AS Diagnostic Criteria - More suited for men?

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unreal3x
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19 Aug 2012, 11:24 pm

If the amount of AS men to women is about 4:1, would you say the diagnostic criteria suits men more because there is more examples of them?

What would you say the differences are between AS men and women?


I know even for men, the criteria doesn't all fit them anyway.



Dillogic
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20 Aug 2012, 12:45 am

Autistic Disorder ratio, 5:1 or so
Asperger's Disorder ratio, 4-5:1 or so

That would mean it's fairly accurate due to the fact that nearly all individuals with Autistic Disorder, whether male or female, are picked up, and that AD and AS are the same disorder....

Wing's original paper put forward that females sometimes appear more superficially sociable than males, but the deficits in two-way social interaction are really the same. Since Asperger's was pretty much defined by this paper in the West, I'd say that's also accurate too.



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20 Aug 2012, 1:29 am

[Link] This lady seems to think so and I think so to. She has a image with a list of symptoms, under List of Female Asperger Traits, that I feel very accurately describes my AS.



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20 Aug 2012, 2:44 am

unreal3x wrote:
If the amount of AS men to women is about 4:1, would you say the diagnostic criteria suits men more because there is more examples of them?

What would you say the differences are between AS men and women?


I know even for men, the criteria doesn't all fit them anyway.


This is something that is currently being debated. One of the leading advocates and researchers of girls and women on the spectrum, Tony Attwood, feels that girls and women are likely to have different characteristics than boys and men, and feels they are indeed underdiagnosed and misdiagnosed because of this.



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20 Aug 2012, 3:15 am

It's a big problem throughout psychiatric medicine, diagnosis tend to be gender orientated and 'health/normality' tends to be interpretated due to what is percieved as gender normative behaviour. It's very complicated.
One of the more widely quoted theories on ASD is that it's an extreme male brain and that has shadowed a lot of ASD public knowledge. Baron-Cohen is quite responsible for that. Then there is the fact that for a lot of us, gender isn't as relavent as it is for many people. I myself have never felt I have a gender, I've always felt in the middle, I'd like a genderless body, for me having a gender has always felt like an unnecessary hinderence.
If it's a subject you are interested in outside of being ASD related then there are some really interesting books and information out there.
'Woman and Madness' by Phyllis Chesler is a good start, I'm reading 'Mad, Bad and Sad' by Lisa Appignanesi at the moment which is 'a history of women and the mind doctors from 1800 to the present'.



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20 Aug 2012, 3:45 am

Yep. I feel sorry for women who would otherwise pass.


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20 Aug 2012, 5:59 am

Quote:
Study by Simon Baron-Cohen on differences in females:
http://docs.autismresearchcentre.com/pa ... %20ASC.pdf
"While this study has documented that adult women with ASC present fewer current socio-communication symptoms, it is an open question as to the underlying reasons for such an effect. Our cross-sectional design is not able to address this question directly and a longitudinal study would be needed to mark developmental changes to explain such differences. However, the contrast between evident childhood symptoms and reduced current autistic interpersonal features fits with anecdotal reports from women on the autistic spectrum [53,54,55,66] as well as our participants’ and their caregivers’ subjective experiences described in the research interviews. This suggests that able women with ASC may be more motivated and may put more effort into developing compensatory skills that help them to appear "socially typical’’. Hence, females with ASC may show different developmental trajectories compared to their male counterparts. Indeed, experienced clinicians have observed that one reason females (girls or women) with ASC may be less easily identified is because of their ability to "camouflage’’ their autism [15,16]. This type of camouflaging may involve conscious, observational learning of how to act in a social setting and by adopting social roles and following social scripts [66]. Hence, a female teenager or adult with ASC may be able to develop reciprocal conversation, social use of affect, gestures and eye gaze, that would place them under the radar for the more commonly understood and recognizable (male) phenotype of ASC [15,19]. Some of the women with ASC reported they consciously "cloned’’ themselves on a popular girl in their class whilst at school, imitating their conversational style, intonation, movements, dress-style, interests, and other mannerisms, in minute detail. This suggests that – with the right motivation – learning can be a very effective compensation strategy and could even be exploited therapeutically. Women who adopt these camouflaging strategies nevertheless report that underneath their superficially sociable behavior they are often experiencing high levels of stress and anxiety as they have to work hard to keep up the mask, and that it is exhausting by the end of the day."

and
Quote:
http://www.yourlittleprofessor.com/girls.html states:
"Like ADHD, symptoms of Asperger's are different in girls than boy, consequently, more boys are referred for an Asperger's assessment than girls; a ratio as high as 10:1 has been suggested. Despite that, epidemiological research suggests a ratio of 4:1 is more accurate, which means that there are potentially thousands of young girls with Asperger's who never get diagnosed.

The primary differences between Asperger's diagnoses in girls and boys seem to be caused by basic differences in the ways boys and girls express themselves. Aggressive behavior is more noticeable, and a child who is overly aggressive is more likely to be evaluated. Because girls have a greater ability to express their emotions, they're less likely to act out when they're upset, confused or overwhelmed. Without this behavioral "compass", the other aspects of Asperger's are more likely to go unnoticed.

