View Full Version : Just told I may have slight Aspergers?


dancinonwater
04-01-11, 07:29 PM
I went back to my Psychiatrist on Wednesday to talk about starting Stratera, as Adderall and Concerta didn't work, and we got talking about how much I hate changes of plans and overreact and that kind of thing, and she told me that she thinks I may have a bit of Aspergers. I've always sort of known this, but a real diagnosis is a lot scarrier than a self diagnosis! I am really smart (i know, it's an aspie trait), and although a lot of people think i'm "wierd", i don't think anyone (besides my parents) really would think i have aspergers, although I guess most people wouldnt think that anyway. So, I just need some support... I mean, this is really new to me and kind of scary. Is there any advice of info someone could give me? Also, is it likely to have ADHD and Aspergers? My Aspergers isn't that bad, but it's definately there. Also, is ADHD on the spectrum, because I know that many geniouses were said to have ADHD, and also some were said to have Aspergers or Autism, so i thought that maybe ADHD is on the spectrum.

thanks so much in advance!

P.S. I have some OCDish symptoms, could this possibly be caused by Aspergers (or maybe even ADHD), or could i have some slight OCD as well?

dancinonwater
04-01-11, 07:47 PM
Oh, I forgot to say, do you think Straterra would still help even if i have Aspergers? Sorry, I'm trying to watch TV while I type, and as you can assume from me being on this forum, that wasn't working out so well! lol

Spikey 723
04-01-11, 07:55 PM
You can have both aspergers and adhd.

And if you do, adhd meds might work for you on the adhd symptoms.

I take ritalin, and it helps with my focus and concentration.

fracturedstory
04-01-11, 08:17 PM
I don't think ADHD is on the spectrum. It can be co-morbid. Being on the autistic spectrum doesn't mean someone is smart it means they fit the diagnostic criteria. I'm sorry but I'm sick of the whole Asperger's people are geniuses thing and I'm in an extremely bad mood today, so I apologise for my assholeness.

ADHD medication can help with your ADHD symptoms but I also find it makes me less obsessional. So it does help with some autistic symptoms too.

dancinonwater
04-01-11, 10:49 PM
I don't think ADHD is on the spectrum. It can be co-morbid. Being on the autistic spectrum doesn't mean someone is smart it means they fit the diagnostic criteria. I'm sorry but I'm sick of the whole Asperger's people are geniuses thing and I'm in an extremely bad mood today, so I apologise for my assholeness.

ADHD medication can help with your ADHD symptoms but I also find it makes me less obsessional. So it does help with some autistic symptoms too.

Haha yeah well I think it's not that aspie's are geniuses, more that most geniouses have aspergers. I think that having such good function in one part of the brain must make it more common to have some problems in another part, like how blind people have great hearing and sense of smell. And thanks for the meds info, I think I'm going to try strattera soon, so i'm excited, as i really think it might work! it would be amazing if it helped with the Aspergers symptoms, but i'm not gonna get my hopes too high.

Trooper Keith
04-02-11, 12:45 AM
I went back to my Psychiatrist on Wednesday to talk about starting Stratera, as Adderall and Concerta didn't work, and we got talking about how much I hate changes of plans and overreact and that kind of thing, and she told me that she thinks I may have a bit of Aspergers.

This is the problem with the whole Asperger's thing. "slight Asperger's" is diagnostic code for "a little socially awkward." Either you can understand that other people are people with feelings other than your own, or you can't. Autism is a very clear difference from "neurotypicals," defined by an inability to comprehend other people as people.

I've always sort of known this, but a real diagnosis is a lot scarrier than a self diagnosis! I am really smart (i know, it's an aspie trait),

It is not.

P.S. I have some OCDish symptoms, could this possibly be caused by Aspergers (or maybe even ADHD), or could i have some slight OCD as well?

I'm going to have a stroke. No, you're probably just a little neurotic and socially inhibited. That seems much more realistic than having "slight OCD and a little bit of Asperger's." Diagnoses aren't spices. You don't get a dash here and a smidge there.

dancinonwater
04-02-11, 01:03 AM
I'm not saying that i just have a little as in like a few traits, I mean like it's not very severe. Gosh....

fracturedstory
04-02-11, 06:56 AM
I think that having such good function in one part of the brain must make it more common to have some problems in another part, like how blind people have great hearing and sense of smell.

