On the Garbage that is the DSM-V

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Broadness isn't the problem. In fact broadness is another problem. You can't seem to actually read what I am arguing. I am saying that people with some symptoms who are credibly autistic will be cut out because they don't have all.

Oh yes, because then we will be able to take account of milder symptoms that people wont have. Fantastic MrXxx.

Your analysis is wrong.

Look at the DSM IV characteristics for autism. They are not convoluted. They are certainly far less wordy and convoluted than the replacement, unless of course you're blind. Although I think we can rule that one out.

Yes of course, and block out those who have some of the criteria of the DSM IV who were then diagnosed, whilst in the DSM V because they don't have mild versions of some of the characteristics they wont be diagnosed anymore because dumbasses can't be bothered to get acquainted with the diagnostic. There is a flood and your solution is to turn on the fire hydrants and close the sewers. Congratulations.

I did. They're wrong.

Changing how you diagnose it so that people MUST have a larger number of issues that aren't necessary will block them out from necessary help. It is not just changing how we refer to it.


Ah, so the old I am a frustrated oversized teenager who doesn't get his way response.


Well that is true. For starters my arguments make sense.


I am sorry but you have to be quite self-centred to think that I would get frustrated at you for not agreeing with me. I have arguments all over this site quite a lot, and I don't expect to convince anyone. I expect to do the right thing.


Given how you are resorting to whingy retorts methinks some psychological projection is going on.

Correct. Broadness is not the problem. Criteria that are too narrow for each type of Autism, and too many different types of Autism, is the problem. Taking ALL of the current criteria for ALL types of Autism, and merging them into a single existing diagnosis, with a broader set of criteria than it previously had, is the idea behind DSM-V Autism criteria.



Examples please. I believe I know where you're going with this, and I do understand why, because I've gone there myself. I do now understand why I was probably mistaken.



Your statement doen't make any sense. Take into account symptoms that people don't have? What universe does that work in?



Of course it is. It must be if you say it is.



Yes, if all you look at is the current Autism criteria, that's is what you will see. But you are totally missing the bigger picture. Autism in DSM-IV is NOT the only form of Autism. Asperger Syndrome is NOT the only OTHER form of Autism there either. In order to understand the full scope of why these changes are being made, you have to take into account ALL forms of Autism listed in DSM-IV, that will ALL come under DSM-V's "Autism Spectrum Disorder."

When you take ALL of the DSM Autism disorders into account, Autism criteria is most certainly far more convoluted and confusing in DSM-IV than it will be in DSM-V.

You need to remember this isn't all about nothing more than AS vs. Autism. This debate is all inclusive of every Autism Spectrum disorder in existence.



The analogy is ridiculous. Your smarminess is even more ridiculous. You've made up your mind and that's that. You're not even listening.

WHO, exactly, do you think will be "blocked out" by these new criteria? As I mentioned before, I think I already know some of the examples you're going to bring up, because I've brought them up MYSELF in the past. I've taken the time to LISTEN and realize I may have been wrong.

But I'd rather hear what you think about this than to assume I already know what you're going to say. I may not know.



No, they are not wrong. You're missing the point. The rationale explains the reasons for them doing what they did. The reasons are what they are. They're not "wrong," or "right." They just are. You are free to disagree with them being valid. Valid and "right" are not the same thing. Invalid and "wrong" are not the same.



You keep saying that people must now have a larger number of issues, but you haven't offered any examples. As I said, I've got a pretty good idea of why you think so, because I've seen the arguments before. The fact is, under close scrutiny, none of the arguments I've seen so far hold any water.



Who's trying to get their way here? Hmm? I don't really care one way or the other what you think. You seem to be pretty invested in convincing everyone here that you are right though.

I am neither frustrated, nor am I trying to "get my way." I'm fifty one years old for gosh sakes, and my feelings are not hurt one bit by people who don't agree with me. "Whatever" indicates I don't care either way. Your agreement or disagreement has no impact on me.



Not to me they don't. All that matters is that they do to you. But one who never questions what he believes never learns or grows.



Fine. If you expect to do the "right thing," then quit thinking you've got all the answers. Listen for a change. Give me some examples of why you think anyone should be excluded by the new criteria, and I'll do my best to explain why I don't believe they will be.

Remember that I once thought along the same lines as you are thinking right now. I've changed my mind. If you're really invested in doing the right thing, you'd want to know why.