Another similarity between ADHD and Asperger's in girls is that the symptoms are more passive in nature, which makes them more difficult to notice. Because the symptoms are milder, parents are also more reluctant to bring their daughter in for a diagnosis.
Some experts speculate that one reason fewer girls are diagnosed is because their peers are more likely to help them cope in social situations, which is where Asperger's symptoms are most readily identifiable. Nurturing is instinctive in females, and so the friends of a young girl with Aspergers will intuitively comfort her when she's upset, or guide her through social interactions. In contrast, boys tend to be more 'predatory' and therefore more likely to tease a boy with Asperger's. Because a girl's friends do their best to help her, her parents and/or teachers may never see symptoms - or may not see them often enough - that would warrant a clinical diagnosis.

One of the key symptoms common between boys and girls is a hyper-focused interest one particular thing or topic. For boys, the special interests are often in areas of science or transportation (trains or airplanes). In girls, the focus is often on animals or classic literature. The interest in and of itself isn't unusual, but a child with Asperger's will have an unusually intimate knowledge of his or her topic of interest. Young girls may play with dolls and have imaginary friends, which doesn't seem at all unusual. However, her interest in these things will continue even when she's a teenager and they should have been outgrown.

Because social situations are stressful and awkward for girls with Asperger's, they often learn to mimic people who have stronger social skills. They may adopt someone else's mannerisms, facial expressions and even vocal intonations. Again, this is sometimes misinterpreted - especially in older children or adults - and may be misdiagnosed as a personality disorder. "

and
Quote:
http://www.guardian.co.uk/society/2012/jul/13/girls-autism-sex-bias-children?utm_source=Newsletter&utm_medium=email&utm_campaign=digest_12 an article on the failure to sufficiently diagnose females on the spectrum.

and
Quote:
Research and Information on how Girls with AS differ from boys and how girls are being failed
I have also read: "In an April 2009 article, Dr. Judith Gould of the UK's National Autistic Society was quoted as saying: "We're failing girls at the moment. We are doing many thousands of them a great disservice. They are either not being picked up in the first place, but if they ask for help they are being turned away. Even if they are referred for diagnosis, they are commonly rejected."

This is quite true of adult females, as well."
"Surviving in the world often requires masking the symptoms of AS, or avoiding the situations which trigger symptoms. As I wrote yesterday, there are adults on the spectrum learn to do this very well. Especially women."


There's loads out there if you start looking.


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20 Aug 2012, 6:08 am

And BTW, yes the studies and research to date have all been done on males. It's no wonder females are having such a hard time.


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Rattus
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20 Aug 2012, 6:31 am

It really does annoy me because I have no doubt I'd have been diagnosed as a small child had I of been male, I would certainly have been diagnosed the first time I was in the mental health system at 15. My parents effectively gave them what is a run down of ASD symptoms but because I was female they assumed I must be personality disordered. It's taken nearly 10 years to get my diagnosis changed.



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20 Aug 2012, 10:26 am

And I firmly believe that in the end, when all us women have finished coming out of the woodwork, there will be no ratio difference to speak of between men and women with AS.


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Rattus
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20 Aug 2012, 11:12 am

whirlingmind wrote:
And I firmly believe that in the end, when all us women have finished coming out of the woodwork, there will be no ratio difference to speak of between men and women with AS.


I believe it will be much closer to 50/50, I don't know whether it will truly be equal because I do believe that some psychiatrists will always cling to the old beliefs unfortunantly.



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20 Aug 2012, 8:28 pm

Because of gender-based differences, women are less likely to be diagnosed as Autistic.

Whether that means that there are fewer Autistic females than males depends on one's definition of Autism. Using current definitions, men are more likely to be diagnosed.

Until Autism and other conditions can be diagnosed neurologically, not just psychotherapeutically, there will really be no way to be certain about the gendered nature of many disorders.


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20 Aug 2012, 8:43 pm

Dillogic wrote:
Autistic Disorder ratio, 5:1 or so
Asperger's Disorder ratio, 4-5:1 or so

That would mean it's fairly accurate due to the fact that nearly all individuals with Autistic Disorder, whether male or female, are picked up, and that AD and AS are the same disorder....

Wing's original paper put forward that females sometimes appear more superficially sociable than males, but the deficits in two-way social interaction are really the same. Since Asperger's was pretty much defined by this paper in the West, I'd say that's also accurate too.

from what read and hard it's higher in the UK
aspergers syndrome 8:1
autistic disorder 9:1

thats what I found out



idratherbeatree
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21 Aug 2012, 12:35 am

Just thought I'd point out, as a transgender person, It wasn't considered because of my feminine behavior.
There is very strong gender bias in the diagnosis.


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21 Aug 2012, 5:22 am

I think that all this talk of "AS is different in women" does not make much sense.

After all, "having AS" IS "having the symptoms and behaviors of AS" - AS is not a kind of independent entity that exists even if you don't have the symptoms associated wth AS (yes, AS is suposed to be a neurological difference with genetic roots, but for all practical effects is a behavioural condition, definid by symptoms alone).

Then, if you don't have the symptoms associated with AS, you don't have AS.



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21 Aug 2012, 5:23 am

[repeated post]



Last edited by TPE2 on 21 Aug 2012, 9:37 am, edited 1 time in total.