Blind people have great hearing and sense of smell because their brain map reorganises itself. I think I read somewhere that the auditory part takes over for the dysfunctional visual part. I need to re-read that chapter again.
My theory is that the autistic brain isn't as plastic but I need more evidence to back up that claim.

I'm critical on the whole mild Asperger's thing too. I also fail to see how one can have AS mild and ADHD severe. It could just be me. I have moderate to high functioning autism and ADHD that isn't as impairing but still enough to need to be medicated. Still ADHD seems more of an attentional issue and autism a sensory, communication/ relating to others and language issue. And at times a motor issue. There's a whole lot more of a dysfunction in the autistic brain than the ADHD one. I'm talking about autism as a whole here, not just AS.

I don't think it is most geniuses have Asperger's but to have Asperger's you need an IQ that is not in the mental retardation range and most doctor's diagnose those with high IQ's with it. It's a stereotype. I also think that maybe people with AS can become more knowledgeable because they have more time to (because of very poor social skills) and the way the autistic brain works is to only be focused on one thing at a time. So you can be a genius who is greatly impaired in other areas. If you are a genius who isn't really that impaired you would more fit the gifted profile.

daveddd
04-02-11, 11:21 AM
i think youre autistic or your not

http://www.ncbi.nlm.nih.gov/pubmed/11411788

corbykins
04-02-11, 12:04 PM
I was diagnosed with ADHD inattentive type and Aspergers. i have been on a stimulant for many years and it has worked really well at relieving some of the ADHD symptoms. i dont think its all that common to have both but im not sure cause so many of the symptoms overlap or are very similar to the point where its hard to tell if its one or the other.
ADHD is not on the spectrum as far as i am aware.

Lunacie
04-02-11, 01:55 PM
It's called a "spectrum disorder", remember?

That means that some cases are quite severe while others ... aren't.

You can have a dash of one disorder and a smidge of another one, that's called "cormorbid disorders."


I went back to my Psychiatrist on Wednesday to talk about starting Stratera, as Adderall and Concerta didn't work, and we got talking about how much I hate changes of plans and overreact and that kind of thing, and she told me that she thinks I may have a bit of Aspergers. I've always sort of known this, but a real diagnosis is a lot scarrier than a self diagnosis! I am really smart (i know, it's an aspie trait), and although a lot of people think i'm "wierd", i don't think anyone (besides my parents) really would think i have aspergers, although I guess most people wouldnt think that anyway. So, I just need some support... I mean, this is really new to me and kind of scary. Is there any advice of info someone could give me? Also, is it likely to have ADHD and Aspergers? My Aspergers isn't that bad, but it's definately there. Also, is ADHD on the spectrum, because I know that many geniouses were said to have ADHD, and also some were said to have Aspergers or Autism, so i thought that maybe ADHD is on the spectrum.

thanks so much in advance!

P.S. I have some OCDish symptoms, could this possibly be caused by Aspergers (or maybe even ADHD), or could i have some slight OCD as well?

Some researchers are actually looking into the possiblity that ADHD and Autism are more closely related than previously thought, in other words, the "spectrum" might be even wider and more inclusive.

Lunacie
04-02-11, 02:01 PM
I was diagnosed with ADHD inattentive type and Aspergers. i have been on a stimulant for many years and it has worked really well at relieving some of the ADHD symptoms. i dont think its all that common to have both but im not sure cause so many of the symptoms overlap or are very similar to the point where its hard to tell if its one or the other.
ADHD is not on the spectrum as far as i am aware.

Well, not a lot of people with ADHD have Asperger's as well, but quite a lot of people with Asperger's also have ADHD. Was looking for a link with more specifics, I know I've seen that info, but can't find it at the moment.

That overlap may be the reason researchers are looking at whether it's all one very large spectrum - possibly including Bipolar. At one time it was thought that each disorder affected (or was affected by) a different part of the brain. But the more research they do, including PET scans and the like, the more parts of the brain they are are affected in people with ADHD. It's not just the frontal lobe as was once believed.

dancinonwater
04-02-11, 05:02 PM
It's called a "spectrum disorder", remember?

That means that some cases are quite severe while others ... aren't.

You can have a dash of one disorder and a smidge of another one, that's called "cormorbid disorders."


Some researchers are actually looking into the possiblity that ADHD and Autism are more closely related than previously thought, in other words, the "spectrum" might be even wider and more inclusive.

