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Rascal77s
Picnic Basket Thief
Joined: Nov 13, 2011
Posts: 2337
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 Posted: Sat Mar 10, 2012 4:07 am Post subject: |
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| enrico_dandolo wrote: | | Yes, I had read it. I found it very informative, but I don't think it adressed what I was saying. |
I think the fact that a bunch of psychiatrists feel that standards set by the DSM 5 are nearly impossible to use in a clinical setting is pretty significant. It's one thing to feel that the standards apply to you, because you know yourself. It's another thing for a clinician to figure out how they apply to you because the clinician can't be you. Basically the gripe is that the tolerances are too tight considering the clinician is dealing with many kind of impairments. If some of you feel that the DSM 5 is more clear at the expense of a bunch of people being f**** over and losing access to services thats your perogative. But life isn't a research study and what's missing from the DSM 5 is the human factor. |
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enrico_dandolo
Phoenix
Joined: Nov 21, 2011
Posts: 866
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| Posted: Sat Mar 10, 2012 5:22 am Post subject: |
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| Rascal77s wrote: | | enrico_dandolo wrote: | | Yes, I had read it. I found it very informative, but I don't think it adressed what I was saying. |
I think the fact that a bunch of psychiatrists feel that standards set by the DSM 5 are nearly impossible to use in a clinical setting is pretty significant. It's one thing to feel that the standards apply to you, because you know yourself. It's another thing for a clinician to figure out how they apply to you because the clinician can't be you. Basically the gripe is that the tolerances are too tight considering the clinician is dealing with many kind of impairments. If some of you feel that the DSM 5 is more clear at the expense of a bunch of people being f**** over and losing access to services thats your perogative. But life isn't a research study and what's missing from the DSM 5 is the human factor. |
I didn't say it applied better to me. The opposite would be true, but then, I'm not yet officially diagnosed, so maybe neither apply. I didn't say it was clearer either. I never said any of that. What I said what, basically, that it seems nicer and shinier, and that it seemed easier to adapt to individuals, instead of just creating labels for every slight variety of the same thing.
Actually, I don't even remember your link mention Asperger's at all, though I may be wrong. It attacked the DSM-V in general.
One thing I said, though, is I strongly doubt that clinicians will magically change their methods because of a change in the DSM. If so many of them disagree with it, they will continue using the DSM-IV, or ICD-10, or whatever they want. The practical consequences of this change on individuals seems overblown to me. |
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EXPECIALLY
Phoenix
Joined: Oct 21, 2011
Age: 29
Posts: 700
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| Posted: Sat Mar 10, 2012 6:47 am Post subject: |
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I know what you mean. With the new criteria I don't think you'd be diagnosed, then again I don't know you at all lol.
But I know I wouldn't be, MAYBE with the current criteria by a psych with a liberal view of ASD behavior.
Here's my thing, you can view autism as either a disorder or a way of processing information.
Yes, it is a very real disorder for the ones who are diagnosed but there are many of us walking around who process information in the same way and for whatever reason have a made a few random neuro connections that have let us slip through the cracks. But is that a bad thing?
It's like knowing that you aren't technically normal but can function as such at the same time. Assuming you can (universal you, not you personally) I see no reason to pursue diagnosis.
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XFilesGeek
Pretentiousness personified.
Joined: Jul 25, 2010
Posts: 1791
Location: The Oort Cloud
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| Posted: Sat Mar 10, 2012 10:41 am Post subject: |
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I predict the exact same thing will happen with the DSM-V that happened with the DSM-iV:
1. Professionals will read it, come to their own personal conclusions about what the criteria "really means" and how it "looks" when people present with ASDs (pretty much like they do right now).
2. The more respectable professionals who bother doing extra research will naturally gravitate to the research that is in line with their own personal preferences (pretty much like they do right now).
3. People will continue to claim that AS and autism are completely separate and present evidence for why they think this. Other people will continue to claim that they're not, and present the evidence for why they think this. Meanwhile, scientists will continue to endeavor to identify more objective ways of determining what is and is not autism, and individuals on internet message boards will continue to debate how many angels can dance on the head of a pin.
In other words.......SSDD.
