Report of the DSM-V Neurodevelopmental Disorders Work Group

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pseudocilia
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28 Mar 2012, 12:16 am

So, I'm still trying to catch up with what is new, what is going away, and what has stayed the same with the new DSM, but I did want to throw my two cents in about the Asperger's diagnosis. I was diagnosed with Asperger's Syndrome when I was around 5 years old, partially because my mother pushed for the diagnosis. Since the diagnosis was not very well known at the time, I believe I got extra help that I needed. While I'm not sure if having a separate diagnosis for AS would help all people on the high functioning spectrum, I don't believe grouping all spectrum disorders into one is necessarily the best way to go either. Having heard from many of my family members who are special ed teachers, the new diagnosis would in fact clump many students from ranging spectrums in the same classroom. I can only imagine if this had been me, and if I didn't have the chance to interact with regular ed students or didn't have the one-on-one interaction with therapists that I had. I think the outreach to change the definitions in the DSM shouldn't left to just us, or the PhDs that write all of these up, but to the teachers in the schools who will be working with these kids. As far as Aspies speaking and flipping out in public like another member said, I think that's absolutely insane. I have Asperger's and I couldn't imagine trying to make a public statement in defense of keeping Asperger's Syndrome over some slight technicality. How utterly embarrassing that would be!!



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16 Apr 2012, 6:10 pm

[quote="Awiddershinlife"]The diagnosis of autism is artificial. It is just a way to organize our thinking about people who have these issues. My problem with the DMS is that everything is given a negative spin. For example the ability to directing one's passions to a specific goal without being distracted by social intrusions and peer pressure has revolutionized society throughout homosapian's history, yet it is now considered a disease and described as "Restricted repetitive & stereotyped patterns of behavior, interests and activities". This is the gift of autism/asperger!![/quote]

this,esp when you think about how many rules and regulations org.'s such as the military have but they wouldnt be diagnosed as AS...wtf



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28 Apr 2012, 10:46 am

I don't like the way the terminology is always so clinical and negative about simple (and often benificial, like HFA) facts of life. Also, as autistic rights activist, I really don't like the term "co-morbidity" that instantly implies that something is wrong, when most of the time it is a simple case of something being different.



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26 May 2012, 2:40 pm

The UK's National Autistic Society has the best explanation of the new DSM-V stuff that I've read thus far:
http://www.autism.org.uk/about-autism/a ... teria.aspx


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Aud
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13 Dec 2012, 8:30 pm

Master_Pedant wrote:
The last manual replaced the previous paradigm of classifying disorders based on inner mental processes (i.e. psychoanalytic and Freudian notions were rejected, most noticeably the removal of neurosis) and replaced with a paradigm based on measurable behaviour. This seems to be the shift from psychoanalysis to behaviourism.

Cognitive neuroscience has given us a lot more objective, relatively value neutral information on cognition in those with mental disorders (or, more neutrally, atypical neurology/minds). This new research trend really should bring psychology back “inward”, except in a much more clear-cut way than Freud did.

That is why I am surprised the new definitions don't include a lot more neurobiological or neurophysiological facts when defining the conditions. It would make matters a lot more precise.


Absolutely! Having worked for a non profit that was heavily involved in trying to add what were then fledgling understandings or mentions of anything "neuro" sciences could at that time provide in the last version of the DSM, it was with total mortification that many of us have received the latest version. There is a rather abrupt bifurcation of concept within the DSM; it claims at once to represent empirical science and yet on the other shows an historically capricious stance on "precision." How bizarre. At any rate thank you for articulating with admirable precision what many cannot. Seriously!



Aud
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13 Dec 2012, 9:42 pm

Sparkstorm wrote:
I don't like the way the terminology is always so clinical and negative about simple (and often benificial, like HFA) facts of life. Also, as autistic rights activist, I really don't like the term "co-morbidity" that instantly implies that something is wrong, when most of the time it is a simple case of something being different.



