condition"


Considering some of the features associated with it , i've also considered Simple Schizophrenia as a possible Dx for me.



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07 May 2010, 2:27 am

I went to back to the neurologist today. We talked about my symptoms and diagnosis. I was previously diagnosed with aspergers along with schizoaffective. However I didn't quite match the defination of schizoaffective because my psychotic symptoms are mild and i do not have classic bipolar symptoms. I more have rapid-cycling episodes of a manic/dissociative state and a pessimistic/narcissistic state as well as episodes of disorganized behaviour and several other states of mind. I told her about autistic catatonia and she agreed that seemed more accurate however I also have unusual preceptions, unusual episodes and odd thinking not normally seen in autistic catatonia so I actually have more of a mix of catatonic and schizotypal features that almost mimic schizoaffective. My parkinsonian hand tremors which occured previously before I ever took medications was a dead giveaway that I had catatonic features associated with aspergers. They changed my diagnosis back to my previous Aspergers/ADHD/Schizotypal/Dyslexia diagnosis but added catatonic features to aspergers and affective features associated to schizotypy. Also adhd is more common in autism while dyslexia is more ommon in schizophrenia. This makes more since to me because my father seems to have traits of aspergers/adhd as well as several other family members on my fathers side having autistic related symptoms such as adhd, ocd, tourettes, and likely undiagnosed aspergers. My mother however is obviously severely dyslexic, has manic episodes, and hallucinations. I agree with the theory that autism and schizophrenia are opposite disorders but that doesnt mean they cant co-occur with the right match of genes. In order to receive an autism/psychosis diagnosis they cant be explained by each other and overlapping symptoms such as negative symptoms and catatonia do not count for diagnosis. I think its what gives me creativity with my music composing and original ideas. I see it more of a gift than a disability and I like that I think differant from most people. I also have an unrelated subarachnoid cyst which is likely responsible for my sleep disorder. The sleep disorder is probablly the most disabling symptom I have. I feel I would be much more productive without it.



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07 May 2010, 2:44 am

I'm curious:

Can you give an example of this "odd thinking"?



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07 May 2010, 7:55 am

Chronos wrote:
I'm curious:

Can you give an example of this "odd thinking"?


Not really, because I haven't lived in anyone else's brain so I can't tell you exactly what is odd and what isn't in here...I have been told that I think oddly, though. I guess the best example I can come up with is the fact that I have been looking for the security camera in my neighbor's apartment for the past week and a half. Does he have a security camera? Nope. I'm just one paranoid mofo.


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07 May 2010, 7:55 am

Chronos wrote:
I'm curious:

Can you give an example of this "odd thinking"?


Not really, because I haven't lived in anyone else's brain so I can't tell you exactly what is odd and what isn't in here...I have been told that I think oddly, though. I guess the best example I can come up with is the fact that I have been looking for the security camera in my neighbor's apartment for the past week and a half. Does he have a security camera? Nope. I'm just one paranoid mofo.