Yeah, that was a curt and unnecessary final remark. I admit it. Get over it so we can have a civil discussion instead of just hollering "you're wrong" at each other.

"Get over it" indicates nothing other than an invitation to man up and offer reasons and examples, and to listen at least a little. It's not a whingy retort (whatever that is).

Toughen up man. Give me some decent reasons for your claims. I may or may not agree with your reasons. You may not agree with mine. At least CONSIDER something other than your own viewpoint.

No, that isn't a problem either. The problem is that some people will not have a few of the characteristics at all, and thus they will be left out because the new diagnosticdemands all the boxes must be checked bar one.


That was the point? It was sarcasm levelled against the insistence of the DSM V that mild autistics must have mild versions of nearly all of the traits.

You know I could have selectively quoted you the same way but I am not an idiot trying to score points.

And they can't be bothered to be able to juggle the differences? I can understand getting rid of PDD-NOS, but by amalgamating all of it they will be cutting out those who are autistic but have some symptoms and not all.

yes, I am listening. Stop using this cliched mudslinging already. The analogy is fine. It says you are deciding to stem the problem of underdiagnosis by actually decreasing the avenues for diagnosis.

Didn't I already tell you? Who's not listening when he can't remember this?:
Yes of course, and block out those who have some of the criteria of the DSM IV who were then diagnosed, whilst in the DSM V because they don't have mild versions of some of the characteristics they wont be diagnosed anymore because dumbasses can't be bothered to get acquainted with the diagnostic.

Also who exactly is smarmy when he first says that I don't listewn and then bolds it later as if you insult me? I mean come on.
You're not acting your age I am sure.

:/
http://thesaurus.com/browse/valid

If you actually look at the DSM V you'll see that you need at least six general characteristics to qualify. For aspergers in the DSM IV you need only three. The three are less general.

Can you actually say how they don't rather than just say they dont?

Don't be full of yourself. I argue for hours over what is right with everyone on here. You're the one making childish comments here.

A dispassionate 'Whatever' is something a teenager says.

And the man who can't accept that six characteristics needed is not more stringent than three is in denial.

I already gave the situation. You already said that the arguments were bumpkis, although you never stated why. Of course I don't think that I have all the answers. How many political cliches are we gonna have? Just tell me why I am wrong about the stringency already rather than just say I am.

Well I actually did explain why you're wrong. I said the new DSM V is more stringent because it makes people have to have six characteristics rather than three, as asperger's did in the original DSM IV, and that'll cut out mild cases. ou just said that I am wrong because you were in the same position as me and because you have counter reasons and because of weird politicized remarks like I 'don't have all the answers', all of which aren't answers. But please, I am waiting.

Whingy retort means a curt reply that sounds like a whine.

Stop pandering to your ego and just tell me rather than say I don't care. I have bothered to reply so far and all you did at the end was say 'whatever' at the end like you don't care to listen.

Where does it show you need six? You need five because you need all three in the first and two in the second. Then they need to impair you and limit you everyday for you to meet it and they need to be present in your early childhood.


Also my question has been what if you only meet half of the first three? Like let's say you can have normal conversations and talk about anything despite your obsessions and narrow interests. Let's say you don't have inappropriate body language but you have a hard time with eye contact and reading body language. Let's say you did to pretend play as a child and you played with other kids using your imagination but yet you had troubles with friendships growing up and had a hard time with getting relationship. But let's say you met two in the next part of the criteria, the whole thing but you didn't meet everything in the social communication part. I think this is what gedrene was on about and why this new criteria I a problem. They would have met the AS criteria but won't be meeting the new ASD criteria despite their sensory issues and their routines and their obsessions.


So basically that would mean lot of people in my group don't have this anymore starting 2013 because I have seen them doing back and forth conversations and I don't see them yapping about their obsessions when they talk, and that would mean my ex who had it wouldn't have this either since I saw him talking to his employees all the time when he worked and he didn't go yapping about his interests. He didn't go into monologues. In fact i have noticed when I do excessive talking, I am the only one doing most of the talking but does that mean I am failing a normal conversation? I don't think so. It's not my fault the other person has nothing to say. They are just listening and making comments to what I say. Then other times me and the other person are doing back and forth conversations. Oh boy I just failed the criteria. And if I am not talking at all because I am not interested in what they are saying, doesn't everyone do this? I am just shy also and not interested in what they are saying. I don't know if it would count if I have a hard time in groups with conversations because I don't know when to speak and I can't seem to keep up with the flow but I do fine on one and one. I can also do fine with small groups of people but that depends. I even talk to people fine I am comfortable with and I talk to my mother fine also and to my husband.