Precisely, none of us enjoys being subjected to the hegemony of the NT power structure. They do indeed feel there is something wrong with anyone not like them. In fact, they wage entire wars against people who simply don't adopt their viewpoint, or share rather amorphous abstract concepts or mores; never mind those who don't share their cognitive style. It is a wonder that more powerful Aspies and HFAs don't stand up in defense of their culture. There are quite a few who have done so in other countries, England, for instance, to good effect. However the culture seems to be one of hiding, one of non-stewardship among those on the spectrum. Adult life with Aspergers amuses me to a certain extent it did not as a child. Most of us are adept at Systems Thinking; some of us gifted. There cannot be a subculture of folks more able to spot a glitch in the system of thinking of the magnitude causing the cognitive dissonance in the United States. Notice they don't mention "Co-Morbidity" of say, a genius IQ. Instead they say "Savant" for us and "genius" for themselves. This fissure runs deep. I am afraid most of us tacitly absorbed it along with the rest of the xenophobic junk that passes for culture around here. Maybe others disagree, and think the connotation of language used does not assert a strong rein on our thinking. For my part, I advocate we all start using positive language in reference to our differences. NTs might be very adept at reading non verbal agendas but most are utterly perplexed when confronted with unexpected words choices.

Try it, it's both fun (for the leveler) and educational (for the bigots). They learn new words and ways of thinking, and we get to hear kind, positive language in reference to ourselves. Win, win, win.



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13 Dec 2012, 10:18 pm

One problem that I have ran into on this sort of issue is that there is not an authoriative source for documents and past arguements, papers, articles, etc. that are pro-neurodiversity. Something like a wikipedia, only more tightly controlled (see below)

The ND "cause" has picked up more than a few supporters from discussions on news stories about autism. It would be helpful if someone could just post a link or an article from the wiki that supports neurodiversity. Think how many supporters we might pick up if more of our arguements and facts were in one place.

The proposed wiki would need to be controlled by individuals who have some sort of understanding of the concept, and restrict access. It would be unhelpful for the wiki to be changed by individuals who do not support the neuro-diversity movement. Those individuals are welcome to their own websites.



Aud
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13 Dec 2012, 10:31 pm

auntyjack wrote:
Embroglio wrote:
It's best to keep it in. Think about how many undiagnosed adults would react at the thought of being told that they have Autism. A good portion of those would just think the psychologist is a quack. Someone with Aspergers is thought of as someone who is odd, nerdy, but a genius, or just socially awkward. Autism is thought being on the same level as being mentally ret*d. I wouldn't even qualify for an ASD diagnosis under dsm5, I barely do under Aspergers as it is.


I don't think it is valid to have a diagnosis that has a category that caters to prejudice. One of the things I dislike about the Asperger dx is the superiority some people seem to feel over people with a dx of Autism. IQ or the ability to communicate verbally do not measure the worth of a person and for many, do not indicate the level of difficulty they have in life.

As for the reaction of undiagnosed adults, many are disbelieving when they first hear about Aspergers in relation to themselves. It is a process of learning and understanding and I see nothing to be gained by using categories which are not clear enough for distinctions to be made.

Auntyjack, I suspect IQ and verbal ability are not being used to measure a person's worth, but possibly a person's ability to function in a manner conducive to providing adult self care, income, and seeing to their own immediate needs (housing, food, etc). What I dislike about the blanket Austism Spectrum dx is that it puts folks like me in a precarious position. I am highly ethical, for instance, and very aware that were someone to know I was "Autism Spectrum" before meeting me, they might have certain expectations or assumptions. Those expectations would NOT be met; and people react very negatively to the unexpected introduction of an Aspergian when they were expecting what their concept of an "Autistic" is... we do NOT present the same way, ot that I have ever witnessed. When people expect one thing and instead get another, the unexpected is typically met with full throttle negativity and confusion. Everybody loses. Everybody's self confidence takes a knock and then the interaction isn't productive. It often fails on myriad levels of non-meeting-of-expectations/constructs. For this reason I fail to see, when humans in general are so seemingly incapable of distgushing shades of likeness when they are blinded by a blizzard of difference, what calling two behavioral modalities that are present at utterly opposite of one another as merely a continuance of one another does to assist in resolving on going issues of marginalization of ALL non neurotypicals by the hegemonic culture which tacitly defines "normalcy." Perhaps the distinctions are protective in a way; they brace NTs for what kind of "not like them" they can expect, and protect the less socially adept from being met with instant negativity.