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07 May 2010, 8:02 am

Ive always requested to have copies of my papers of what is written about me from the doctors. Not only psychological reports but also medical reports such as blood work because it can be useful to review what is written about you and to do your own research. Ive always realized i do think differantly than other people, however i dont think of it as a bad thing. From what I've learned from what doctors have written comments about me I appear differantly to them as I do to myself and I do not agree with how I am interperted, but at the same time I think about what Im doing because I have no idea what is approperiate sometimes although I am good at guessing what might be. I susspose I think differantly from other people because I have ideas that nobody else seems to think of. Its more of creative thinking, but psychologists will label it as being "odd". I realize that most people do not agree with my theories so I do not talk about them to people I dont know very often anymore because they do not understand the points I try to make. I used to talk about my beliefs all the time because they strongly intrested me and I wanted to share what I had discovered but after doing so i came to realize that it makes people think that you are being crazy. I susspose that most people with autism spectrum disorders do in fact think differantly than other people. I susspose that wasnt what I meant to mention. I do have trouble keeping my thoughts in order sometimes but not quite as bad as someone with full on disorganized schizophrenia although I go through short phases where i randomly cannot think a coherant thought for a while. These phases do not seem to be stress induced and i have been unable to notice any pattern to them. That's more what I was mentioning although what psychologists have mentioned as odd thinking is probablly a referance to my personal beliefs which I feel should not be classified as a symptom becuase it is simply being more creative and without new ideas, nothing would get done. I actually think of all kinds of things but i am able to determine which thoughts are more logical that ones that arent and seperate what doesnt make sense from what does make sense although there have been times where this took some time. I suspose I will give an example of one time I had an illogical idea and caught myself. A few weeks ago I parked in a parking lot and upon leaving my car I realized the other cars had parking passes. There was no sign stating that I needed a parking pass so I decided to ignore the rule because it would be their fault if they gave me a ticket for it. By the time I had entered the building of where I was at I had become incredibally angry that they were going to give me a ticket for parking where they didnt have a sign. I started coming up with a plan for how I was going to get revenge for my ticket I would get because I felt I would show them not to mess with me. I even felt like attacking people in the building for setting me up. By the time I got back to my car I was almost looking foward to revenge and then I noticed that I never even got a ticket while I was gone and I might not have needed a parking pass anyways to begin with at those hours. I came to my senses and realized what I was thinking didnt make much sense yet I could remember it seeming like a perfectly reasonable excuse to get revenge. I am not sure if things like this are delusional. I imagine their not because I get over these thoughts with time. I have also done things such as last week my friend gave me $3 to go to the store and get her an energy drink. I had what seemed like a thought from an outside source tell me to buy a $3 scratch ticket with the money because I would win for sure so I spent it on a scratch ticket instead and I could still buy the soda and my friend would be happy because I would also be able to buy a few sodas. Upon scratching the ticket I won my money back so I figured maybe I was susposed to buy the next ticket after that one so I did. I ended up losing and had to go home without the soda or the money and explain why I came back with nothing. These are not the same as what I was talking about creative ideas. My creative ideas are more along the lines of my personal belief on how the multiverse and what we know as reality works. It would take me hours to explain my life theories and nobody has ever understood before anyways so I wont get into that for now.



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07 May 2010, 8:11 am

My eldest has Asperger's, ADHD and bi-polar. He's had to stop taking meds for the ADHD because it was causing him to have bi-polar mood cycles. He seems more schizophrenic to me, but after several long talks with his Psychiatrist, and teachers it's clear he's not. His impulse control is reduced and some of the odd stuff going on is due more to his ADHD. I will say that he is very centered despite all that he has going on. He has visual disturbances but is very matter of fact about them. He's extremely well grounded in the real world.



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07 May 2010, 8:12 am

I'd like to see a brief list of the deciding factors that can be used to differentiate between the two conditions. I've seen bits of diagnostic protocols for stuff beginning with schizo and they're horribly similar to AS.

But I'd be wary of officially switching labels if I began to think I was schizo. No doubt my GP would be offering me dodgy pharmaceuticals immediately. In some ways I have yet to be convinced that schizo anything really exists........I was brought up in the time of R.D.Laing who reckoned there were as many definitions of schizophrenic as there were psychiatrists.



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07 May 2010, 8:13 am

A woman gives birth to a child that she later abuses.

That child grows up to be an emotional train wreck who leaves a series of self-destructed relationships in their wake.

Why did the woman abuse the child in the first place?