Maybe we are all taking this too literal?

Gendrene, you've gone beyond ridiculous with your responses. Go back and read our entire exchange from the beginning (my original response). Right from the get go, you responded by dissecting my entire post, which was nothing more than a polite expression of my opinion, and inserted rather rude and unfounded accusations, calling me "crass," "cliche," writing in condescending tone, and attacking my logic, of which I had actually offered very little. My original response was nothing more than my personal opinion, which last time I checked, I am free to post anywhere on these forums. It was not addressed to you personally, and was not intended as a commentary on you personally.

You, however, chose to take it personally, responding with snide remarks, aimed directly at me.

My comment about "crying the sky is falling," was not a meant the way you took it. "Crying" in that context, was intended the same way it is intended when referring to a "town cryer." Crying has more meanings than sobbing like a baby, and I did not mean it that way.

I was going to respond line by line to your last reply to me, but there's no point. All you did in that reply was repeat what you have already said. You haven't once answered my request for examples, which I asked for a couple of posts ago, yet you have the audacity to accuse me of giving no examples.

Where are yours?

Here's one I know of:

Good example. I used to think the same thing, but here's why I changed my mind:

First of all, you have to take into account that the "bad posture" thing isn't simply about bad posture. It's about using posture as body language. Read the criteria again, then take into account the full scope of what it means, in context:

(1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

What this means is the use of any form of nonverbal behavior to regulate social interaction. "Body postures," in that context, doesn't mean just plain poor posture. It means using body posture to accurately communicate emotions or other types of subtle communication.

Body posturing, facial expressions and eye contact are all external ways of presenting communication. They are, when they are awkward or not present at all, ways in which Autism can be physically "seen." Let's face it, if nobody with Autism ever looked or acted in any way that differed from anyone else around, nobody would have any reason to think there were anything different about us. There would be no criteria to describe it, there would be no diagnosis, and therefore, there would be no Autism. We would all still be nothing more in the eyes of the world but uncooperative, selfish, self centered, egotistical miscreants who just need more discipline.

It is precisely because we appear different that others are able to discern we ARE different. Much of that difference can be seen in our awkward use of body language, if we use it at all.

I would dare say that probably ALL of us, display some form of awkward or non-existent body language (e.g. poor eye contact, poor communicative posturing, inappropriate gestures or facial expressions). I say "dare say," because I do not have any particular studies at my fingertips to "prove" it, but it is an educated guess based on twelve plus years of personal research, reading, diagnosis of four out of five of my immediate family members (including myself), a brother in law with AS, and now almost two years talking to dozens of users here on WP, plus five years of conversations with dozens of users on other forums for Autistics.

That said, I think, with some degree of confidence, that those of us who have any form of Autism far more than likely meet the criteria, "Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures."

The purpose of the new criteria was never to exclude anyone who meet the current criteria. If you have Autism (pick your form, AS, PDD-NOS, HFA, or whatever), now, you will still have Autism under the new criteria.



The inclusion of this rationale is a message to all professionals implementing the new criteria, informing them that the intention is to make them more clear, AND to increase the sensitivity with which they are assessed. Meaning the intention is that less people who HAVE Autism, should be missed than are currently being missed. That is the stated intention.

Any professionals that start diagnosing Autism less than before, would be ignoring the stated intentions of the APA. Follow me? The problem is not the criteria, as I originally said. The problem would be professionals that don't do their homework and train properly. And that's already a problem.

Also, you need to look more closely at the DSM-IV criteria. There are not just three criteria to be met for AS, there are no less than SEVEN. DSM-V also requires seven, but they are a little differently worded and structured.

http://www.dsm5.org/ProposedRevisions/P ... px?rid=97# (You'll have to click the DSM-IV tab to see the correct page)

2 in the A category, 1 in the B category, and C, D, E, and F. That's seven, not three. DSM-V requires all three from A, two from B, and C, D, and E. That's still seven, no more than before.

I'm not sure why you seem to be so convinced all hell will break lose with these new criteria. I really believe you've got nothing to worry about.

Let me ask you a pointed question. I see your profile says "Have Aspergers - Undiagnosed." Have you actually been to a professional about your AS? Have you actually tried to get a diagnosis yet?

