Is this what a diagnosis should look like?

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I was seen by a psychiatrist who said unlikely I have ASD (had been seeing him due to anxiety symptoms) and referred me for CBT. Went for initial CBT assessment a few weeks ago and psychologist said likely ASD and arranged a further appointment for mid July. Since the psychologist meeting I've been waiting for his letter confirming and it has arrived today. Letter sets out what was discussed; 46 on the AQ, 5 on the EQ and a brief summary of the last year etc. as I has had some big changes at work that triggered a prolonged period of anxiety. The pertinent paragraph is "... I think it would be accurate to say that the anxiety appears to me to be secondary to an underlying ASC, which is not unusual in this group of people and that the contextualisation of experience itself can be therapeutic as it gives access to a knowledge base around coping with some of the difficulties of making transitions".

So is that it? Do I have ASC or is this too ambiguous? In the letter he suggests he did the letter because I asked for it for my employer- that's partly true but if this isn't a diagnosis then will a written diagnosis look any different? I'm going back in a couple of weeks but it would help to know in the meantime what he actually means.

Anyone? I posted this at about the time all those spam messages appeared so perhaps it was missed?

It sounds like it's just a letter confirming what went on in the appointment but not an actual diagnosis, if you're going back for a proper assessment then the report from that should be a lot more detailed and clear about whether you have an ASC/ASD.

Although it's not clear whether you're going back for an assessment or just another appointment, I would enquire about having a proper assessment for ASD. Good luck.

Thanks. This has upset me a bit really as I'm now getting different answers from the doctors I have seen. The psychiatrist has said I'm probably not ASD and so treated me for anxiety, referring me on for CBT. The letter I have referred to above was from my initial consultation with the psychologist to start the CBT. I'm seeing them both later this month but, having had a period of being ok I'm getting really frustrated that I now don't know who has primacy- will the psychologist do the assessment or does the psychiatrist decide if I can be assessed or not? I appreciate I won't find the answer on here but it's annoying having to wait again, especially as my treatment will presumably depend on my actual diagnosis.

Rather than counting down the days until my next appointment I have written to the psychologist to ask why I now have contradictory opinions. As the treatment I get will depend on the actual diagnosis then I don't think it's unreasonable to ask for a full ASD assessment now. I'm hoping that my letter will mean that the psychologist will be able to start the process of getting the assessment arranged or at least will know what I want prior to our meeting.

Your description suggests that your diagnostician (psychiatrist) believes that he knows better than most of the world's diagnostic criteria for autism. The current criteria, both DSM and ICD, are abundantly clear about what must happen for a diagnosis, and it isn't all that complicated. It is remarkably simple for even amateurs to understand. While the Cambridge screening tests (AQ and EQ) are good indicators (very good in my opinion), they aren't required to be used in diagnosing (though many diagnosticians sometimes do refer to them).

I read the "pertinent paragraph" as actually diagnosing ASC with a comorbid diagnosis of anxiety. This combination is very common among diagnosed autists. But, I agree that the paragraph could have been a little more obvious. Maybe your diagnostician had his doubts about the evidence, but was willing to go where the evidence pointed. He mightn't have been able to explain away your argument but, in his mind, he found a way to satisfy your evidence without breaking it down piece by piece.

It is quite common for experienced diagnosticians to lack experience with adults, and especially those adults with good masking skills.

If you would like a more explicit written assessment, you could ask your diagnostician to rewrite the paragraph in question "so that your employers would understand completely." He should be able to provide that service, easily.

You should take the ASQ or the AQ, If the results are conflicting than there was a problem with that is so weird.. ASD and ASC mean the exact same thing. Autism Spectrum Disorder, Autism Spectrum Condition. That is weird. There the same thing. PDDs are all ASD related, the least on being Rett's Syndrome. Which is bizzare, they all are related which is why they're in the PDD catagory. It's Bizzare, though. Since I have a PDD-NOS I don't have Autism Spectrum Disorder I have Autism Spectrum Conditon. Like what is this. You should consult the doctor on this, Why does he have a degree if he is this stupid. ASC = ASD. This is weird. Doctors, Ain't know $hit and act like it. I'd respect them more if they told me that.

