View Full Version : Cynical Science and Tourette's


Don S.
07-07-11, 10:17 AM
What follows is a comment I made to an erudite layman regarding the field of medications.

[Note: Dr. Arthur K. Shapiro (1923-1995), a NYC psychiatrist, who more than anyone else established the current paradigm that Tourette’s Syndrome is organic, published his 1968 “landmark” paper in a British psychiatric journal after it had been rejected by every major American one. It is worth noting that within his paper, Dr. Shapiro dismissed the then prevailing view that TS is a psychological affliction and best treated by psychoanalysis. It is also worth noting that at that time most, if not all, American psychiatric journals were dominated by: psychoanalysts. (A Cursing Brain? The Histories of Tourette Syndrome (p. 172), Howard I. Kusner; Harvard <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comhttp://www.addforums.com/forums/ /><st1:PlaceType alt=</st1:PlaceType>University Press (September 1, 2000)]
__________________________________________________ ___________.

Is it not more than a tad ironic that in light of the fact that when Dr. Shapiro first advanced his new paradigm dismissing the psychoanalytic school in favor of an organic one in regard to TS that he faced so much (entirely predictable!) resistance and hostility that any who challenges his now established one faces the same reaction (and, I might add, for the exact same reason: the threat to the status quo in which so many have such a vested interest)?

Alas, hasn’t such always been the case with science? Who was it who observed that by and large new ideas are not accepted by convincing those who hold to the old, but rather when the old guard gradually dies out and the new replaces them?

<?XML:NAMESPACE PREFIX = O /><O:p< font>Science has reversed itself so many times in the past that at times it seems to have little more solidity than religion. Is it any wonder why it is so difficult to persuade a cynical and distrustful public regarding issues such as global warming?

As far as there being a greatly expanded pool of TS subjects in modern times, that is certainly true. By eliminating the criterion that TS symptoms have to be debilitating in order to merit the classification, voila the affliction was suddenly lifted from orphan disease status which greatly enhanced both donations to charitable institutes and governmental funding.

Not only is this true with TS, but the number of now recognized mental health afflictions as classified within DSM has grown exponentially over the last thirty years or so. This has come from pathologizing personality traits to the point that one wonders if there is anyone left who might be termed “normal.” Of course, many of the victims of said newly formulated afflictions might require treatment and their afflictions research.

__________________________________________________ _____________

The gentleman in question kindly referred me to the source of the quote that I referred to but had not remembered at the time. It was by the venerable Nobel Laureate German physicist Max Planck, the founder of quantum theory. Here is the exact quote:

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”

Dr. Planck later characterized matters more succinctly with:

“Science advances one funeral at a time.”

Worth noting.
</O:p<>

AbsentMindProf
07-07-11, 11:47 AM
Is it not more than a tad ironic that in light of the fact that when Dr. Shapiro first advanced his new paradigm dismissing the psychoanalytic school in favor of an organic one in regard to TS that he faced so much (entirely predictable!) resistance and hostility that any who challenges his now established one faces the same reaction (and, I might add, for the exact same reason: the threat to the status quo in which so many have such a vested interest)?

Alas, hasn’t such always been the case with science? Who was it who observed that by and large new ideas are not accepted by convincing those who hold to the old, but rather when the old guard gradually dies out and the new replaces them?

Science has reversed itself so many times in the past that at times it seems to have little more solidity than religion. Is it any wonder why it is so difficult to persuade a cynical and distrustful public regarding issues such as global warming?


Well, I would say that the scientific community shouldn't too quick to jump on the bandwagon of every new idea that gets proposed. When a theory is accepted by a large majority of qualified scientists it's often because a large body of data supports that view. That doesn't mean that it couldn't still be wrong -- it just means that someone is going to have some work to do to convince the rest of us that the established consensus is wrong. Would it be better for the scientific community to be constantly lurching from theory to theory? I agree that scientists are often too reluctant to admit it when their pet theories are proven wrong. That's not completely illogical, though. As a scientist, I am ALWAYS more familiar with my own data because I'm the one that spent years collecting and analyzing them. Doesn't it make sense that I would be more inclined to trust data that I've worked with all day long for two years than data that I read about in a paper and never saw firsthand? However, despite this reluctance to admit to being wrong, the scientific process is set up in such a way that it is very likely that my error will eventually be discovered (even if it's after my death). That's a heck of a lot better than many belief systems in which the same foolish ideas persist for centuries.