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07 May 2010, 8:42 am

it is estimated that 17% of people with autism spectrum disorders develop catatonic features in their teens. This can resemble certain types of schizophrenia. The symptoms for autistic catatonia are.

a. increased slowness affecting movements and verbal responses
b. difficulty in initiating and completing actions
c. increased reliance on physical or verbal prompting by others
d. increased passivity and apparent lack of motivation
e. reversal of day and night
f. Parkinsonian features: tremor, eyerolling, dystonia, odd stiff posture, freezing in postures, etc.
g. excitement and agitation
h. increase in repetitive, ritualistic behaviour

Last month my neurologist perscribed me anti-parkinsonian medications which made my symptoms horribly worse. I brought up autistic catatonia this time and she agreed I seem to have a mild form of it. I noticed in myself the last 4 symptoms, however the first 4 I had more as a teenager/early 20's and then they are not as serious anymore. It seemed to develop around 16, become severe by 20 and then settle back down to mild symptoms. I would say around 20 was when I felt my functioning level was at my hardest point in life and I was unable to function well at all although these symptoms were only a portion of what I was expierancing. abilify seems to work well for these symptoms minus the tremors, although I have heard people say that autistic catatonia does not respond well to antipsychotics. I susspose everyone is going to respond differantly though.



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07 May 2010, 9:00 am

A woman gives birth to a child that she later abuses.
That child grows up to be an emotional train wreck who leaves a series of self-destructed relationships in their wake.
Why did the woman abuse the child in the first place?

This is probablly a psychological trick quesiton but I like trying to figure these out. Most people would probablly guess that the woman was abused herself, however I think it takes more than that to abuse children. Im going to guess she was thinking that the child would grow up to kill the father for not being there for them. However it would be more logical for the child to kill the mother for putting them through the abuse. On another note child abuse is one thing I feel strongly against. I have known people who were abused as children and ptsd seems to be much worse than having any genetic disorder.



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07 May 2010, 9:03 am

heliocopters wrote:
Chronos wrote:
I'm curious:

Can you give an example of this "odd thinking"?


Not really, because I haven't lived in anyone else's brain so I can't tell you exactly what is odd and what isn't in here...I have been told that I think oddly, though. I guess the best example I can come up with is the fact that I have been looking for the security camera in my neighbor's apartment for the past week and a half. Does he have a security camera? Nope. I'm just one paranoid mofo.


I have been struggling with the whole "magical thinking" thing myself. What constitutes "magical thinking"? I mean, many people believe in the paranormal or the occult- these have been around as long as there have been people. If I say I have psychic premonitions am I having "magical thoughts" or possibly delusions of grandeur? When I was a kid I would stop my whirling in circles just to let my mom know "something bad is going to happen" and something significant would happen (next day I was in a serious scar crash with my nanny, for example). I have had prophetic dreams and sudden intrusive thoughts that turned out to be some type of premonition. I think these things happen to everyone. When do they become symptoms of schizo disorders? What if you really are psychic and your hallucinations are actually ghosts or a premonition?

Perhaps you saw/heard/felt/thought really hard about something that made you come to the conclusion that your neighbor had the camera. I have done things like this where a combination of things led me to make certain conclusions, and people would wonder where i came up with such things. Of course I never remember the exact chain of thoughts that led me there. I am not arguing your new self- diagnosis I just had a lot of thoughts on the matter of schizo-affective and all the schizophrenia type disorders. I find it all baffling.



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07 May 2010, 1:12 pm

Where can I find detailed information on schizotypy?

I've been searching for a little while, and so far all I know is that it's a very vague condition that could describe just about anything (including Aspergers).

"People with this type of personality have features known as anhedonia (difficulty experiencing pleasure), cognitive slippage, ambivalence (uncertainty) and interpersonal aversiveness (preference to be alone)."

"1. Unusual experiences: The disposition to have unusual perceptual and other cognitive experiences, such as hallucinations, magical or superstitious belief and interpretation of events (see also delusions).
2. Cognitive disorganisation: A tendency for thoughts to become derailed, disorganised or tangential (see also formal thought disorder).
3. Introverted anhedonia: A tendency to introverted, emotionally flat and asocial behaviour, associated with a deficiency in the ability to feel pleasure from social and physical stimulation.
4. Impulsive nonconformity: The disposition to unstable mood and behaviour particularly with regard to rules and social conventions."

"* May have transient psychotic experiences
* Negative features (social withdrawal, affective blunting)
* Cognitive disorganisation
* Have never met diagnostic criteria for schizophrenia"

This is all about as vague as vague can get..."negative features"?? Come on!


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