It's funny you say the whole spectrum thing... like how it is a SPECTRUM, so there are extremes and people in the middle. I was just thinking that i should have mentioned this point in my last post while i was at dance class! Anyway, yeah I think that there is a good chance that the spectrum is wider than we originally thought, but i dont know obviously... anyway, thanks for making that point, I've asked questions about this other places on the internet, and people were always like, you can't have mild aspergers, one person even said, "it's like a light switch, on or off." Do they not understand the whole SPECTRUM thing? haha oh well... people will never understand most things like that, even when the answers are right in front of them.

anyway, thanks for your post!

Lunacie
04-02-11, 05:25 PM
It's funny you say the whole spectrum thing... like how it is a SPECTRUM, so there are extremes and people in the middle. I was just thinking that i should have mentioned this point in my last post while i was at dance class! Anyway, yeah I think that there is a good chance that the spectrum is wider than we originally thought, but i dont know obviously... anyway, thanks for making that point, I've asked questions about this other places on the internet, and people were always like, you can't have mild aspergers, one person even said, "it's like a light switch, on or off." Do they not understand the whole SPECTRUM thing? haha oh well... people will never understand most things like that, even when the answers are right in front of them.

anyway, thanks for your post!

I'm sure that some people consider Autism to be the general spectrum with different extremes within it, and that Asperger's is just one example on the spectrum. And that's right as far as it goes.

But within Asperger's I'm sure there are some who are more disabled by the disorder than others - and the symptoms can wax and wane in each person differently over time. Learning coping skills or taking meds could make it look like you have a milder version, and stress or cormorbid conditions could make it look more severe.

I'm not saying that I have a complete understanding of Autism by any means. Just drawing some logical (to me) conclusions from what I have learned.

Jr1985
04-02-11, 07:45 PM
Indeed, it's a spectrum.

People consider my AS to be "mild", yet when I attend my social support group, it's usually me who's standing in the corner by themselves, while the other aspies chat amongst themselves. I think people confuse "less obvious" for "mild", which aren't really the same thing. For instance, some people I've met have had really obvious AS (monotone voice, odd gait, etc), yet are more capable of speaking in group situations than me.

fracturedstory
04-02-11, 08:20 PM
In 2013 the spectrum will be merged into autistic disorder ranging from mild/moderate/severe. There will be no PDD. There will be no Asperger's. So this wider spectrum research will be redundant.

You can be mild AS if you want just don't become one of the those people that view autism as a gift or think you are superior than those more affected. Those are the two reason why I am critical about mild AS.

I don't even go to a support group. If I did I wouldn't be talking to people but if I did I'd probably get into arguments with them.

Anyway, I think the less obvious you are the more anxiety you get. Somehow being closer to normal makes you more anxious than being so obviously abnormal.
Poor choice of words there that will get me a bit of a lecture but..meh.

Fortune
04-02-11, 08:37 PM
KMiller,

No, this isn't what autism is. Yes, theory of mind deficits do exist, and it is also not always possible to perceive what other people are thinking and feeling because it is difficult to read facial expressions, tone of voice, and body language. However, of all of the people I know on the autistic spectrum (ranging from what LFA to HFA/AS), not one of them seems to have any difficulty comprehending other people as people, and they seem to be able to determine that other people have thoughts and feelings different from their own.

This is where theory fails, when dealing with real people. I realize you'll probably dismiss personal experience as meaningless, but it is not difficult at all to find numerous writings by autistic people online that critique the entire "theory of mind" thing, and simultaneously acknowledging that other people are people. There is also at least one study critiquing the whole "theory of mind" thing, and I'll see if I can dig it up again.

Actually, it's kind of funny - those theory of mind puzzles are pretty complex language. What happens when you ask a child with deficits in understanding language to decode a complex word puzzle? I am not at all surprised most autistic children fail these tests, whether or not they personally have actual theory of mind deficits.

Don't you think it's pretty invasive to tell someone that their therapist is wrong and suggest you have a better idea of what's really going on? You're just someone on the internet.

Lunacie
04-02-11, 08:54 PM
In 2013 the spectrum will be merged into autistic disorder ranging from mild/moderate/severe. There will be no PDD. There will be no Asperger's. So this wider spectrum research will be redundant.

You can be mild AS if you want just don't become one of the those people that view autism as a gift or think you are superior than those more affected. Those are the two reason why I am critical about mild AS.

I don't even go to a support group. If I did I wouldn't be talking to people but if I did I'd probably get into arguments with them.