I should note that you also said that science "has reversed itself so many times in the past that at times it seems to have little more solidity than religion". That seems to be inconsistent with your criticism that scientists are too resistant to new ideas. First you said that scientists are too resistant to new ideas -- then you said that we must not know anything because we change our views so often. I don't think you can have it both ways.

The reality, of course, is that scientific ideas are known with varying levels of certainty. When you read a news article that says "scientists discover that X causes cancer" that's probably something that is at the forefront of scientific knowledge. There is a good chance that it is supported by only ONE study -- the one being reported. Of course there is a strong possibility that this will later be proven incorrect, because the proposal that X causes cancer is a new idea with minimal evidence to support it.

That does not mean, however, that scientists are just stumbling around in the dark without establishing any facts with a very high degree of certainty. You might read a news article tomorrow that says that "Oops, X doesn't really cause cancer after all" -- but you will NEVER read an article that says "oops, viruses and bacteria don't really cause disease". For example, we can say beyond any reasonable doubt that Europa is a moon that orbits Jupiter and that it is covered mostly by ice. We can say beyond any reasonable doubt that the galaxies in our universe are moving away from each other. We can say beyond any reasonable doubt that the abducens nucleus is a part of the brain that is important for generating eye movements.

There are tons and tons of theories in science that have almost no chance of being proven wrong. Unfortunately, the popular press rarely has anything to say about how much background evidence there is to support a discovery they are reporting on, so the general public has no way of knowing which scientific ideas are rock solid and which are not.



As far as there being a greatly expanded pool of TS subjects in modern times, that is certainly true. By eliminating the criterion that TS symptoms have to be debilitating in order to merit the classification, voila the affliction was suddenly lifted from orphan disease status which greatly enhanced both donations to charitable institutes and governmental funding.

DSM-IV diagnostic criteria for TS do not say anything about requiring that the TS symptoms be "debilitating". You can compare the DSM-IV and the DSM-V diagnostic criteria here:

http://www.dsm5.org/proposedrevision/Pages/proposedrevision.aspx?rid=111#

By clicking on the different tabs, you can also read the rationale for the proposed changes. I should also note that anyone diagnosed with TS under the proposed DSM-V criteria would also be diagnosed with a tic disorder under DSM-IV. The changes would merely affect *WHICH* tic disorder a person would be diagnosed with. It's not about creating some large body of new patients.

It is true that psychological disorders tend to be diagnosed only if they cause the person distress or interfere with important life activities in some way. That's just a good practical approach -- why label someone (and possibly give him access to prescription drugs) if the person is doing fine in his life?

In the case of TS, there has been a greater recognition that the tics can cause distress due to the negative reactions of others.


Not only is this true with TS, but the number of now recognized mental health afflictions as classified within DSM has grown exponentially over the last thirty years or so. This has come from pathologizing personality traits to the point that one wonders if there is anyone left who might be termed “normal.” Of course, many of the victims of said newly formulated afflictions might require treatment and their afflictions research.

This a much more complex issue than you seem to realize. A major reason for the increase in the number of disorders is simply that many existing diagnostic categories are being divided into two or more new diagnostic categories as psychologists learn more about them. That just makes sense. As we learn more about a disorder, there is a strong possibility that we will discover important subgroups within that diagnostic category.

If, for example, ADHD is eventually subdivided into two distinct disorders (ADHD and Sluggish Cognitive Tempo), that won't be because psychologists are on some evil quest to trick society into giving them more grant money. If this happens it will be because they come to realize that ADHD-C and SCT are sufficiently different in etiology and treatment needs that it is more useful to subdivide ADHD into two distinct disorders. If you look far enough back in time, there was a time when people with almost any psychological disorder were labeled as having "mania" (or some other similar term). As time went on, we learned that autism is not the same as schizophrenia and neither of those is the same as ADHD.

