Just Diagnosed, yet somewhat Skeptical (Long)
25 Apr 2013, 2:59 pm
Hello again. This is my second post to WP. Earlier this week, I was diagnosed with Aspergers.
I am not certain if this is a normal reaction, but I am somewhat skeptical of the process. Let me give you some background.
I first learned about Aspergers in mid-December 2012 and then spent the past 4 months reading everything I could about the “condition”. I became interested not only in Aspergers, but also other “conditions” (i.e. certain Personality Disorders) that could be “confused” with Aspergers. I spent many, many hours each week reading Wrong Planet (and other online forums) as well as more than a dozen books (about both Aspergers and Personality Disorders).
To help the diagnosis process, I began documenting areas I felt could help with the evaluation, including: online test scores (AQ=41; EQ=20; SQ=44; RDOS=126), therapy history, list of anxieties, list of ocd traits, list of social interaction difficulties, list of sensory difficulties, list of motor difficulties, list of work difficulties, list of special interests, stimming, rituals/routines. Just about everything I could remember, beginning from when I was around 3. The entire document was > 30 pages.
I also identified a list of "conditions" that I "could" be "diagnosed" and provided to the Psychologist (including: Aspergers, Extreme Introversion, Shyness, Nonverbal Learning Disorder, Social Anxiety, Generalized Anxiety, Avoidant Personality, Schizoid).
The in-person diagnosis (performed by a Psychologist) consisted of the following:
- WAIS IQ Test
- Memory Test (additional tests targeted at testing short-term working memory – manipulating both simple and complex information)
- Social Skills Test (where I listened to recordings of expressions with various voice intonations and matched them to pictures of faces)
- Executive Functioning Test (similar to Wisconsin Card Sorting Test)
- Rorschach Test (this was primarily to determine if I had a personality disorder)
I also completed a myriad of questionnaires including:
- AQ
- EQ
- Multidimensional Anxiety Questionnaire (MAQ)
- Y-BOCS Symptom Checklist (Y-BOCS)
- Behavior Rating Inventory of Executive Function (BRIEF-A)
- Brown Attention-Deficit Disorder Scales (Brown ADD Scales)
- Western Psychological Services (WPS)
Interestingly, I thought the social skills test was rather “easy”. The Psychologist showed me a list of faces and I was supposed to guess which emotion was ‘pinned’ to each expression. Then, the Psychologist played some audio recordings of people saying things (with various voice intonations). And, I was supposed to match the expression with a face. From my perspective, it’s pretty easy to guess most emotions by looking at the mouth (which is where I usually look, when speaking to people): corners of mouth up (happy), corners of mouth down (sad), mouth open (surprise). The voice intonations were fairly exaggerated (I just needed to close my eyes and listen carefully).
Based upon everything (including the 30+ page document I provided the Psychologist), I was diagnosed with Aspergers. There were a couple of anomalies. The Psychologist indicated that my Verbal Index and Perceptual Reasoning Index were both on the higher end, which was unusual for Aspergers (she indicated that Verbal Index is typically high, but not the Perceptual Reasoning Index). She also indicated that the Social Skills Testing was about average. The Psychologist indicated I had difficulty with Executive Functioning and Multi-Tasking, with particularly issues with complex memory.
So…I am quite skeptical by nature. I am wondering:
1. How these tests prove I have Aspergers?
2. Whether I “influenced” the diagnosis by providing this write-up (i.e. was this a self-fulfilling prophecy)?
3. The validity of these questionnaires (which is influenced by how I felt at the time when I completed them, as opposed to 10 or 20 or 40 years ago)
I am just curious if anyone out there (who was previously diagnosed) ever feels skeptical about what appears to be a non-perfect science.
25 Apr 2013, 3:21 pm
It sounds like your approach to the situation was aspie in nature. Seeking any and all information on the subject and related. But it sounds like you are correct to be skeptical of the dx if your social skills are normal and your perception scores are high.
So what characterisitics do you have that make you think you have aspergers...? Or some kind of personality disorder....?
25 Apr 2013, 3:30 pm
Could have written this myself. I was diagnosed a couple of months ago, very late in life and did the reading round etc. Even worse when I read the report, full of inaccuracies but actually these were not relevant and I know really that it is correct. Usually I would have written back to correct the details, then I realised this would just reinforce the diagnosis! Hope we both come to terms with AS and use the knowledge to move on.