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Sora
away away
Joined: Sep 16, 2006
Age: 25
Posts: 5645
Location: Europe
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| Posted: Sat Mar 10, 2012 11:05 am Post subject: |
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| Rascal77s wrote: | | enrico_dandolo wrote: | | Yes, I had read it. I found it very informative, but I don't think it adressed what I was saying. |
I think the fact that a bunch of psychiatrists feel that standards set by the DSM 5 are nearly impossible to use in a clinical setting is pretty significant. It's one thing to feel that the standards apply to you, because you know yourself. It's another thing for a clinician to figure out how they apply to you because the clinician can't be you. Basically the gripe is that the tolerances are too tight considering the clinician is dealing with many kind of impairments. If some of you feel that the DSM 5 is more clear at the expense of a bunch of people being f**** over and losing access to services thats your perogative. But life isn't a research study and what's missing from the DSM 5 is the human factor. |
I'm not sure that how they feel is important by itself, there's some information missing to arrive at a conclusion. It would be more interesting to consider their opinion with respect to a measure of their objective mastery of the DSM-IV criteria as opposed to how they feel they have mastered the DSM-IV, meaning how comfortable they're with it.
At the moment, psychiatrists might feel that the old criteria are far easier to administer in a clinical setting because of how used they are to the old criteria - but given the number of wrong or "random" diagnoses within the spectrum, their confidence in the criteria and/or their own abilities to use these criteria seems to be more than questionable.
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Rascal77s
Picnic Basket Thief
Joined: Nov 13, 2011
Posts: 2337
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| Posted: Sat Mar 10, 2012 2:55 pm Post subject: |
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| Sora wrote: | | Rascal77s wrote: | | enrico_dandolo wrote: | | Yes, I had read it. I found it very informative, but I don't think it adressed what I was saying. |
I think the fact that a bunch of psychiatrists feel that standards set by the DSM 5 are nearly impossible to use in a clinical setting is pretty significant. It's one thing to feel that the standards apply to you, because you know yourself. It's another thing for a clinician to figure out how they apply to you because the clinician can't be you. Basically the gripe is that the tolerances are too tight considering the clinician is dealing with many kind of impairments. If some of you feel that the DSM 5 is more clear at the expense of a bunch of people being f**** over and losing access to services thats your perogative. But life isn't a research study and what's missing from the DSM 5 is the human factor. |
I'm not sure that how they feel is important by itself, there's some information missing to arrive at a conclusion. It would be more interesting to consider their opinion with respect to a measure of their objective mastery of the DSM-IV criteria as opposed to how they feel they have mastered the DSM-IV, meaning how comfortable they're with it.
At the moment, psychiatrists might feel that the old criteria are far easier to administer in a clinical setting because of how used they are to the old criteria - but given the number of wrong or "random" diagnoses within the spectrum, their confidence in the criteria and/or their own abilities to use these criteria seems to be more than questionable. |
If a foreman gives a construction worker a screw driver to hammer nails into a wall you're going to end up with a screwed up wall. This isn't about "the spectrum", they object to the DSM 5 as a whole. And they're right, the process is screwed up therefore the manual is screwed up. As you can see below many practicing clinicians aren't very happy.
| Quote: | The wise, safe, and responsible thing for APA to do now is to delay publication of DSM-5 until the
missing second stage of rewriting and retesting can be completed. The wordings that do poorly in the
first stage of field testing should be rewritten to finally attain the clarity and consistency necessary in an
official manual of psychiatric diagnosis. The newly revised (and hopefully final) versions should then
undergo the second stage of field testing as originally envisaged to ensure that they now work. The extra
time will also allow for the independent scientific reviews of controversial DSM-5 proposals called for
in a petition that has already been signed by more than 11,000 mental health professionals and is
endorsed by 40 professional organizations (including many divisions of the American Psychological
Association, the American Counseling Association, and the British Psychological Society). |
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btbnnyr
Rabbit In Cat's Clothing
Joined: May 19, 2011
Posts: 3106
Location: Lost Angleles Carmen Santiago
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| Posted: Sat Mar 10, 2012 4:02 pm Post subject: |
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The socially aloof and active-but-odd social profiles can eggsist in the same person at different developmental stages or in different situations at the same age. Assigning one profile to AD and the other profile to AS is taking a simplistic overgeneralized non-contextual approach - the usual NT approach to autism because NTs lack the internal context to understand how autistic behaviors work on the inside.
