Returning with official diagnosis

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I joined way back in 2012 (according to last posts) just before getting an evaluation. I saw a lot of the traits for a low-needs resident of the spectrum, but the psychiatrist I saw then thought it more likely that I just had bad social anxiety. That's when my imposter syndrome kicked in hard and I stopped coming here.

Last year my wife was officially diagnosed, and she insisted I see someone again. This doctor was old school and still believes Asperger's should be a valid diagnosis, so I was surprised when he officially diagnosed me as autistic. So I thought I'd wander back in here and see what's new after a decade?

I'll probably jump into several threads down the line to get specific answers to questions, but in the meantime feel free to throw out anything you feel it's important for me to know right away!

Welcome back!

As you seem to know, the autism landscape has changed since 2012. In 2013 DSM-5 was published and it combined a few DSM-IV diagnoses, including Asperger's  Syndrome, and called the result "Autism  Spectrum  Disorder". Your history spans that boundary so I guess you get to claim whatever diagnosis that got put into writing after a professional Adult Autism Assessment.

My assessment was performed in 2019 and I thought it was kind of fun! My official diagnosis is Autism Spectrum Disorder, Level 1 (Mild) but apparently I provided the psychologist with enough information they were able to add a note that I also satisfied the criteria formerly associated with Asperger's  Syndrome (I suspect that observation was possible because I'd provided credible information about my development to just a little past my first birthday).

Welcome back then!
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Social anxiety was a kind of diagnosis that I had hypothesized in 2001, reading some of Watzlawick-Nardone's books.

(Palo Alto, CA)

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I had a diagnosis similar to yours and the path was to have one of Social Phobia in 2005.

From an excellent psychiatrist and psychotherapist we have CTUs who in practice are Court experts, therefore they are competent people.


After 4 years from my intuition (I have a predilection for studying Psychiatry and Psychology, I would also say, because Medicine was my first university choice, which I then abandoned.
My training was in completely different subjects, which included electronics, so the very easy choice for me to undertake was the natural one: electronic engineering.

At 4 years old I had already chosen that my future would be to do Electronic Engineering, in fact I excelled in this area.

I dispel a myth of restricted interests for us autistics: because I also studied other subjects, including Law.

Without ever finishing one of these choices.

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Excuse my description, the presentation is yours.

Maybe it's useful to see if it's the only one like this here, usually my Autistic contacts almost always have at least two degrees in faculties, even different ones.

*But unlike me, the degree of severity of their autism was lower than mine.

But it gets worse: so I'll start by saying that in this I consider myself very lucky because I evolved precisely because I could.
Among other things, without any help and any medical indications, always up to my intuitions

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In Myers-Briggs I always appear in INTJ tests, in fact I think I fall under it.


We INTJs have a lot of flaws, even if we have an uncommon mind because we are like architects of thought.

And generally when we think we do so only if this has a purpose of innovation and usefulness for others too.


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I have always written that high-functioning Autistics are the voice for their more fragile siblings: the low-functioning ones.

The truly particular thing is that they are often the ones who have particularities such as Savantism and others.

So some of them are exceptional individuals, with incredible peculiarities. But most of them with heavy inconveniences compared to us.

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This post is a condensation of a decidedly more complex thought, and a descriptive phase is missing, often as ecdoctics describes, we arrive at decidedly more simplistic definitions summarized to the true ones that are too complex to be understood.Lachman Method, Recensio, therefore Stemma Codicum.

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Today there is no critical edition of an ancient text that does not report its stemma codicum.

The exact reconstruction of it is in the method of Lachmann the purpose of the recensio, which is the preliminary activity necessary for the emendatio, with which the editor tries to correct all the errors that have occurred in a handed down text to establish the best form, as close as possible to the original written by the author.

Thus giving a critical edition of the text.