Anyway, I think the less obvious you are the more anxiety you get. Somehow being closer to normal makes you more anxious than being so obviously abnormal.
Poor choice of words there that will get me a bit of a lecture but..meh.

This is something I've been wondering about since my granddaughter is considered high-functioning, atypical, autistic and her anxiety is normally through the roof.

I think as she gets older and understands the differences, there should be less anxiety, although other feelings may take the place.

Anti-depressant meds has been helping with her anxiety for about a month now. Wish we'd had a doctor who'd have prescribed them sooner.

Fortune
04-02-11, 09:05 PM
I went back to my Psychiatrist on Wednesday to talk about starting Stratera, as Adderall and Concerta didn't work, and we got talking about how much I hate changes of plans and overreact and that kind of thing, and she told me that she thinks I may have a bit of Aspergers. I've always sort of known this, but a real diagnosis is a lot scarrier than a self diagnosis! I am really smart (i know, it's an aspie trait), and although a lot of people think i'm "wierd", i don't think anyone (besides my parents) really would think i have aspergers, although I guess most people wouldnt think that anyway. So, I just need some support... I mean, this is really new to me and kind of scary. Is there any advice of info someone could give me? Also, is it likely to have ADHD and Aspergers? My Aspergers isn't that bad, but it's definately there. Also, is ADHD on the spectrum, because I know that many geniouses were said to have ADHD, and also some were said to have Aspergers or Autism, so i thought that maybe ADHD is on the spectrum.

thanks so much in advance!

P.S. I have some OCDish symptoms, could this possibly be caused by Aspergers (or maybe even ADHD), or could i have some slight OCD as well?

Okay, so:

Being a genius is not an AS trait. The average IQ for people diagnosed with AS is slightly higher than the overall average because anyone who would fit the criteria but has an IQ below 70 would be diagnosed as autistic instead (being seen as an intellectual developmental delay). The percentage of people diagnosed with AS who are gifted or higher is the same as the general population (about 2%), unless there is information I am unaware of.

I think that it's too easy sometimes for people to identify something as mild when it may not be.

There is some theorizing that ADHD is related to the autistic spectrum. I believe (but do not recall the exact numbers) that a higher percentage of people diagnosed with ADHD also meet the criteria for an ASD, and that about 75% of people diagnosed with an ASD meet the criteria for ASD. The idea that they are related is not controversial at all, but whether or not it is the case has yet to be demonstrated.

I find a real diagnosis to be rather reassuring, rather than scary. It's good to know for sure what I am dealing with. I know it's scary at first, but it's worth it to come to terms with it.

One of the features in AS is something about "meaningless rituals," which are not necessarily performed because of anxiety. I have several of these, which actually help me in various ways, although others might define them as "meaningless." They're not OCDish, though.

OCD itself is a kind of anxiety disorder. So it comes down to why do you do these things? What do you get from them? Do you do them because you find them pleasant or do you do them because something bad might happen if you don't? Do you get intrusive thoughts that you can't get rid of, even if you know they're not true?

dancinonwater
04-02-11, 10:00 PM
Don't you think it's pretty invasive to tell someone that their therapist is wrong and suggest you have a better idea of what's really going on? You're just someone on the internet.

Thanks, seriously, it may be unlikely (i'm not sure that it is, but still...), but you don't know me, and you don't know my diagnosis. Gosh, I think sometimes people can get a bit controlling on the web...

Fortune
04-03-11, 03:34 AM
There is some theorizing that ADHD is related to the autistic spectrum. I believe (but do not recall the exact numbers) that a higher percentage of people diagnosed with ADHD also meet the criteria for an ASD, and that about 75% of people diagnosed with an ASD meet the criteria for ASD. The idea that they are related is not controversial at all, but whether or not it is the case has yet to be demonstrated.

"about 75% of people diagnosed with an ASD meet the criteria for ADHD."

I got this information from Attwood's The Complete Guide to Asperger's Syndrome. I don't have it handy to track down his citation.

And to make this more than a simple correction, the paper that critiques the theory of mind tests as used with autistic children:

http://psych.wisc.edu/lang/pdf/Gernsbacher_autistic_modules.pdf

The relevant part starts on page five.

Also, I realize that Simon Baron-Cohen regards theory of mind as a core deficit of autism. I don't believe he has really supported this theory well, just based on the above paper.