A lot of the socially aloof vs. passive vs. active-but-odd differences can be explained by a person's communication abilities, verbal and non-verbal. A child lacking communication abilities, like speech and gestures, will appear socially aloof. Once the child gains communication abilities, she may come to appear passive or active-but-odd, depending on the social situation.
When I was a child, I was socially aloof, because I lacked basic functional communication abilities. I did not speak, and I did not use gestures. I had zero verbal thoughts in my mind, so there was no way that I was going to be able to generate any in real-time for speaking to myself or others. When my mother asked me basic yes/no questions about being hungry/thirsty/sick/hurt/bathroom, I could not answer them through verbal or non-verbal communication, no yes/no, no nod/shake, but appeared like I had heard and understood nothing. This continued well into school-age. In the context of this lack of communication abilities, socially aloof was the only possibility and had nothing to do with me wanting or not wanting to communicate. Communication was not an option, both because I could not when it occurred to me and because it did not occur to me most of the time. Around age eight, I started developing communication abilities, and once I had spontaneous functional speech, I no longer appeared socially aloof, but more passive, being able to respond to overtures of others and functional questions. On certain topics, like those of my special interests, I could appear active-but-odd, going on and on and on in a group of people about a topic and not getting it at all that others are bored or annoyed. I could talk about topics, usually physical ones like science or nature related, but still not about myself or my internal states of mind or others or others' internal states of mind. It's only within the past couple of years that I have been able to verbalize my own states of mind and communicate that to others, but when it comes to others' states of mind, I still have almost no ability to verbalize their thoughts, and it doesn't help that their states of mind are so different from mine and foreign to me, and even if I knew them, I would use different words to describe the same states than they would use.
What I am trying to say that the social profiles that are said to distinguish AD and AS may have an underlying cause in the communication aspect of the triad, and the development of communication skills, or lack thereof, may reflect severity of the autism. So it is not like Asperger's children have this social style for some mysterious reason, and Kanner's children have this other social style for some other mysterious reason, and these social styles and mysterious reasons distinguish Asperger's and Kanner's Syndromes as ones requiring different definitions in the DSM. It may be more like some autistic children develop verbal and non-verbal communication abilities faster than others, and some autistic children have the potential to develop high levels of communication skills and some do not, and this is a spectrum of severity, as in the DSM-V, that results in distinct social profiles that cannot be generalized to AD like this and AS like that, so it is bester not to generalize at all, but focus on individuals with individual sets of traits.
Edit: Also, autistic people with a certain set of traits will see themselves as very different from other autistic people with another set of traits. Someone who had early communication development and was not or does not remember being socially aloof will see themselves as having a distinct condition from someone who is socially aloof as an adult and does not respond to others at all. Someone who does not use much speech as an adult will see themselves as having a distinct condition from someone who talks on and on and on in social situations. People who have been both will find it hard to make these distinctions. |
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Sora
away away
Joined: Sep 16, 2006
Age: 25
Posts: 5645
Location: Europe
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| Posted: Sat Mar 10, 2012 6:02 pm Post subject: |
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| Rascal77s wrote: | | If a foreman gives a construction worker a screw driver to hammer nails into a wall you're going to end up with a screwed up wall. This isn't about "the spectrum", they object to the DSM 5 as a whole. And they're right, the process is screwed up therefore the manual is screwed up. As you can see below many practicing clinicians aren't very happy. |
I did understand your point and respect your opinion. I merely expressed my disagreement about the issue because personally, I disagree that this specific concern is the a stand-alone problem about the DSM-V and the very mental health professionals that will be required to use it.
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Autism + ADHD
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The trouble with having an open mind, of course, is that people will insist on coming along and trying to put things in it. Terry Pratchett |
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slave
Always stuck between 13-38Hz and tired of it.
Joined: Feb 29, 2012
Age: 100
Posts: 1319
Location: Dystopia Planetia
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| Posted: Tue Mar 13, 2012 12:48 am Post subject: |
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| XFilesGeek wrote: | I predict the exact same thing will happen with the DSM-V that happened with the DSM-iV:
1. Professionals will read it, come to their own personal conclusions about what the criteria "really means" and how it "looks" when people present with ASDs (pretty much like they do right now).