It is also the case that, as more is learned about a disorder, psychologists learn to recognize milder and milder cases of it. For example, 20 years ago, it was very unlikely that a person with Asperger syndrome would have been recognized as having a form of autism. As psychologists learned more about it, however, it became clear that AS is, indeed, a form of autism and that persons with this disorder need various therapies to do well. It wasn't some evil quest to diagnose everyone. I promise.

Current diagnostic practice for most psychological disorders requires that the symptoms be causing distress and/or significantly interfering with important life activities. Again, this a good common sense practical approach.

Don S.
07-07-11, 01:06 PM
Absent,

I deeply appreciate your having taken the time to respond to my post at all, let alone to the extent that you did. My appreciation is all the more heartfelt in that you are the first person (to my knowledge) with your credentials and research experience to deign “speak” with me, save brief email correspondences.

Your considered response deserves the same from me, and I shall present such as soon as time permits. You make some excellent points. However, I feel as though some of these points are made at the expense of my (regretfully) having used imprecise language in certain instances. I shall elaborate within my response.

Thank you again.

Dizfriz
07-07-11, 01:43 PM
Yes, science can be wrong and can change as new evidence comes in. This is not a weakness but instead is a strength of science. Sometimes the change is not as fast as some would prefer but evidence always wins out in the end.

Issac Asimov wrote a wonderful article on this which I think quite relevant in this context. From this, one can see that science is always "wrong". The best we can do is to get closer and closer approximations to reality. We never get there and we never should as having more things to learn and explore is what drives science. Unfortunately it involves human beings with all their foibles and inconsistencies but somehow, science manages to keep on plugging and learning new things and yes, changing views.

Issac Asimov The Relativity of Wrong http://chem.tufts.edu/AnswersInScience/RelativityofWrong.htm

This is considered a classic and perhaps even definitive essay on this topic, so enjoy.

Dizfriz

Don S.
07-07-11, 01:56 PM
Yes, science can be wrong and can change as new evidence comes in. This is not a weakness but instead is a strength of science. Sometimes the change is not as fast as some would prefer but evidence always wins out in the end.

Issac Asimov wrote a wonderful article on this which I think quite relevant in this context. From this, one can see that science is always "wrong". The best we can do is to get closer and closer approximations to reality. We never get there and we never should as having more things to learn and explore is what drives science. Unfortunately it involves human beings with all their foibles and inconsistencies but somehow, science manages to keep on plugging and learning new things and yes, changing views.

Issac Asimov The Relativity of Wrong http://chem.tufts.edu/AnswersInScience/RelativityofWrong.htm

This is considered a classic and perhaps even definitive essay on this topic, so enjoy.

Dizfriz

I had to jump in briefly to respond to your post.

If you ever have an hour sometime (I know time can be precious to many), then please read my (linked-to below) short story. Aside from affording readers the chance to understand what it can be like to suffer from TS as a kid and how such kids (privately) feel as a result, you will discover how I have personally felt about the “Immortal Isaac” since childhood.

Most assuredly, I shall read your link ASAP... with great interest!

Thank you again.

Best regards,

Don S.

P.S. In light of your comments, I thought you would in particular appreciate this quote:

"Science cannot solve the ultimate mystery of nature. And that is because, in the last analysis, we ourselves are part of nature and therefore part of the mystery that we are trying to solve."

Max Planck, Where is Science Going? (1932)

Don S.
07-08-11, 10:37 AM
Absent,

Although it is hardly necessary to do so for a man of your intelligence and education, in case any others reading here might not be familiar with the precise definition of the word “cynical," I shall define it now. It means: The belief that people are motivated by and act out of self-interest.

In 1968, Dr. Arthur K. Shapiro published an iconoclastic article regarding TS in which he derided the then prevailing paradigm that TS is a psychological affliction and that psychoanalysis is the preferred therapeutic remedy. He sent his study article to every major psychiatric journal in America, all of which had editorial boards dominated by psychoanalysts. All of them rejected his paper.