Bluerose
04-03-11, 07:44 AM
***Mod Note***
This thread has been edited in order to restore harmony and to remind members that it is possible to disagree with others without becoming aggressive in your posts.

fracturedstory
04-03-11, 08:07 AM
However, of all of the people I know on the autistic spectrum (ranging from what LFA to HFA/AS), not one of them seems to have any difficulty comprehending other people as people, and they seem to be able to determine that other people have thoughts and feelings different from their own.

Well.......not all of us can. I've certainly seen many scenarios on WP when people get so caught up in their opinion they can't see the other person's point of view. I used to be like that. Now I am sometimes like that.



I think that it's too easy sometimes for people to identify something as mild when it may not be.

I think children that are diagnosed with high functioning autism these days are too mild.
They actually talk to people and have friends. My mum would have been over the moon if I did just one of those. I guess I was more severe than I thought - than anyone thought.

Jr1985
04-03-11, 08:46 AM
In 2013 the spectrum will be merged into autistic disorder ranging from mild/moderate/severe. There will be no PDD. There will be no Asperger's. So this wider spectrum research will be redundant.
Indeed. But autism is still a spectrum condition, the fact that there are "grades" suggests this is so.

You can be mild AS if you want just don't become one of the those people that view autism as a gift or think you are superior than those more affected. Those are the two reason why I am critical about mild AS.
I don't think autism is a gift, and I can see how it would annoy people to suggest it was. People who say that are probably trying to make us or themselves feel better, but really it just invalidates our suffering.

However, I do think there are some positive aspects to having autism. Like our ability to be extremely logical and have a natural ability to think critically. We also seem to be able to see things as they are, not as we would like them to be (i.e. we seem less likely to resort to "magical thinking" than NTs). I'm over generalising of course, but I do think it's more likely for ASpies to have these traits than NTs.

Of course, the positive "symptoms" don't take away from the fact that autism is a developmental disorder, which can cause a lot of suffering. Although, I'd say we probably wouldn't suffer as much if people were more understanding.

Anyway, I think the less obvious you are the more anxiety you get. Somehow being closer to normal makes you more anxious than being so obviously abnormal.
Poor choice of words there that will get me a bit of a lecture but..meh.
Agreed. I have a lot of anxiety, and I do worry about people viewing me as "abnormal". That's why I joined the support group, to help me confront that fact that I am different.

Jr1985
04-03-11, 09:06 AM
Well.......not all of us can. I've certainly seen many scenarios on WP when people get so caught up in their opinion they can't see the other person's point of view. I used to be like that. Now I am sometimes like that.
Yes, sometimes I think people are stupid for the ideas they have, like how could they possibly think that way. But really it's because I can't see their point of view.

I think people with AS can be aware that other people have thoughts and feeling different from their own, but it's on an intellectual level rather than an instinct.

I think children that are diagnosed with high functioning autism these days are too mild.
They actually talk to people and have friends. My mum would have been over the moon if I did just one of those. I guess I was more severe than I thought - than anyone thought.
Just because you consider someone "mild" doesn't mean they don't have difficulties. They may manage to have friends, but it could be really stressful for them to initiate and maintain friendships. You never really know what goes on inside someone's head. I have a few friends, but they're mostly female and weird themselves (some being assessed for AS). I find it really difficult to get on with NT males.

As for talking to people, I usually try and remember standard phrases to say to people, like "hello, how are you?". I also find it much easier to talk to older females. I have real difficulty being spontaneous and speaking to peers. Again, I can do it on an intellectual, but not instinctual, level.

Being mild could really just mean that they're good at hiding their difficulties, like me. Seems I am the master of deception when it comes to hiding my problems. Probably why it took so long to get a diagnosis. :(

Lunacie
04-03-11, 09:40 AM
"about 75% of people diagnosed with an ASD meet the criteria for ADHD."
>


Thank you. I knew I had seen those stats somewhere but couldn't find them myself yesterday (which wasn't a great day for me).



Well.......not all of us can. I've certainly seen many scenarios on WP when people get so caught up in their opinion they can't see the other person's point of view. I used to be like that. Now I am sometimes like that.



I think children that are diagnosed with high functioning autism these days are too mild.
They actually talk to people and have friends. My mum would have been over the moon if I did just one of those. I guess I was more severe than I thought - than anyone thought.