But the reconstruction of the stemma codicum allows an adequate selection of the lessons, only if the review is closed or vertical; if instead we are faced with an open review, or horizontal, as Giorgio Pasquali calls it, that is, if the entire tradition does not derive from a single archetype, the stemma codicum is ineffective and it is necessary to resort to "internal criteria", evaluating which of the different lessons adheres most to the author's usus scribendi or which is the lectio difficileor ("the most difficult lesson", and therefore improbably due to some copyist, who actually tends to trivialize the lessons of the exemplar being copying).

*The meaning of what happened to simplify autism by trivializing it as in the last DSM and ICD.

Then we will find ourselves between 2 DSM and 2 ICD outlining that the simplification had only been trivialized to "give it shape rather than substance". Now we autistic people are "form" For the DSM and ICD. In the next 2 DSM and ICD manuals, I hypothesize we will become "substance", that is, the real expression of what we are and not the trivialized simplification of a complex construct, such as we are. Therefore the diagnoses are all "invalid" due to obvious diagnostic simplifications.

A diagnosis is based on Manuals. If these manuals are evidently simplified, the diagnoses themselves will be *incoherent* and we will in any case have a *Wrong diagnosis.

Because in fact (Substance) the evaluation of Asperger people differs from those of HFA (1,2,3) which are simplified (substance).

There is no better or worse, but I underline it: there is a different interpretative archetype that it is *Complex.

This is a mental mechanism that is applied to every field, and by trivializing the whole human being loses the main road, to slip into maze-like paths that lead to delays and uselessness. Returning to autism: this proves to be increasingly harmful for diagnostics, making it incongruous and not differentiating as well as it should.

If we don't reason, and on evidently wrong texts, we will never be able to do so, we will never progress on a precise logical basis. But everything will be simplified, only that research after the DSM5 reveals that this definition is wrong, studies show that it is, the bibliographical references are there and they are all subsequent to the latest DSM.

Therefore an Asperger is different from a subject hypothesized as HFA (various levels), nosographies therefore too simplistic. Therefore wrong.

Be careful because only in appearance they seem superimposable, seen better they are not. I predict that we will arrive in 1 or 2 new DSMs (6th or 7th).

In the meantime we will all have wrong and gross diagnoses.

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My initial diagnoses were only comorbid with DSM5 simplified autism.

So they just joined each other, let's not say it was a root, but ramifications and that's it.

I now have a simplified root in HFA level 2.


My complex reality is instead that of Asperger's which is different, and the studies that establish this are happening in large quantities.


Some will say that it is difficult to think as I outline.


I reply with just one word:-"exactly".

(Huck Finn)

You are always so calm and pleasant to read Double Retired.

You always give me that feeling of tranquility of mind.

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My feeling is that
In your case expressed a sort of double diagnosis.

Let me explain: a psychiatrist or specialist can make use of the DSMs he chooses as they are deemed useful by him.


The peculiarity of your case is that like me you have two diagnoses which are obviously different from each other.

That is, in appearance they are very similar.
But in the 4th and 5th DSMs they cancel each other out.

As you have described so many times, everything changes in the 5th.


But it is the simplification that subsequent studies outline is wrong.

That is, it is too trivialized in that manual.



Your doctor (I assume) knows.


The year 2019 comes just after the first studies that specifically differentiate between HFA and Asperger's.

He (doctor) made a smart choice.


He included two different diagnoses, pointing out in a broad sense that you are Asperger's and not HFA level 1.


But while waiting for clarity in the 6th manual, he has not only included you in one nosography, but in both.

That is, according to science and conscience he did the right thing.

I sense he has doubts about the simplistic classification of HFA in your case.

And I think you have Asperger's.

Now we Asperger's are a subcategory of the basic category that HFA various levels (1,2, and 3).

In your case you will smile about this situation.

You have a two-furcation diagnosis.

The roads lead to different exits though.

Still on a logical basis, I write to you that if you checked the DSM4 in the description of Asperger's syndrome you would probably find yourself perfectly on that diagnostic path.

While you would find differences in how (I hypothesize) you are, and I don't think that your diagnosis is comparable to that of the DSM 5th.

Because if you read and analyze the two DSMs you will find (I hypothesize) some similarities between how you are and the DSM 4th, while some differences in the descriptive in the DSM 5th.