That is not suggestive to you?

In relatively recent times, reports have been very encouraging in regard to treating TS with various cognitive behavioral therapies (e.g., Duke, UCLA) and such has been derided by many within the TS “community.”

That is not suggestive to you?

(To spell it out, if TS is an organic affliction, then how could any sort of talk therapy possibly have any efficacy in treating it, barring resorting to a “New Age” paradigm?)

A common ploy when I express such cynicism is for people who disagree with me to try to label me (usually by implication) as a “conspiracy theory nut." I’m most decidedly not. There’s no need for colleagues to consult with one another when self-interest is at stake. It is hardly necessary for intelligent people to have someone else point out to them what is and is not in their professional interests (irrespective of the facts of a matter) and how they should react to it (often in a virtually Pavlovian manner). They are quite capable of independently assessing such and arriving at the same conclusion as others in their positions. I’m sure there was no collusion among the editors of the various psychiatric journals Dr. Shapiro submitted his paper to in 1968.

In regard to my assertion that dropping the criterion that TS symptoms need to be debilitating in order to merit the classification, I was referring to the change made from DSM-IV in DSM-IV-TR in 2000 which revised the text in the former which required that symptoms of tic disorders cause stress or impair functioning. By using the word “debilitating,” I might well have overstated the case. However, the fact remains that this revision greatly increased the segment of the population eligible to be classified as having the affliction. I was not referring to changes made that you referenced in DSM-V from DSM-IV.

Even if my understanding of this is incorrect, however, the indisputable fact remains that for a long while TS was considered a rare affliction, basically synonymous with those who are afflicted with corporillia. Somewhere along the line, the definition of the affliction was greatly expanded. As recently as 1981, a TS case was used as an example of an “orphan disease” on the medical television show<?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comhttp://www.addforums.com/forums/ /><st1:City alt=</st1:City> Quincy (which helped spur the passage of the Orphan Drug Act.). Now it is "thought" that as many as between one and ten children in a thousand are afflicted with the disease.

Defining diseases by pronouncement and consensus based upon subjective symptomatic rating scales, as opposed to objective pathogenetical factual evidence (as with AIDs, cancer, mumps, measles, etc.), opens the door to all sorts of ulterior agendas. As the late Michael Crichton pointed out, no one ever says: “The consensus is that the moon revolves ground the Earth.” Facts of nature are decided by their mere existences and discovered by humans. Facts of nature are not created by humans!<?XML:NAMESPACE PREFIX = O /><O:p></O:p>

Again, if TS is an organic affliction, then devise an objective test to diagnose it as with cancer or any other physical disease! It’s been over forty years now since this proposition took hold. How much time is reasonable for those positioning a positive hypothesis to produce substantive proof? How much more money is to be expended searching from an alleged anomaly within the central nervous system that perhaps does not exist? Why should those who are skeptical of said hypothesis be expected to prove a negative? That is not the scientific way: except, apparently, when convenient.

I shall address some of your other points in a subsequent post, hopefully later today and, once again, I thank you for your thoughts and time.

Dizfriz
07-08-11, 12:37 PM
Defining diseases by pronouncement and consensus based upon subjective symptomatic rating scales, as opposed to objective pathogenetical factual evidence (as with AIDs, cancer, mumps, measles, etc.), opens the door to all sorts of ulterior agendas. As the late Michael Crichton pointed out, no one ever says: “The consensus is that the moon revolves ground the Earth.” Facts of nature are decided by their mere existences and discovered by humans. Facts of nature are not created by humans!>>

Again, if TS is an organic affliction, then devise an objective test to diagnose it as with cancer or any other physical disease! It’s been over forty years now since this proposition took hold. How much time is reasonable for those positioning a positive hypothesis to produce substantive proof? How much more money is to be expended searching from an alleged anomaly within the central nervous system that perhaps does not exist? Why should those who are skeptical of said hypothesis be expected to prove a negative? That is not the scientific way: except, apparently, when convenient.