I've seen the same scenario on other forums, surely all those people don't have ASD? People just get attached to their own opinion and feel threatened when others disagree. I think that's part of the human spectrum.

But being able to talk to others and having (perhaps limited) friendships is just one of the traits of Autism. There are three main areas that are looked at in a Autism diagnosis, my granddaughter more than met two of them but she is able to look at people's faces/eyes and talk to them - although what she says is often a jumble of seemingly disconnected thoughts that apparent tie together in her mind somehow. But that's why her diagnosis at this time is Atypical Autism.

She has had a bunch of therapy - the child development specialist said that 3 years ago he would have given an unconditional dx of Autism. But although we love to see the progress she has made, we've had to come to terms with the fact that she will never "outgrow" this disorder.

Some days she is able to talk to others and make an effort to be sociable - other days she says "I don't want to talk now" or just stonewalls us. I'm the same way. When you see me one day you might notice that I'm not looking right at a person, I take a quick look and then look at something else, alternating like that. When you see me one day I might be able to chat with someone and seem to enjoy it, but there are a lot of days when I ignore those who talk to me or am quite abrupt in my answers.

I've been told the most consistent thing about Autism is the inconsistency. Just because someone doesn't look very Autistic one day doesn't mean they didn't spend the whole week before that looking very Autistic.

Fortune
04-03-11, 12:22 PM
Well.......not all of us can. I've certainly seen many scenarios on WP when people get so caught up in their opinion they can't see the other person's point of view. I used to be like that. Now I am sometimes like that.

I did try to point out that theory of mind deficits do exist, I just don't think they're definitive or as encompassing as "doesn't realize people are people." I know I had a much harder time with realizing that people could have different opinions than mine when I was younger, and I can be pretty stubborn if I am certain I am correct in an argument.

The meaning of "doesn't realize people are people" is pretty absolute.

Yes, sometimes I think people are stupid for the ideas they have, like how could they possibly think that way. But really it's because I can't see their point of view.

I think people with AS can be aware that other people have thoughts and feeling different from their own, but it's on an intellectual level rather than an instinct.

This is a distinction separate from whether they are aware that people are people at all, and points to the ability to see that other people do have thoughts and feelings, which is what I was getting at.

And I mean, being someone with AS, I tend to be aware that other people are people. I do sometimes have to be reminded that they have thoughts and feelings I need to take into account, especially in some social situations where I am focused on the socializing and not reading other people. This is not a lack of awareness (perhaps intellectually, rather than intuitive) but may be a problem with multitasking as well (can I hold a conversation and imagine what you might be thinking at the same time? Maybe not, although this is also a problem with nonverbal communication). The scripting you describe below is useful: Since I can't read people all that well, I have ways of asking people instead.

As for talking to people, I usually try and remember standard phrases to say to people, like "hello, how are you?". I also find it much easier to talk to older females. I have real difficulty being spontaneous and speaking to peers. Again, I can do it on an intellectual, but not instinctual, level.I do this too. Oh, I remember trying to explain myself in the small talk thread here a few months ago. One of the many hints I was not dealing with the same issues as many other ADHDers (also the thread where people were saying ADHD gave them the power to read people more intuitively, and I was saying "But I had to learn this deliberately...")

Being mild could really just mean that they're good at hiding their difficulties, like me. Seems I am the master of deception when it comes to hiding my problems. Probably why it took so long to get a diagnosis. :(This is what I was trying to get at by pointing out that someone may appear mild to others. A lot of people learn to hide things over time, and then have to overcome that for a diagnosis. A lot of psychiatrists and psychologists are completely unaware of this (or of the various ways that autistic people learn to socialize), and may mistake these things if one is honest about them for signs of other conditions.

daveddd
04-03-11, 02:21 PM
i think a lot of people have trouble seeing things from others point of view

Fortune
04-03-11, 02:51 PM
i think a lot of people have trouble seeing things from others point of view

Yes, I think this is the issue.

Trooper Keith
04-03-11, 06:34 PM
It's called a "spectrum disorder", remember?

That means that some cases are quite severe while others ... aren't.

You can have a dash of one disorder and a smidge of another one, that's called "cormorbid disorders."

No, you have to meet criteria to have a disorder. A person who cleans compulsively doesn't have "a little OCD," a person who occasionally gets distracted doesn't have "a little ADHD" and a person with no social skills doesn't ****ing have "a little autism."