The only reason I'm asking is because, if you have not, I would wonder why you feel so strongly about how things will play out if you're not even yet personally familiar with the process.

I am NOT denigrating your self diagnosis. I spent over a year here self-diagnosed. I never hold that against anyone. I'm just wondering what's making you so sure about the way you're perceiving this whole thing.

@gedrene.look stop worrying.it may be true that one must have 3 or how many ever boxes checked technechly.what is or isnt a technical symton is subjective and not easily defined.just because you dont think you could fit all the criteria doesnt mean a doctor could see that you fit the general profile and see symtoms you dont see.for instance echolalia can be extremly obvious or very subtle and the same goes with all other criteria.i see all your points but i dont see you or anyone else not getting dianosed.also your pretty articulate here and im sure you could get a doctor to understand how autism manifests itself in you.if i was a doctor i would easlily see you have samantic pragmatic disorder,which is mild but is a ASD

You need to try to remember too, that this isn't just about AS versus Autism. It's about all five forms of Autism.

Asperger's Disorder
Kanner's Syndrome
PDD-NOS
Rett's Syndrome
Childhood Disintegrative Disorder.

All five are now included in the new criteria for ASD. So the whole system of diagnosis IS much simpler in DSM-V. And if you consider the fact that with higher functioning forms of Autism, one can learn to adapt, cope and mask many symptoms. As we get older, we may start out qualifying for AS, but end up not qualifying anymore, but will qualify for PDD-NOS. In other words, with the current system, your diagnosis can change over time.

It is also fairly well established that as one approches old age, symptoms can return and even worsen, meaning your diagnosis could be AS at one age, PDD-NOS at an older age, and back to AS at an even older age.

If that isn't confusing, then nothing is.

With the new criteria, you either are, or are not, Autistic. From there it's just a matter of degree. How severely it presents may change over time. You may go up and down the severity scale, but you're still Autistic (much as you are now, but it's not only less confusing to us and professionals, it's also a lot less confusing to people first learning about Autism)

I did see the comment you made that professionals ought to be able to deal with the current DX criteria, and I don't disagree with you on that point. The reality is though, a lot of them don't get it the way they are. You would not believe how many professionals told us our kids couldn't have AS or Autism, based solely on a single criterium they did not meet. All of them criteria that are not required, but part of the groups of possible symptoms out of which only two or three are required.

We may like to think that professionals ought to know their business better, but the reality simply doesn't support that desire a lot of the time. And that, as I've been pointing out, has been, and will continue to be a big part of the problem. Simplifying the criteria SHOULD take care of at least some of that, but only time will tell.

It is my understanding that the DSM is regularly reviewed and amended as deemed necessary and useful based on the experiences of those who use it. As far as I recall the proposed changes were proposed at least in part because studies and reviews had shown that there was no significant difference between those assessed and diagnosed with Asperger's and those diagnosed with 'High Functioning' Autism. As adults are increasingly seeking assessment the criterion relating to language delay was proving difficult to assess due to lack of information and in any case any language delay was shown to have no long-term significance or impact.

My son was diagnosed, aged 7, according to the criteria in WHO ICD-10, ie, he "has complex difficulties involving significant and qualitative impairments in the areas of social interaction, social communication and play/flexibility of thought.". His assessment was detailed, conducted over a period of weeks and took into account the opinions of a variety of professionals, myself and his own thoughts.

My son would also easily meet the criteria for an diagnosis of Asperger's in terms of DSM IV and also the new criteria proposed for DSM V.

My son has struggles and requires a range of supports and accommodations, but I suppose he could be considered to be comparatively "mildly" affected if you want to think about it that way. He attends a mainstream primary school, does not require an aide within the classroom nor has he had to change school to access additional services, eg, an autism unit.

I think the new criteria seem fair and the proposed grading according to severity useful, sensible and clear. The rationale given for the changes make sense and serve to streamline and consolidate the diagnostic criteria.

Not sure if anyone brought it up so far in the thread, but according to the DSMV comments section individuals previously diagnosed with aspergers are expected to fit into the revised diagnostic criteria for autism spectrum.

However with PDD NOS, no comments have made regarding existing PDD NOS cases in the DSMV comments section, that I have seen. Current cases of PDD NOS only require two out three of the core triad criteria of impairments in social interaction/communication/repetitive stereotypical behaviors and interest category.