But then again maybe I am just way out in left field on every account, stranger things have certainly happened in my world.

Thanks, Auntyjack, for making me THINK harder on this and articulate those thoughts.
In summary I suspect some Aspergians in my circles view themselves as Stewards in a way; since some of us are capable of infiltrating the existing social structure in America and achieving relative success within it; we have an obligation to use our unique abilities to OPEN minds, rather than close them; to bring positivity where before there was confusion. To speak up, so to speak. Oh how perfect an example. Isn't the Eugenics supporting group much maligned in non-NT circles self called:
Autism Speaks!

?
Possibly they need to meet a few Aspies, and gain an up close and personal understanding of the fact that some Autistics certainly DO speak, in fact some of us have rarely shut up for an instant since the age of, oh, 2 (my dad insists, yes, 2, 2 is when a lot of Aspergians get on that first monologue ;-).



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24 Dec 2012, 1:44 am

fidelis wrote:
It doesn't make much sense to me either. That's why I put it in quotes. It's not the best way to explain it. If I have to explain this is how: the part of my brain that filters my behavior is unconscious. By observing other people and learning to control my emotions I can sort of replicate any behavior that I experience consciously at an unconscious level. When I say control my emotions I don't mean the behaviors spawned from the emotions, I mean the actual emotions. I've been trying to teach my friend Zac, who also has ASD, how to do this trick, but the English language isn't designed for this type of communication.


Thank you for putting this into words. I know exactly what you mean and never could quite express it.



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18 Feb 2013, 5:55 pm

Sparkstorm wrote:
Also, as autistic rights activist, I really don't like the term "co-morbidity" that instantly implies that something is wrong, when most of the time it is a simple case of something being different.

All co-morbidity means is that you have a physical/mental disorder in conjunction with another physical/mental disorder (respectively). It's a medical term, and implies nothing except for what people without qualifications project onto it.


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25 Feb 2013, 12:05 am

Yes, I don't like it either. I know what it means scientifically, but still do not care for it. Instead, I thing co-occurring makes much more sense even if it does not roll off the tongue as easily.

Anyway, when is the exact release date for dsm5? I wanted to hear more about the updates on it, but don't know where to look.

They can't take away a diagnosis given under dsmiv, can they? I don't know if I would qualify for ASD then. Maybe that social communication disorder that Temple Grandin spoke about.



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01 Mar 2013, 11:26 am

I don't think anything which includes the word 'morbid' is neutral. 'Co-existent' or 'correlated' but not morbid. It means deseased.



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25 Apr 2013, 3:03 pm

Aud wrote:
I am [...] very aware that were someone to know I was "Autism Spectrum" before meeting me, they might have certain expectations or assumptions. Those expectations would NOT be met; and people react very negatively to the unexpected introduction of an Aspergian when they were expecting what their concept of an "Autistic" is... we do NOT present the same way, ot that I have ever witnessed. For this reason I fail to see, when humans in general are so seemingly incapable of distgushing shades of likeness when they are blinded by a blizzard of difference, what calling two behavioral modalities that are present at utterly opposite of one another as merely a continuance of one another does to assist in resolving on going issues of marginalization of ALL non neurotypicals by the hegemonic culture which tacitly defines "normalcy."


