Similarities & Differences: Why the DSM-V Makes Sense

Post Reply New Topic

I know what you mean. With the new criteria I don't think you'd be diagnosed, then again I don't know you at all lol.

But I know I wouldn't be, MAYBE with the current criteria by a psych with a liberal view of ASD behavior.

Here's my thing, you can view autism as either a disorder or a way of processing information.

Yes, it is a very real disorder for the ones who are diagnosed but there are many of us walking around who process information in the same way and for whatever reason have a made a few random neuro connections that have let us slip through the cracks. But is that a bad thing?

It's like knowing that you aren't technically normal but can function as such at the same time. Assuming you can (universal you, not you personally) I see no reason to pursue diagnosis.

I predict the exact same thing will happen with the DSM-V that happened with the DSM-iV:

1. Professionals will read it, come to their own personal conclusions about what the criteria "really means" and how it "looks" when people present with ASDs (pretty much like they do right now).

2. The more respectable professionals who bother doing extra research will naturally gravitate to the research that is in line with their own personal preferences (pretty much like they do right now).

3. People will continue to claim that AS and autism are completely separate and present evidence for why they think this. Other people will continue to claim that they're not, and present the evidence for why they think this. Meanwhile, scientists will continue to endeavor to identify more objective ways of determining what is and is not autism, and individuals on internet message boards will continue to debate how many angels can dance on the head of a pin.

In other words.......SSDD.

I'm not sure that how they feel is important by itself, there's some information missing to arrive at a conclusion. It would be more interesting to consider their opinion with respect to a measure of their objective mastery of the DSM-IV criteria as opposed to how they feel they have mastered the DSM-IV, meaning how comfortable they're with it.

At the moment, psychiatrists might feel that the old criteria are far easier to administer in a clinical setting because of how used they are to the old criteria - but given the number of wrong or "random" diagnoses within the spectrum, their confidence in the criteria and/or their own abilities to use these criteria seems to be more than questionable.

If a foreman gives a construction worker a screw driver to hammer nails into a wall you're going to end up with a screwed up wall. This isn't about "the spectrum", they object to the DSM 5 as a whole. And they're right, the process is screwed up therefore the manual is screwed up. As you can see below many practicing clinicians aren't very happy.

The socially aloof and active-but-odd social profiles can eggsist in the same person at different developmental stages or in different situations at the same age. Assigning one profile to AD and the other profile to AS is taking a simplistic overgeneralized non-contextual approach - the usual NT approach to autism because NTs lack the internal context to understand how autistic behaviors work on the inside.

A lot of the socially aloof vs. passive vs. active-but-odd differences can be explained by a person's communication abilities, verbal and non-verbal. A child lacking communication abilities, like speech and gestures, will appear socially aloof. Once the child gains communication abilities, she may come to appear passive or active-but-odd, depending on the social situation.

When I was a child, I was socially aloof, because I lacked basic functional communication abilities. I did not speak, and I did not use gestures. I had zero verbal thoughts in my mind, so there was no way that I was going to be able to generate any in real-time for speaking to myself or others. When my mother asked me basic yes/no questions about being hungry/thirsty/sick/hurt/bathroom, I could not answer them through verbal or non-verbal communication, no yes/no, no nod/shake, but appeared like I had heard and understood nothing. This continued well into school-age. In the context of this lack of communication abilities, socially aloof was the only possibility and had nothing to do with me wanting or not wanting to communicate. Communication was not an option, both because I could not when it occurred to me and because it did not occur to me most of the time. Around age eight, I started developing communication abilities, and once I had spontaneous functional speech, I no longer appeared socially aloof, but more passive, being able to respond to overtures of others and functional questions. On certain topics, like those of my special interests, I could appear active-but-odd, going on and on and on in a group of people about a topic and not getting it at all that others are bored or annoyed. I could talk about topics, usually physical ones like science or nature related, but still not about myself or my internal states of mind or others or others' internal states of mind. It's only within the past couple of years that I have been able to verbalize my own states of mind and communicate that to others, but when it comes to others' states of mind, I still have almost no ability to verbalize their thoughts, and it doesn't help that their states of mind are so different from mine and foreign to me, and even if I knew them, I would use different words to describe the same states than they would use.