Off hand, I cannot think of any DSM disorder for which we have an "objective test".. How the brain works is hard to unravel and we are just now approaching having some research tools that might give more insight and perhaps more effective treatments for a number of these disorders.

ADHD has been described for over 200 years and we still do not have any objective test for it. It is strictly a clinical judgement call but it is very, very real.

As with ADHD, therapy does not make TS go away, only managed. In the case of TS, we do not have very good tools for TS currently but work is being done. I think we are beginning to get to the point where we might have a better idea of the mechanisms behind both but we have still a lot learn.

I can find no ulterior agendas but science does tends to move slowly in the absence of evidence. We really do not know a lot about TS. We do know that TS is somehow related to ADHD but we do not know how.

A small but important point, TS like ADHD is considered to be a disorder, not a disease.

You present some interesting ideas. Thanks for posting them.


Dizfriz

Don S.
07-08-11, 06:50 PM
Absent,

I’ll concede your point where you took issue with my criticizing science for reversing itself so often in the past and then also criticizing scientists for being doctrinaire and unwilling to accept new ideas per Max Planck’s quotation. Your explanation concerning how reports of single studies concluding, for example, such and such causes cancer are overplayed by the mainstream media, which is how most people read or hear about such developments, seems reasonable to me. Perhaps this is a leading contributing force to public skepticism concerning contemporary science.

In regard to your point regarding the proliferation of new disorders within DSM over the last several decades, I shall bow to your greater experience. Nevertheless, there have been a great many entirely new afflictions (as opposed to “spin-offs”) formulated and added to the mental health lexicon as well.

I believe that most of these new afflictions are merely names given to personality traits and resulting behaviors when the latter reach a point where they might be deemed detrimental to an individual’s well-being. What I object to in regard to TS is the definitive assertion that TS is caused by an organic abnormality within the central nervous system, presumably the brain, which I hold to defy common sense observations concerning the affliction.

(Instead of recounting them here yet again, any who are interested are welcome to read my TS articles at my website (or elsewhere online), particularity the second and third listed ones at my site.)

The following is an excerpt from the Wikipedia artice regarding Social Anxiety Disorder regarding speculations as to its cause:

“Evolutionary context

A long-accepted evolutionary explanation of anxiety is that it reflects an in-built 'fight or flight' system, which errs on the side of safety. One line of research suggests that specific dispositions to monitor and react to social threats may have evolved, reflecting the vital and complex importance of social living and social rank in human ancestral environments. Charles Darwin (http://en.wikipedia.org/wiki/Charles_Darwin) originally wrote about the evolutionary basis of shyness and blushing, and modern evolutionary psychology (http://en.wikipedia.org/wiki/Evolutionary_psychology) and psychiatry also addresses social phobia in this context.<SUP id=cite_ref-56>[57] (http://en.wikipedia.org/wiki/Social_anxiety_disorder#cite_note-56#cite_note-56)</SUP> It has been hypothesized that in modern day society these evolved tendencies can become more inappropriately activated and result in some of the cognitive 'distortions' or 'irrationalities' identified in cognitive-behavioral models and therapies.”

This is very close to my proposed hypothesis as to the underlying cause of TS and why I believe that CBT has shown such promising results in the treatment of the disorder; a therapeutic option that would have no efficacy if TS were in fact organic.

If “SAD” had been formulated several decades ago, I believe it would have been classified under the broad nomenclature of “neurotic.” I believe all such afflictions are related and stem from the same underlying cause: chronic anxiety caused by what I term to be “acute self-awareness,” an evolutionary process in which the instinct for survival becomes paramount and counterproductive to functioning at an optimal potential, exactly as alluded to in the above excerpt regarding SAD. Although the etiology for all such afflictions is the same, individuals might manifest symptoms of just one of these disorders or any combinations of them (which is why there is such a high comorbidity rate amongst them).

Tics by TS sufferers are attempted defense mechanisms in order to dispel receptive (obsessive) thought patterns that the mind finds objectionable. This accounts for premonitory signs of impending tics as reported by TS sufferers (such as myself) and are used by cognitive behavioral therapists to instruct their TS patients in an attempt to avert impending tics. This is referred to as: “Surf the urge” in such therapies.