If you take everybody diagnosed with Asperger's and compare them to each other, you'll probably find what look like "polar opposites" of ability all over the place. The same thing would happen with those diagnosed with Autistic Disorder -- although maybe to a greater extent.

Aud wrote:
Possibly they need to meet a few Aspies, and gain an up close and personal understanding of the fact that some Autistics certainly DO speak


It's not just people diagnosed with Asperger's who can speak -- not everyone with Autistic Disorder is incapable of speech; I have trouble with communicating through speech in many situations, but that doesn't mean I can't speak at all. The dividing line between Asperger's and Autistic Disorder is not as clear as many people think it is.

Personally, I think that lumping all the diagnoses together could be a good thing -- because the fact of the matter is that people with autism (any kind of autism) are all different from one another in numerous ways. A model of the differences in symptoms and functioning among people with ASD diagnoses, if put into a geometrical/visual-spatial form in my mind, looks more like a koosh ball than a thermometer/ladder/ruler -- it's more complicated than a single, two-directional spectrum....I think that lumping all the current diagnoses together might force people to look at more of the dimensions of ASD and look more at individual needs/differences than at how closely someone fits a narrow stereotype.

I could be totally wrong about this, but...I think that even if lumping all the diagnoses together doesn't compel non-autistic people to consider individual differences when meeting or thinking about people with ASDs, I don't think it will make the situation any worse than it already is in terms of people just imagining stereotypes instead of getting to know the person with Asperger's/Autistic Disorder/PDD/ASD...because as it is, there's huge variation between people with the same diagnosis and most people use stereotypes and preconceived notions about autism/asperger's as the basis for their expectations of someone on the spectrum, instead of getting to know that someone as an individual. Stereotypes don't really account for any range in behavior/presentation or functioning at all -- they're a way of looking at people and saying, "because you can be described as A, you must be/have exactly W,x,Y, and z because all people with A are/have exactly W,x,Y and z".... if you're missing x, if your 'z' is drawn backwards, or if your 'W' is actually a lowercase 'w' then you automatically don't match the stereotype and people get confused/upset/angry/argumentative/dismissive or just completely refuse to believe that you don't have 'x', or that instead of a 'W you actually have a 'w'.


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bryanmaloney
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30 Apr 2013, 9:35 am

Yuugiri wrote:
Sparkstorm wrote:
Also, as autistic rights activist, I really don't like the term "co-morbidity" that instantly implies that something is wrong, when most of the time it is a simple case of something being different.

All co-morbidity means is that you have a physical/mental disorder in conjunction with another physical/mental disorder (respectively). It's a medical term, and implies nothing except for what people without qualifications project onto it.


Then why doesn't the DSM talk about "co-morbidity" of cancer with schizophrenia or of cirrhosis of the liver with bipolar disorder?

Language as used is never actually neutral, it always comes with presumptions and assumptions.



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30 Apr 2013, 6:59 pm

bryanmaloney wrote:
Yuugiri wrote:
Sparkstorm wrote:
Also, as autistic rights activist, I really don't like the term "co-morbidity" that instantly implies that something is wrong, when most of the time it is a simple case of something being different.

All co-morbidity means is that you have a physical/mental disorder in conjunction with another physical/mental disorder (respectively). It's a medical term, and implies nothing except for what people without qualifications project onto it.


Then why doesn't the DSM talk about "co-morbidity" of cancer with schizophrenia or of cirrhosis of the liver with bipolar disorder?

Language as used is never actually neutral, it always comes with presumptions and assumptions.


Co-morbidity refers to conditions that are correlated or even implicated in causation. No one has cancer with a schizophrenia comorbid because the two are not implicated together. Also, I do not recall that the DSM focuses on physical ailments.



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03 May 2013, 5:25 pm

I received this link in an email from the GRASP general email list. It looks like NIMH is having second thoughts about the DSM 5 in general.

http://mindhacks.com...m_source=feedly