2. The more respectable professionals who bother doing extra research will naturally gravitate to the research that is in line with their own personal preferences (pretty much like they do right now).
3. People will continue to claim that AS and autism are completely separate and present evidence for why they think this. Other people will continue to claim that they're not, and present the evidence for why they think this. Meanwhile, scientists will continue to endeavor to identify more objective ways of determining what is and is not autism, and individuals on internet message boards will continue to debate how many angels can dance on the head of a pin.
In other words.......SSDD. |
Agreed.
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OddDuckNash99
Hypercoaster
Joined: Nov 16, 2006
Posts: 2527
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| Posted: Tue Mar 13, 2012 8:12 am Post subject: |
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| Rascal77s wrote: | | The more I think about it the worse the DSM 5 looks. There is a huge outcry in the medical community right now because they feel that, in the words of one professor, 'the dsm 5 will take us back to the dark ages of the DSM 2'. The whole thing is a train wreck. |
Amen. The DSM-5/V (has it officially been decided if they're rejecting the Roman numeral?) is an absolute abomination from what has been proposed. And not just with how they're removing AS and reclassifying ASDs. As far as I can tell, every single class of psych disorders is being slaughtered. I think one of the most infuriating proposals is making a SEPARATE class for Obsessive-Compulsive Spectrum Disorders, a class that INCLUDES OCD itself! While I'm all for making an OCSD section for things like trich, compulsive skin-picking, and compulsive hoarding not obviously linked to OCD fears of death/safety, it is absolutely ridiculous to remove OCD from the ANXIETY disorder category, when it is the most severe of the anxiety disorders! Any OCD-er will tell you that the torture of OCD is the anxiety, dread, and guilt that comes from the obsessions, and putting OCD itself in a category with spectrum disorders that merely show compulsive behaviors and impulse control is just ludicrous.
So far, the only thing I see beneficial in the proposals is the addition of binge-eating disorder. The rest can go in the trash as far as I'm concerned. And don't even get me started on how they are choosing to keep the currently horrible definition of bipolar I mania...
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Nash: Recognition...
Helinger: Well, try seeing accomplishment!
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CyclopsSummers
tunnel visionary
Joined: Jun 22, 2008
Age: 26
Posts: 1902
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| Posted: Tue Mar 13, 2012 9:39 am Post subject: |
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I'm more perplexed that the DSM-V sustains gender dysphoria as a disorder. This is the 21st century.
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vermontsavant
My father 1934 to 2010
Joined: Dec 08, 2010
Age: 37
Posts: 1779
Location: Bellows Falls,Vermont USA
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| Posted: Tue Mar 13, 2012 10:07 am Post subject: |
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im curious under the new system,if you already have a formal aspergers DX.
1.does that mean you automaticly have a level 1 autism DX
2.or does that mean your previous diagnosis automaticly vacated and you will need a new formal DX
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CyclopsSummers
tunnel visionary
Joined: Jun 22, 2008
Age: 26
Posts: 1902
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| Posted: Tue Mar 13, 2012 10:10 am Post subject: |
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| vermontsavant wrote: | im curious under the new system,if you already have a formal aspergers DX.
1.does that mean you automaticly have a level 1 autism DX
2.or does that mean your previous diagnosis automaticly vacated and you will need a new formal DX |
That is a good question. I do not have the answer.
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Rascal77s
Picnic Basket Thief
Joined: Nov 13, 2011
Posts: 2337
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| Posted: Tue Mar 13, 2012 11:36 am Post subject: |
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| vermontsavant wrote: | im curious under the new system,if you already have a formal aspergers DX.
1.does that mean you automaticly have a level 1 autism DX
2.or does that mean your previous diagnosis automaticly vacated and you will need a new formal DX |
2 |
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OddDuckNash99
Hypercoaster
Joined: Nov 16, 2006
Posts: 2527
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| Posted: Tue Mar 13, 2012 11:37 am Post subject: |
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| CyclopsSummers wrote: | | I'm more perplexed that the DSM-V sustains gender dysphoria as a disorder. This is the 21st century. |
Ditto. Almost mentioned that in my post. Keeping transsexuality in the DSM-V is no different than homosexuality being in the DSM-III. It's highly offensive.
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