25 Apr 2013, 3:42 pm
So what characterisitics do you have that make you think you have aspergers...? Or some kind of personality disorder....?
Catwhisperer…Thanks for the reply. Some notes:
Regarding IQ Test:
- The Perceptual Reasoning Index (PRI) consists of: Block Design, Matrix Reasoning, Visual Puzzles.
- The Verbal Comprehension Index (VCI) consists of Vocabulary, Similarities and Information.
- I scored higher on the PRI (123) than I did on VCI (114).
- I was curious if other diagnosed individuals saw this type of deviation (where PRI > VCI).
Regarding Social Skills Test:
- I am terrible (particularly when with more than 1 or 2 people). And, I hate making eye contact.
- However, I was able to “pass” the test, because I learned over the years how to “read” the mouth - corners of mouth up (happy), corners of mouth down (sad), mouth open (surprise).
- I was curious if other diagnosed individuals were able to do the same (score relatively high on this test).
As a note, there’s one other reason for my skepticism. I have worked in software development for > 20 years. I have worked with 100s of engineers, testers, etc. I can only think of one person who was a bit “different” (and am quite certain he was on the spectrum). But that’s it. Everyone else seemed reasonably “typical” to me. Other than, of course, the Sales guys.
In any event, I accept the diagnosis. I guess I am simply skeptical of the process (and how easily it can be gamed).
25 Apr 2013, 3:45 pm
It's by no means a perfect science, far from it. The lack of a valid neurological test for ASDs does lead to a great deal of controvery.
I am curious, after reading your story, what made you seek a diagnosis?
_________________
Our first challenge is to create an entire economic infrastructure, from top to bottom, out of whole cloth.
-CEO Nwabudike Morgan, "The Centauri Monopoly"
Sid Meier's Alpha Centauri (Firaxis Games)
25 Apr 2013, 3:45 pm
mikassyna - The Psychologist indicated it (my document) was the longest, most thorough write-up she has ever seen (written by a patient). I suppose this is an Aspie trait.
25 Apr 2013, 4:16 pm
I am curious, after reading your story, what made you seek a diagnosis?
AgentPalpatine…Thanks for the reply. So…
I have been on a self-discovery for the past several decades, trying to better understand who I was. Probably, I attribute this to the fact that I wasn’t happy and felt that something was “off”.
Initially, I started looking into MBTI to explain/understand my preferences (I am an INTJ). I purchased several books and spent hours reading blogs and online message boards. Probably, it was at this time I first realized that other people didn’t think exactly like me. I had assumed, growing up, that everyone thought just like me. That we all shared a common algorithm for making decisions.
Whenever I was unemployed (mostly due to layoffs), I referred back to the Meyers Briggs books looking for answers. Anytime I was unhappy in work (which was often), I referred back to the Meyers Briggs books looking for answers. Anytime I was dissatisfied with life (which was often), I referred back to the Meyers Briggs books looking for answers.
Unfortunately, my Meyers Briggs type did not provide the answers I was looking for. There was always something "missing". It didn't explain why I always felt "different" than my peers (especially while growing up). It also didn't explain my challenges socially. It didn't explain my troubles at work. It didn’t explain my depression and weird behaviors (which I now know to be Anxiety and OCD).
I had just recently quit a job I had for 1 month (after having been unemployed for 6 months). I had not been really enthusiastic about the job search, because I had not really enjoyed working the past 20+ years. It was at this time that I figured out that it had something to do with the way in which I related to the world. But, I did not quite understand how/why.
I decided to take an Intro to Psychology course offered online by Yale. It’s been a long time since I took a Psychology class (way back in High School, when Freud was the major theory taught). I had always wanted to go back to school to study Psychology (along with a bunch of other subjects including but not limited to Sociology, Economics). So I did. During a lecture, the professor mentioned Autism and Aspergers.