For years, attention has been polarizing on too many studies that highlight this.

You will tell me: but I am calm like this.

Real!

In fact in your case I write it because you would be able to understand some things that make the difference.

At your age and with your experience and your exceptionalities, this did not lead to any objective problems.

However, for others, resolving this issue is fundamental, I am referring to even very young children, even teenagers.

In any case, a manual with evidence of errors such as the 5th one can create inaccurate diagnoses.

Inaccurate diagnoses in turn create incorrect therapies.

In some therapies people can obtain advantages, improvements, always depending on their potential obviously


With the release of the DSM-5, many are wondering about Asperger's Syndrome (AS) and high-functioning Autism.

In the new manual, AS has been absorbed into Mild Autism Spectrum Disorders together with part of the HFA.
Asperger's syndrome shares with autism the presence of impairments in social skills, but differs from autism in that the skills language are largely preserved and cognitive functioning is normal.

Although the current diagnostic classification system, the DSM 5, has included Asperger's Syndrome within the large category of Autism Spectrum Disorders, removing the presentation of the syndrome in a separate diagnostic category, current scientific literature and experts in the field still debate the possibility that Asperger's Syndrome may consist of a specific disorder characterized by a profile of abilities that does not manifest itself in any other condition.

Some children who manifest classic characteristics of autism in early childhood, they later learn to speak using complex sentences, acquire basic social skills, and reach an intellectual level that is within the normal range. This condition has been described as “high-functioning autism” or HFA. HFA differs from “low-functioning autism” (IQ less than 70) in terms of clinical presentation, prognosis and need for support or assistance in living.

Since high-functioning autism and Asperger's syndrome are both characterized by the presence of normal cognitive functioning, numerous studies have attempted to delineate the differences between the two conditions.

Research that has dealt with the topic has provided contradictory results: most of the research has highlighted the significant similarities between the two conditions (Wilson et al. 2014), while other authors have continued to underline the importance of considering them as different clinical entities (Montgomery et al. 2016).

Some studies in particular have highlighted quantitative, rather than qualitative, differences between Asperger Syndrome and high-functioning autism, most of which concern linguistic, cognitive and social functioning (Volkmar and McPartland 2014).

Furthermore, some neuroimaging studies have underlined the qualitative differences in the distribution of gray matter in the brain of individuals between AS and HFA (Bi et al 2018).

A recent study (Margari et al., 2018) aimed to compare the clinical profiles of 150 subjects, aged between 3 and 18 years. 80 subjects diagnosed with Asperger's Syndrome (AS) according to the DSM-IV-TR criteria, and 70 subjects who received a diagnosis of Autistic Disorder and who had a medium-high IQ (HFA) took part in the study.

Results show that the two groups differ significantly in several areas: Area of communication: with respect to which the two groups differed in the presence or absence of a history of delay in language development before the age of 3, in favor of subjects with Asperger's.

The two groups also differed significantly in the qualitative component of language: in the Asperger group there was a greater use of the propensity for "precise and pedantic speech" or an excessively formal use of speech, similar to a monologue focused on a particular topic, and characterized by a peculiar prosody.

In the HFA group, on the contrary, the occurrence of "literal interpretation of the other's speech" was greater. Intellectual functioning: the average intelligence quotient values were significantly higher in the AS group compared to the HFA group, while the differences between verbal and performance scales were not found to be statistically significant between the two groups. Academic performance: another notable point of differentiation between HFA and AS is the prevalence of learning disabilities which were significantly more frequent in the HFA group, with the exception of dysgraphia that emerged frequently in both groups, without a significant difference. Comorbidities: Rates of comorbid disorders are significantly higher in the AS group than in the HFA group. People with AS showed more anxiety and depressive symptoms than those with HFA.

Welcome back to Wrong Planet!

Hello and welcome back!

I hope your wife will consider joining, too!

Welcome - hope Wrongplanet is right for you. (Even on your Second Time)

Welcome back to the site.