As for researchers who are promoting ADHD as a form of autism, I will remind you that there are a lot of agendas in the academic world, and one agenda, promoted by the so-called "autistic community," is to "normalize" autism. This is accomplished by stretching criteria to make everything a form of autism.

This is also a stupid thing. Unfortunately, the "autistic community" has entrenched itself such that any criticism is automatically "oppression" at the hands of "neurotypicals." It's stupid, agenda-oriented science, it's academically dishonest, and it's entirely political. I have no interest in it.

Trooper Keith
04-03-11, 06:36 PM
"about 75% of people diagnosed with an ASD meet the criteria for ADHD."


When symptoms overlap, that does not mean both symptoms are to be diagnosed. That Asperger's disorder overlaps with ADHD does not mean that all people who meet said criteria for Asperger's disorder have ADHD. It means that they have Asperger's disorder, and that disorder accounts for the symptoms better. An ADHD diagnosis is not warranted.

Diagnosing someone with every disorder that their symptoms meet criteria for is sloppy, bad diagnostic practice. It is unfortunately entirely too common.

Trooper Keith
04-03-11, 06:49 PM
KMiller,

No, this isn't what autism is. Yes, theory of mind deficits do exist, and it is also not always possible to perceive what other people are thinking and feeling because it is difficult to read facial expressions, tone of voice, and body language.

"The essential features of Autistic Disorder are the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interests."
. . .
"Often an individual's awareness of others is markedly impaired. Individuals with this disorder may be oblivious to other children (including siblings), may have no concept of the needs of others, or may not notice another person's distress."

I will admit that this is an "often," not an always.

This is where theory fails, when dealing with real people. I realize you'll probably dismiss personal experience as meaningless,

You forget that I have clinical experience working with autistic population, both with individuals diagnosed with Asperger's disorder and individuals who were profoundly autistic with mental retardation. I am not talking out of my *** or reading out of a textbook when I describe autistic populations as generally oblivious to the needs, interests, or emotions of others. I am not autistic, but I have extensive experience with the population, as well as personal experience working with autists in and out of the clinical setting.

Again, I admit that the DSM specifies "often" rather than always. However:

People with autism function in profoundly different ways. This includes Asperger's disorder. Also, autism must, by definition, have an onset at younger than 3 years of age. I find it suspicious that there are people with ADHD diagnosed later in life, I find it fairly implausible that someone with such pervasive deficits in social interaction skills might not be recognized at a young age. While I admit that it must happen, I am generally suspicious of any diagnosis of autism that occurs after the child is grown.

Remember, the impairment must be "marked." That is clinical speak for "easily visible and impairing." Avoiding eye contact, while a component of social inhibition, is not diagnostic of autism. Despite this, the autistic community, with its political agenda of normalizing itself, insists that anyone who doesn't like crowds, who gets upset by fast flickering lights, who has trouble with eye contact, or who obsesses over a topic has "mild autism" or "autistic features" or that they are "on the spectrum." This is completely baseless and utterly stupid.

Don't you think it's pretty invasive to tell someone that their therapist is wrong and suggest you have a better idea of what's really going on? You're just someone on the internet.

I find it fairly self-evident that a therapist might be wrong who is making claims about things that cannot be claimed. "Slight Asperger's" is not a meaningful thing. It is meaningless. It is a sloppy, stupid term for explaining someone's social awkwardness. It is a catchphrase, and nothing more. So no, I have no inhibitions about criticizing a colleague about making meaningless statements, or, worse, promoting a political agenda of a special interest group.

Trooper Keith
04-03-11, 06:54 PM
I think that it's too easy sometimes for people to identify something as mild when it may not be.

I find that it's too easy to call something a "mild case of something" when there is nothing there.

There is some theorizing that ADHD is related to the autistic spectrum. I believe (but do not recall the exact numbers) that a higher percentage of people diagnosed with ADHD also meet the criteria for an ASD, and that about 75% of people diagnosed with an ASD meet the criteria for ASD. The idea that they are related is not controversial at all, but whether or not it is the case has yet to be demonstrated.

It is entirely controversial. The only community in which such a claim is not controversial is the autistic community. To everyone else, it is a bold and unsubstantiated claim. It is, therefore, controversial.

I don't mind controversial. My thesis is highly controversial. But I haven't published the findings of my thesis before I've completed the research to confirm it. Unfortunately, the people who propose a relationship between ADHD and autistic disorders have put the oxcart before the ox.