I'm going to second what AspieUtah said, except I'm not going to be nearly as nice. The psychiatrist sounds stupid to me. I would go see someone else. The AQ and the EQ have way too few questions to be relied on for diagnosing autism in an adult. Plus, although I always am interested to see Baron-Cohen's work (he and his team invented the AQ and the EQ), their work is frequently if not always overturned by subsequent research.

Hehe!


I wouldn't say that the diagnostician is "stupid," but I would put him in the same category of diagnostician I had during my first (botched) assessment: Inexperienced and/or professionally blinded. While they can ably diagnose children, they claim to have "never seen an autistic adult."

I like Baron-Cohen, but I agree that a thriving university autism clinic probably can't afford the time and money for its staffers to perform research. So, of course, they led the world in instruments like the AQ et al., but, with all their screening tests still in Beta-test status, it isn't suprising to see other methods surpassing them.

Was that too, nice?

In the United Kingdom (and many other nations including, to a degree, the United States), most clients and many diagnosticians don't like the term "disorder" used in diagnostic criteria. Unfortunately, U.S. law requires the term to be used in any diagnosis which hopes to be reimbursed for payment by one of more government agency.

So, Simon Baron-Cohen Phd agreed and has since used only the phrase "Autism Spectrum Condition" to describe his diagnoses. The World Health Organization's diagnostic ICD manuals used to prefer "conditions" over "disorders" too, but now appears likely to adopt Autism Spectrum Disorder in its upcoming 11th version. Maybe Europe (or at least the U.K. National Health Service) is getting as legalistic as the United States has become.

Thanks for all the replies, some very good points made.

At present I don't know if I have anxiety or anxiety with underlying ASD. I suspect it is the latter but hope it's the former as, in theory, that is completely curable. If it is ASD then I would like to know rather than ignoring it as I could then make better decisions about what I do with my future; rather than aiming for something that ASD would probably preclude I can instead focus on my actual strengths.

This is my first experience of mental health services as with previous anxiety problems I have been treated by the GP. I have never been convinced anti depressants work for me. When I have had a problem and have been prescribed ADs I have found I started to feel better after a couple of weeks. Of course I put this down to the ADs working but looking back I also removed the cause of the anxiety too so it could be the pills has no effect. Most recently I was taking my current ADs and thought they were working until I had a new period of anxiety (I was due to have surgery and having never stayed in hospital before I was terrified ) which the ADs didn't help with. The psychiatrist upped my dose but I had also cancelled the surgery so the problem had also gone away.

SSRI antidepressants never did a thing for me. After I stopped them, I read the Scientific American magazine survey of SSRI efficacy ( http://www.scientificamerican.com/artic ... ants-work/ ) and learned that, at best, they are about 50/50 effective. There are certain times when they are worse than doing nothing.

I sprained my back the other day and spent most of yesterday in a haze of muscle relaxers and pain. I'm not sure what I typed.

But yeah I think AspieUtah and I are saying the same thing. The AQ (and the EQ) should be used WITH other diagnostic tools, not alone and not just with each other. And if a person thinks they haven't seen any or many autistic adults they can't accurately diagnose adult autism. I don't think it's possible for an adult to peel back all the masking and socialization techniques that have been drilled into every human being our whole lives, so it's not possible to show what any of us would look like if we weren't trying so hard to look normal. And EVERYONE tries hard to look normal- we just don't realize it. That's why I combed my hair this morning and took the time to put my socks on before my shoes and not vice versa.

Lots of clues about autistic adults can easily look like something else. Autistic adults can look anxious, depressed, lonely, confused, allergic, very stupid or very smart, or all sorts of things that have no basis in what the actual person is like. For example, an autistic adult may be suffering from grief or some other extreme emotion but react to it by getting sleepy or being very interested in something. It can be pretty confusing for people not familiar with autistic adults.

Ohh, I am sorry to learn that you were hurt. It might be too soon to consider, but, a very light massage in the coming days might help finish off the sprain.

I was only joking about your description of how "nice" I can be. Most people who know me don't ever call me nice. I took it as flattering.

Really? You always seem very considerate here on Wrong Planet.

Thanks! And, no, these people tend to turn their disagreements about my political career into reasons to shun me or continue their criticisms after almost 35 years. I don't mind, really. I was quite successful while they weren't. 'Nuff said.