Diferential diagnosis of AS - the public vs. the experts?

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TPE2
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26 Apr 2011, 10:40 am

I thing that I have noted is that seems to be a divorce between the public and the reaserchers about the diferential diagnosis of AS.

In these forum (and all around the internet) they are recurrent the threads about "Asperger or introvert?", "Asperger or ADHD?", "Asperger or gifted?", "Asperger or schizoid?", "Asperger or avoidant?", etc.

In contrast, 99% of the research about "Asperger or [X]?" is about the question "Asperger or HFA?".

This is even more salient if we take in consideration that, even according to the people who believes that AS and HFA are different, the distinction is largely irrelevant in practice, because the intervention for AS and for HFA is the same (basically, social skills lessons and a more predictable environment); in other words, even if a HFA is misdiagnosed as Aspie (or the opposite), there is no real problem in that.

Now, contrast with, let say, social anxiety - I imagine that to misdiagnose an Aspie as having social anxiety or AvPD can be very problematic: if an Aspie is convinced that their problem is "anxiety" and that what he need is to "break the shell" and become more self-confident, probably the result is that he will commit even more social mistakes.

Question - why the scientific community is obsessed by a largely irrelevant question (AS vs. HFA) almost ignoring all other potential diferential diagnosis?

My theory - probably is a problem of over-specialization: the researchers who study Asperger's are psychiatrist specilized in ASD, then they will compare AS with the other diagnosis that they know, classical autism.



Verdandi
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26 Apr 2011, 11:17 am

I am not sure why this is, although I suspect on some level that there's an urge to view AS - as a label separate from autism - as a "real" thing that is really separate from autism, and thus prove it. And yet studies seem fairly inconclusive. Some say they're the same thing, some find "differences" but these differences seem a bit irrelevant when your diagnosis depends on who diagnoses you.

I spent several years under the impression that I had social anxiety. I actually needed distance from socializing and then going back to it to see that it wasn't anxiety at all. The thought of socializing did prompt anxiety in the past because it was so draining and stressful, but without the anxiety, it is still draining and stressful. I was trying to find differentials between SPD and AS and the most informative discussions were here, even though there are three actual studies on this.



BTDT
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26 Apr 2011, 12:14 pm

The researchers have a much different goal--they want to find out what causes Aspergers/HFA/Autism. Since we don't know what causes any of these, it is quite possible that they may be taking the wrong approach by comparing similar syndromes, but this is an accepted scientific methodology. Some of this is driven by what folks are willing to pay for--it isn't too hard to find hysterical parents who will support this sort of research.

The proper diagnosis an entirely separate issue for folks who are looking for the root cause of the Autism spectrum.



anneurysm
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26 Apr 2011, 1:04 pm

I read a scientific journal article recently which demonstrated that up to 3/4 of people with autism spectrum disorders would also qualify for a secondary diagnosis. The most common disorders were anxiety and depression, but a significant part of the ASD population studied was found to also qualify for diagnoses of social anxiety, OCD, ADD, or even schizophrenia-type disorders. I think that it shouldn't be a question of "X or Y" because often X and Y occur together.


_________________
Given a “tentative” diagnosis as a child as I needed services at school for what was later correctly discovered to be a major anxiety disorder.

This misdiagnosis caused me significant stress, which lessened upon finding out the truth about myself from my current and past long-term therapists - that I am an anxious and highly sensitive person but do not have an autism spectrum disorder.

My diagnoses - social anxiety disorder and obsessive-compulsive disorder.

I’m no longer involved with the ASD world.