Repetitive stereotypical behaviors and interests is required as a stand alone criteria category, in the revision of the DSMV, for ASD, and there are currently individuals diagnosed with PDD NOS, that do not have impairments in this criteria category.

It has been suggested by some, that these individuals currently diagnosed or new individuals diagnosed without the Repetitive stereotypical behaviors and interests category may potentially be placed in the new Social communication disorder diagnosis in the DSMV.

Bah. I've seen enough perusing through the OP's posts from day one of your arrival to draw what I now believe to be an accurate enough conclusion.

IMHO, you haven't much to concern yourself with. I highly doubt any competent professional would diagnose you with any form of Autism, though we're probably never going to find out anyway. Everything about your posts, from day one, has been all about "teaching us" how to view and handle Autism. You haven't shown one shred of evidence you have any interest at all in getting a diagnosis, which begs the question, "What the hell are you so cranked up about the DSM for?"

Pretty much everything you've posted from the beginning suggests you don't even believe it's a disorder. Funny how vocal some self-diagnosed people can be about that particular point. I find it rather ironic. Over 2600 posts just since July. Impressive if it weren't for the fact that you obviously aren't here to learn a damned thing from anyone here. You came to preach. That's clear as a bell.

But who on earth do you think you are coming here to teach all of us, many of whom have ponied up and PAID for our own diagnoses, because we were not arrogent enough to trust our own judgment? Who do you think you are coming here, telling us all how to handle it, with no proof you have any idea what you're talking about? I suppose we're just supposed to take your word for it. "I have Autism. I know because I know, so you should all just sit back and let me tell you how to live with it, because you whiney good for nothings don't have a clue!" No, that's not me putting words in your mouth. That's me paraphrasing the general gist of your posts over the course of the past several months since your arrival.

Look, I don't have anything against self diagnosed people who've done their research, KNOW it's a real problem, and come here to LEARN. That does not describe you. You've got your mind made up about everything. You don't seem to think it's a real problem. You seem to believe "mind over matter" will solve all our problems. You don't seem to recognize that Autism is in the MIND. It's a very real disability that affects many of us to an extreme degree. Minimizing that reality is insulting.

You talk a lot, and reveal a huge amount of misinformed opinions based on nothing more than your own logic.

I have managed so far to not feel justified in calling anyone out claiming to have diagnosed themselves. Until now. You sir, as far as I am concerned, are a fraud. If I am wrong, fine. PROVE IT. Get a diagnosis. Put up or shut up.

And, if I do turn out to be wrong, feel free to announce it. I have no problem admitting when I'm wrong. But, if you do, sit back and start learning about it. Stop preaching to the rest of us. Because if you do have Autism, it's YOUR Autism, not ours. Everyone's is different. What works for you doesn't necessarily work for anyone else. That's probably the most important thing about Autism you need to learn.

If you aren't willing to admit it is a real disability, over which some of us have little to no control, then you really do NOT understand it. And, if you don't believe thats what it is, this whole thread is nothing but a farce.

Last edited by MrXxx on 22 Nov 2011, 2:39 pm, edited 1 time in total.

Autistics have no impairments in social interactions. This is because neurotypicals don't know how to deal with autistics so they are the problem.

Always remember this, no two apsies are the same. I don't personally fit all of the symptoms, the criteria is a rough guide. The spectrum varies, Aspergers can manifest itself as a mild to sereve form, there is no "one fits all" form. However the criteria provides professionals with a guide, they can identify the symptoms and from there assess what needs to be done. It's just a guide, not a"be all and end all"

Always remember this, no two apsies are the same. I don't personally fit all of the symptoms, the criteria is a rough guide. The spectrum varies, Aspergers can manifest itself as a mild to sereve form, there is no "one fits all" form. However the criteria provides professionals with a guide, they can identify the symptoms and from there assess what needs to be done. It's just a guide, not a"be all and end all"

Ah, five! My mistake. I misread.


Exactly!


That may be a bad assumption, because the fact is that psychological guidelines may be taken too literally or not literally depending on the psychiatrist/psychologist. It's better to be safe than sorry.

But I am not your son. I only have some of the symptoms. I can qualify under the DSM IV but not under the DSM V because the DSM V insists I must have more characteristics than what the docs say I have. I might be let in before that time, but the fact is that others will be left out.

In re: to League_Girl's question, is it possible the problem is that the DSM V is still geared to diagnose children and doesn't take into account the coping skills learned over the years? I'm wondering, I don't know.