(In my short story, a boy with TS is instructed to “float” through his obsessive thoughts, an insight I gained thirty years ago from the works of a pioneering behavioral therapist (actually, a medical doctor) who specialized in nervous illnesses.)
<?XML:NAMESPACE PREFIX = O /><O:p></O:p>
TS might be termed to be nothing but a distinct variation of OCD; tics instead of irrational rituals. The underlying cause is the same, only the manifestation diverges. <O:p></O:p>

Thanks again for your response.

Best regards,


Don S.

Don S.
07-08-11, 07:24 PM
Off hand, I cannot think of any DSM disorder for which we have an "objective test".. How the brain works is hard to unravel and we are just now approaching having some research tools that might give more insight and perhaps more effective treatments for a number of these disorders.

ADHD has been described for over 200 years and we still do not have any objective test for it. It is strictly a clinical judgement call but it is very, very real.

As with ADHD, therapy does not make TS go away, only managed. In the case of TS, we do not have very good tools for TS currently but work is being done. I think we are beginning to get to the point where we might have a better idea of the mechanisms behind both but we have still a lot learn.

I can find no ulterior agendas but science does tends to move slowly in the absence of evidence. We really do not know a lot about TS. We do know that TS is somehow related to ADHD but we do not know how.

A small but important point, TS like ADHD is considered to be a disorder, not a disease.

You present some interesting ideas. Thanks for posting them.


Dizfriz

Thank you once again for steering me to the Asimov article, which I found most illuminating. Aside from his creatively fertile mind, his lucidity in writing is what caused me to fall in love with his works as a kid. (It is common for kids like I once was to gravitate towards escapist literature.)

I found his thoughts most interesting, such as pointing out that the once widely held belief that the world is flat was not nearly as outrageous as we might deem such to be today. It had been based on observation. Asimov points out that the curvature of the earth is nearly zero per mile.

In regard to your point concerning my referring to TS as a “disease” as opposed to a "disorder,” according to Wikipedia, at least, here is the definition of the latter:

“A disease is an abnormal (http://en.wikipedia.org/wiki/Abnormal) condition affecting the body of an organism."

If TS is supposed to be a physical affliction caused by some unspecified and (ever so!) elusive anomaly within the CNS, then why not call a spade a spade? Another example of medical doublespeak?<O:p

Thanks very much again. I have appreciated your input as well.

Best regards,

<O:p
Don
<O:p
<O:p

Dizfriz
07-09-11, 01:53 PM
Thank you once again for steering me to the Asimov article, which I found most illuminating. Aside from his creatively fertile mind, his lucidity in writing is what caused me to fall in love with his works as a kid. (It is common for kids like I once was to gravitate towards escapist literature.)

I found his thoughts most interesting, such as pointing out that the once widely held belief that the world is flat was not nearly as outrageous as we might deem such to be today. It had been based on observation. Asimov points out that the curvature of the earth is nearly zero per mile. Just as with the idea that the earth is the center of the universe with the sun going around it. With the data set they had then, it was not an unreasonable conclusion.

In regard to your point concerning my referring to TS as a “disease” as opposed to a "disorder,” according to Wikipedia, at least, here is the definition of the latter:

“A disease is an abnormal condition affecting the body of an organism." Wiki is a good beginning source for looking up information but is hardly definitive. If you could note that the DSM is a handbook of "Mental Disorders", not mental disease. While it has some flaws, the term disorder is more specific. Since you like Wiki, here is their discussion:

Disorder

In medicine, a disorder is a functional abnormality or disturbance.[10] Medical disorders can be categorized into mental disorders, physical disorders, genetic disorders, emotional and behavioral disorders, and functional disorders.