What I am trying to say that the social profiles that are said to distinguish AD and AS may have an underlying cause in the communication aspect of the triad, and the development of communication skills, or lack thereof, may reflect severity of the autism. So it is not like Asperger's children have this social style for some mysterious reason, and Kanner's children have this other social style for some other mysterious reason, and these social styles and mysterious reasons distinguish Asperger's and Kanner's Syndromes as ones requiring different definitions in the DSM. It may be more like some autistic children develop verbal and non-verbal communication abilities faster than others, and some autistic children have the potential to develop high levels of communication skills and some do not, and this is a spectrum of severity, as in the DSM-V, that results in distinct social profiles that cannot be generalized to AD like this and AS like that, so it is bester not to generalize at all, but focus on individuals with individual sets of traits.

Edit: Also, autistic people with a certain set of traits will see themselves as very different from other autistic people with another set of traits. Someone who had early communication development and was not or does not remember being socially aloof will see themselves as having a distinct condition from someone who is socially aloof as an adult and does not respond to others at all. Someone who does not use much speech as an adult will see themselves as having a distinct condition from someone who talks on and on and on in social situations. People who have been both will find it hard to make these distinctions.

I did understand your point and respect your opinion. I merely expressed my disagreement about the issue because personally, I disagree that this specific concern is the a stand-alone problem about the DSM-V and the very mental health professionals that will be required to use it.

Agreed.

Amen. The DSM-5/V (has it officially been decided if they're rejecting the Roman numeral?) is an absolute abomination from what has been proposed. And not just with how they're removing AS and reclassifying ASDs. As far as I can tell, every single class of psych disorders is being slaughtered. I think one of the most infuriating proposals is making a SEPARATE class for Obsessive-Compulsive Spectrum Disorders, a class that INCLUDES OCD itself! While I'm all for making an OCSD section for things like trich, compulsive skin-picking, and compulsive hoarding not obviously linked to OCD fears of death/safety, it is absolutely ridiculous to remove OCD from the ANXIETY disorder category, when it is the most severe of the anxiety disorders! Any OCD-er will tell you that the torture of OCD is the anxiety, dread, and guilt that comes from the obsessions, and putting OCD itself in a category with spectrum disorders that merely show compulsive behaviors and impulse control is just ludicrous.

So far, the only thing I see beneficial in the proposals is the addition of binge-eating disorder. The rest can go in the trash as far as I'm concerned. And don't even get me started on how they are choosing to keep the currently horrible definition of bipolar I mania...

I'm more perplexed that the DSM-V sustains gender dysphoria as a disorder. This is the 21st century.

im curious under the new system,if you already have a formal aspergers DX.
1.does that mean you automaticly have a level 1 autism DX
2.or does that mean your previous diagnosis automaticly vacated and you will need a new formal DX

That is a good question. I do not have the answer.

2

Ditto. Almost mentioned that in my post. Keeping transsexuality in the DSM-V is no different than homosexuality being in the DSM-III. It's highly offensive.

The fact that politics and greed have taken over the DSM 5 completely is highly offensive. I wouldn't wipe my ass with the DSM 5 as it stands.

Think greed got into the DSM book long time ago in my opinion. I not read the post if someone mentioned the "DSM V Introversion slip up".

It might be different elsewhere, but without a definite expression in form of a diagnosis insurance won't pay for what they call "treatments" of what's "wrong" until it's "right" such as hormone therapy or sex reassign surgery.

No idea of political correctness about this topic so feel free to correct me/my wording, but:

If the diagnosis were to be removed completely people who pursue such changes will have to be rich or will be forced to stay put. In case someone can pay for what they want, it will also likely be very difficult to convince health professionals that it's not "all in your head" and that your "ill" experience can be "removed" but a perfectly real thing wrong with your gender that needs to be changed.

Maybe there needs to be a shift in perspective of what the medical issue is. Perhaps removing it from the DSM but keeping it in the ICD, putting it into another category to point out that being born and growing up with the wrong gender makes up the "disorder", not making it out as if the realisation that it is wrong and the association with the opposite gender is a behavioural problem by calling it a mental disorder or (in case of the ICD) a disorder of personality and behaviour.