I started reading up on Aspergers and had one of those “Aha” moments. I seemed to have a number of symptoms mentioned. I rarely look people in the eye (only upon meeting them, sometimes when they speak, rarely when I speak). For some reason, I must look away when thinking and expressing any mildly complex thought. When I talk to people, I stare at the area between the nose and mouth. I also have a terrible time remembering Faces. I am incredibly honest (I have a hard time telling a life, so I don't). I was terrible at Team Sports. I had issues with motor skills (riding a skateboard, ice skating, roller skating). I have at least 20 stims. I was bullied at a youth. My favorite topics, when young, were studying baseball statistics and baseball history, star trek (attended convention, read over 20 books each multiple times), astronomy (built my own telescope), and computers. There's more. I could talk about the difficulty I had buying clothes, because they didn't feel right (shoes were particularly hard, but so were socks, underpants, jeans). Or, I could talk about how I jump when I hear sudden noises (vacuum cleaners, lawnmowers). Or, I was terrified of roller coasters. Or, I could happily eat the same thing for lunch for several months straight. Or, I would feel anxiety if I was not able to follow my routine.
So, I began reading everything I could about Aspergers. I also took several online tests. And, finally, I decided to pursue a diagnosis. Just to be sure.
25 Apr 2013, 4:27 pm
While I can't tell you one way or the other if you're an Aspie, I can say that many Aspies have previously looked at the Meyer-Briggs, and they also found something "missing".
_________________
Our first challenge is to create an entire economic infrastructure, from top to bottom, out of whole cloth.
-CEO Nwabudike Morgan, "The Centauri Monopoly"
Sid Meier's Alpha Centauri (Firaxis Games)
25 Apr 2013, 5:20 pm
Panddora Thanks for the reply.
I 100% agree (about the importance of being able to "come to terms" with AS).
My main issue, at this time, has been a feeling of "purposelessness". This is not something new (i.e. I have felt "purposeless" for quite a long time now, well before I ever learned about AS).
I am hoping to use this new found realization (of being diagnosed with AS) to develop a purpose that is consistent with who I now understand myself to be. If that makes sense.
25 Apr 2013, 6:33 pm
AgentPalpatine, I had one more thing to add to my prior response. I sought a diagnosis to answer some "burning" questions I had:
- Why did I have social issues as a child?
- Why do I have social issues as an adult?
- Why do I have difficulty in work situations?
- Why don’t I feel like I fit in?
- Why am I struggling to set goals?
- Where can I find others like me?
- How can I find peace for the remainder of my life?
I had investigated/researched a number of possible "conditions" (including: Aspergers, Extreme Introversion, Shyness, Nonverbal Learning Disorder, Social Anxiety, Generalized Anxiety, Avoidant Personality, Schizoid) and wanted a professional assessment.
My AS diagnosis (along with Adjustment Disorder) provides answers to some of these questions. I still need to search for an answer to the final question ("How can I find peace for the remainder of my life?"). Thank you.
26 Apr 2013, 12:05 am
This is all common stuff for Aspergers. The cardinal impairment is the social one, though. I thought that an early history was desirable for a diagnosis, backed up by medical records or some corroboration by a family member. In your case it sounds as though the doc has taken your own words at face value, so maybe your symptoms are more obvious than you think. I don't think you need to be sceptical.
Tyri0n
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Joined: 24 Nov 2012
Age: 37
Gender: Male
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26 Apr 2013, 12:10 am
I am not certain if this is a normal reaction, but I am somewhat skeptical of the process. Let me give you some background.
I first learned about Aspergers in mid-December 2012 and then spent the past 4 months reading everything I could about the “condition”. I became interested not only in Aspergers, but also other “conditions” (i.e. certain Personality Disorders) that could be “confused” with Aspergers. I spent many, many hours each week reading Wrong Planet (and other online forums) as well as more than a dozen books (about both Aspergers and Personality Disorders).
To help the diagnosis process, I began documenting areas I felt could help with the evaluation, including: online test scores (AQ=41; EQ=20; SQ=44; RDOS=126), therapy history, list of anxieties, list of ocd traits, list of social interaction difficulties, list of sensory difficulties, list of motor difficulties, list of work difficulties, list of special interests, stimming, rituals/routines. Just about everything I could remember, beginning from when I was around 3. The entire document was > 30 pages.
I also identified a list of "conditions" that I "could" be "diagnosed" and provided to the Psychologist (including: Aspergers, Extreme Introversion, Shyness, Nonverbal Learning Disorder, Social Anxiety, Generalized Anxiety, Avoidant Personality, Schizoid).