The term disorder is often considered more value-neutral and less stigmatizing than the terms disease or illness, and therefore is preferred terminology in some circumstances. In mental health, the term mental disorder is used as a way of acknowledging the complex interaction of biological, social, and psychological factors in psychiatric conditions. However, the term disorder is also used in many other areas of medicine, primarily to identify physical disorders that are not caused by infectious organisms, such as metabolic disorders. If TS is supposed to be a physical affliction caused by some unspecified and (ever so!) elusive anomaly within the CNS, then why not call a spade a spade? Another example of medical doublespeak? Why use the term "doublespeak"? An attempt at linguistic precision is hardly doublespeak and is not a very good accusation to make. I could make the accusation that you are trying to use the most negative connotation you can but I do not really think this was your purpose.

Keep on with the conversation but treat others with respect.

Dizfriz

Don S.
07-09-11, 02:15 PM
Just as with the idea that the earth is the center of the universe with the sun going around it. With the data set they had then, it was not an unreasonable conclusion.

Wiki is a good beginning source for looking up information but is hardly definitive. If you could note that the DSM is a handbook of "Mental Disorders", not mental disease. While it has some flaws, the term disorder is more specific. Since you like Wiki, here is their discussion:

Why use the term "doublespeak"? An attempt at linguistic precision is hardly doublespeak and is not a very good accusation to make. I could make the accusation that you are trying to use the most negative connotation you can but I do not really think this was your purpose.

Keep on with the conversation but treat others with respect.

Dizfriz

You’re right. That was not my purpose. In fact, I don't even understand what you mean.

The medical/mental health communities cannot have it both ways. They cannot define the word “disease” in such a way that would include TS as it is currently defined and then call it a “disorder” instead. That is what I term “doublespeak,” and I don’t see why you would take offense. However, I am sorry that you evidently did.

Dizfriz
07-09-11, 02:41 PM
You’re right. That was not my purpose. In fact, I don't even understand what you mean.

The medical/mental health communities cannot have it both ways. They cannot define the word “disease” in such a way that would include TS as it is currently defined and then call it a “disorder” instead. That is what I term “doublespeak,” and I don’t see why you would take offense. However, I am sorry that you evidently did.

From your earlier post:

In regard to your point concerning my referring to TS as a “disease” as opposed to a "disorder,” according to Wikipedia, at least, here is the definition of the latter:

“A disease is an abnormal condition affecting the body of an organism."

If TS is supposed to be a physical affliction caused by some unspecified and (ever so!) elusive anomaly within the CNS, then why not call a spade a spade? Another example of medical doublespeak? You very much seemed to be addressing this to my statement that TS is considered a disorder rather than a disease. If you were not accusing me of doublespeak then I have no problem with what you said although I might not agree with it.


So lets address your point. Where is the mental health community referring to TS or any tic disorder as a disease? It is currently identified as a disorder such as implied by the the related diagnosis.

Tourette's Disorder 307.23, Tic Disorder NOS 307.2 and Transient Tic Disorder 307.21.

It is clear that TS is currently described as a disorder. The term disease is used in a general way in some settings but not usually in the mental health one.

I was making a rather small point for clarity. You can call it anything you wish but it is more accurately described in the mental health setting as a disorder not a disease. That was the point I was making and nothing else.

Dizfriz

Don S.
07-09-11, 03:20 PM
From your earlier post:

You very much seemed to be addressing this to my statement that TS is considered a disorder rather than a disease. If you were not accusing me of doublespeak then I have no problem with what you said although I might not agree with it.


So lets address your point. Where is the mental health community referring to TS or any tic disorder as a disease? It is currently identified as a disorder such as implied by the the related diagnosis.

Tourette's Disorder 307.23, Tic Disorder NOS 307.2 and Transient Tic Disorder 307.21.

It is clear that TS is currently described as a disorder. The term disease is used in a general way in some settings but not usually in the mental health one.

I was making a rather small point for clarity. You can call it anything you wish but it is more accurately described in the mental health setting as a disorder not a disease. That was the point I was making and nothing else.

Dizfriz

I was referring to the DSM classification and not your mere reproting of such. I'm sorry if a poor choice of words on my part failed to make such clear.

The irony here is that I most decidedly do not consider TS to be a “disease.” I believe “disorder” (or “syndrome”) is indeed more appropriate for this affliction. I was simply pointing out that since TS is currently positioned as a neurological “disorder” which results from some unspecified anomaly within the central nervous system, then it would more appropriately be classified as a disease, at least in accordance with the definition thereof that I cited.

Dizfriz
07-09-11, 05:18 PM
I was referring to the DSM classification and not your mere reproting of such. I'm sorry if a poor choice of words on my part failed to make such clear.

The irony here is that I most decidedly do not consider TS to be a “disease.” I believe “disorder” (or “syndrome”) is indeed more appropriate for this affliction. I was simply pointing out that since TS is currently positioned as a neurological “disorder” which results from some unspecified anomaly within the central nervous system, then it would more appropriately be classified as a disease, at least in accordance with the definition thereof that I cited.

Many of the DSM disorders result from some unspecified anomaly in the brain. Schizophrenia, Panic Disorder, Major Depressive Disorfer, Anxiety Disorders, ADHD, Tic disorders, Bipolar and a number of others. That we do not know exactly the causes or objective diagnostic tests does not negate their reality nor their seriousness.

We call these disorders and not diseases for a very good reason. The term disorder, while having its problems, does differentiate well between medical issues such as infections, heart disease, liver diseases etc. This differentiation in important as it minimizes confusion especially with the general public.

There is some overlap and controversy over disease vs disorder but among professionals disorders are described as just that and this is fairly well settled.

If you want some controversy, get into the issues concerning the terms mental illness and mental disorders. That arena has some real disagreements.

I stress this because the ratio of guests and members is huge and so many come here to learn more about ADHD. Accurate information is a major key to dealing with the disorder and this includes terminology.

Dizfriz

sarahsweets
07-09-11, 08:39 PM
Speaking strictly as a layman or laywoman ....disease, disorder, syndrome, condition, no matter how you slice it they all require validation and treatment.

Don S.
07-10-11, 12:24 PM
Many of the DSM disorders result from some unspecified anomaly in the brain. Schizophrenia, Panic Disorder, Major Depressive Disorfer, Anxiety Disorders, ADHD, Tic disorders, Bipolar and a number of others. That we do not know exactly the causes or objective diagnostic tests does not negate their reality nor their seriousness.

Dizfriz

Nor, might one add, does the fact that that the alleged organic abnormalities within the central nervous system have yet to be found prove that they exist!

Please note that I am only taking a position on what were once referred to as “neurotic” afflictions. Although I am uncertain, I believe that there is a high likelihood that such afflictions as schizophrenia and clinical depression (and bi-polar) are caused by an organic anomaly within the CNS.

Rather than rehashing the point here, please see my last two responses on the personality disorders thread that I recently initiated. The two threads seem to have become conflated.

Thank you. <O:p

Hyperman87
07-31-11, 10:04 AM
I completely agree and in fact if you do a search on Wikipedia and many respected websites on ADHD at least it's now generally considered to be a Neurological(Nervous System)Disorder and is included in wikipedia long list of disorders of the Nervous System. I think that's now the general opinion is that it is a Neurological Disorder that effects Behaviour, Impulse, and Cognition. Most information on ADHD has changed in the last decade. It used to widely be considered psychiatric.Just as the definition of Tourette's has changes from Psychiatric to neurologic.

Hyperman87
07-31-11, 10:22 AM
To me all of those terms Disorder, Disease, aliment, Illness, All mean one thing something in the human body or mind is not working right.It's an abnormal state of function of a body system or an organ or the mind which is really just a part of the Brain and Nervous system anyway once science can pin down more info on physical and chemical abnormalities most mental Illnesses will be classified as Nervous System Disorders. Good news for ADHD is that it already is generally considered to be a Physically based Nervous System Disorder and is included in Wikipedia's list of Disorders of the Nervous System and many other respectable websites consider it as such.That's why I always refer to it as a Neurological disorder.:) we've come so far when it comes to ADHD in just the last decade when I was diagnosed as a child it was largely considered a Mental illness.

lusy15
08-26-11, 02:39 AM
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