The in-person diagnosis (performed by a Psychologist) consisted of the following:
- WAIS IQ Test
- Memory Test (additional tests targeted at testing short-term working memory – manipulating both simple and complex information)
- Social Skills Test (where I listened to recordings of expressions with various voice intonations and matched them to pictures of faces)
- Executive Functioning Test (similar to Wisconsin Card Sorting Test)
- Rorschach Test (this was primarily to determine if I had a personality disorder)
I also completed a myriad of questionnaires including:
- AQ
- EQ
- Multidimensional Anxiety Questionnaire (MAQ)
- Y-BOCS Symptom Checklist (Y-BOCS)
- Behavior Rating Inventory of Executive Function (BRIEF-A)
- Brown Attention-Deficit Disorder Scales (Brown ADD Scales)
- Western Psychological Services (WPS)
Interestingly, I thought the social skills test was rather “easy”. The Psychologist showed me a list of faces and I was supposed to guess which emotion was ‘pinned’ to each expression. Then, the Psychologist played some audio recordings of people saying things (with various voice intonations). And, I was supposed to match the expression with a face. From my perspective, it’s pretty easy to guess most emotions by looking at the mouth (which is where I usually look, when speaking to people): corners of mouth up (happy), corners of mouth down (sad), mouth open (surprise). The voice intonations were fairly exaggerated (I just needed to close my eyes and listen carefully).
Based upon everything (including the 30+ page document I provided the Psychologist), I was diagnosed with Aspergers. There were a couple of anomalies. The Psychologist indicated that my Verbal Index and Perceptual Reasoning Index were both on the higher end, which was unusual for Aspergers (she indicated that Verbal Index is typically high, but not the Perceptual Reasoning Index). She also indicated that the Social Skills Testing was about average. The Psychologist indicated I had difficulty with Executive Functioning and Multi-Tasking, with particularly issues with complex memory.
So…I am quite skeptical by nature. I am wondering:
1. How these tests prove I have Aspergers?
2. Whether I “influenced” the diagnosis by providing this write-up (i.e. was this a self-fulfilling prophecy)?
3. The validity of these questionnaires (which is influenced by how I felt at the time when I completed them, as opposed to 10 or 20 or 40 years ago)
I am just curious if anyone out there (who was previously diagnosed) ever feels skeptical about what appears to be a non-perfect science.
No ADHD? Take it from a pro, attention deficits can mimic all kinds of social problems that typical aspies have. I don't have the same emotional dysfunction that others do, but I have social problems due to my attention deficits and lapses. I am officially diagnosed with Asperger's, and they suggested ADHD was a possibility also but didn't really screen for it.
Personally, I think Asperger's is overdiagnosed.
One thing: did you have prosody issues: I have SEVERE prosody issues, and these were kind of the tail that wagged the dog, causing me to get diagnosed.
26 Apr 2013, 12:22 am
Noetic Thanks for the reply.
I forgot to mention that the Psychologist had me complete a Free-Form Intake questionnaire as well as the Vineland Adaptive Behavior Scales.
The Free-Form Intake questionnaire included basic questions about Gross Motor capabilities (when did I first crawl, walk alone, run), Fine Motor capabilities (when I could feed myself with a spoon, write letters, tie shoes), Language capabilities (when did I first use single words, sentences), Social/Adaptive capabilities (when was I potty trained during day/night). It also asked me to describe my temperament, sleeping patterns, eating patterns when I was an infant and any problems with early child development. It also asked me to document various milestones with each grade in school (e.g. performance, best subjects, salient comments from teachers/parents, key events). Fortunately, most of this information could be relatively easily answered based upon looking at my Baby book (yeah – I never realized how important this record-keeping book was).
The Free-Form Intake questionnaire also asked about mental health issues in the family (on my mom and dad’s side). I had to ask my parents about this and I learned some new stuff that I hadn’t known before!
The Vineland Adaptive Behavior Scales asked even more detailed questions about my “capabilities during early ages (e.g., 0-4, 5-6, 6+, etc.). As an example, it would ask whether I could crawl up stairs, or crawl down stairs before age 4. Or, it would ask if I could ride a bicycle between ages 5-6. Unfortunately, this level of detail was not in my Baby book. I asked my parents (who are both in their 70s) to help complete the Vineland Adaptive Behavior Scales questionnaire. Unfortunately, they weren’t too helpful.
One final thing. I just figured out (via googling) that the Memory Test I referenced above was actually the Wechsler memory scale.
You know…after responding to everyone’s questions, I am becoming less skeptical.
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