I find a real diagnosis to be rather reassuring, rather than scary. It's good to know for sure what I am dealing with. I know it's scary at first, but it's worth it to come to terms with it.

"Slight Asperger's" is not a real diagnosis.

One of the features in AS is something about "meaningless rituals," which are not necessarily performed because of anxiety. I have several of these, which actually help me in various ways, although others might define them as "meaningless." They're not OCDish, though.

Meaningless rituals exist in the general population. Once more for posterity: having symptoms of a disorder does not mean that you have a "mild presentation" of said disorder. A person who has a beer every other night every day for a year is not a "mild alcoholic." A person who uses cocaine once a year is not a "mild substance abuser."

Trooper Keith
04-03-11, 06:59 PM
Thanks, seriously, it may be unlikely (i'm not sure that it is, but still...), but you don't know me, and you don't know my diagnosis. Gosh, I think sometimes people can get a bit controlling on the web...

I don't know you from Adam and I am not questioning your diagnosis, I am questioning the validity of a case of "slight Asperger's" and challenging the notion from an academic standpoint. Whether you have Asperger's disorder or not is unknown to me. What I am saying, that having a few traits of a disorder without having the core symptoms does not make for a "slight case" of a disorder anymore than having a papercut is a "slight maiming" is not relevant to your diagnosis. It is simply cautionary conjecture.

Trooper Keith
04-03-11, 07:05 PM
The meaning of "doesn't realize people are people" is pretty absolute.

This is a distinction separate from whether they are aware that people are people at all, and points to the ability to see that other people do have thoughts and feelings, which is what I was getting at.

I read the relevant parts and changed my opinion to suit the facts. As I noted before, the book states "often," not "always." As such, I do take back what I said about that being a necessary condition of the disorder. It is only a sufficient condition (when present in tandem with the associated traits).

Jr1985
04-03-11, 07:09 PM
When symptoms overlap, that does not mean both symptoms are to be diagnosed. That Asperger's disorder overlaps with ADHD does not mean that all people who meet said criteria for Asperger's disorder have ADHD. It means that they have Asperger's disorder, and that disorder accounts for the symptoms better. An ADHD diagnosis is not warranted.

Diagnosing someone with every disorder that their symptoms meet criteria for is sloppy, bad diagnostic practice. It is unfortunately entirely too common.
Actually, my psychiatrist suggested that diagnosing AS and ADHD, when the symptoms of both are met, is good clinical practice, and I tend to agree with her.

If someone has a diagnosis of AS, then there is no medication available. But some people with AS/Autism can have profound executive dysfunction, virtually identical to that seen in ADHD. These symptoms can be treated with medication, but they are only licensed for ADHD, so giving them a dual-diagnosis gives them access to medication that may greatly improve their symptoms.

It seems a bit silly and potentially dangerous to question whether someone is a "True Aspie (TM)", just because they aren't as severe as yourself. Just because someone doesn't perfectly fit a collection of subjective diagnostic criteria, or is capable of making friends and knowing that other people have thoughts and feeelings different to their own, does not mean that they don't have profound difficulties due to other autistic symptoms. It invalidates their difficulties if you accuse them of being a fraud. "You're not a True Autistic(TM), pull yourself together!" is what it suggests to me. So some people aren't as severe as you, big deal, it's not a competition.

Jr1985
04-03-11, 07:23 PM
I find that it's too easy to call something a "mild case of something" when there is nothing there.
Yes, maybe they're just imagining their symptoms, or making them up for attention. :rolleyes:

"Slight Asperger's" is not a real diagnosis.
No, but "Mild Autistic Disorder" will be.

Meaningless rituals exist in the general population. Once more for posterity: having symptoms of a disorder does not mean that you have a "mild presentation" of said disorder. A person who has a beer every other night every day for a year is not a "mild alcoholic." A person who uses cocaine once a year is not a "mild substance abuser."
Isn't this the entire foundation of mental illness, etc? That everyone expresses some "symptoms" to a degree, but it's when those symptoms become so extreme, that they cause significant impairment in their lives. If the "mild presentation" is enough to cause significant problems for the person then I'd say they have a disorder.

Lunacie
04-03-11, 07:26 PM
No, you have to meet criteria to have a disorder. A person who cleans compulsively doesn't have "a little OCD," a person who occasionally gets distracted doesn't have "a little ADHD" and a person with no social skills doesn't ****ing have "a little autism."

As for researchers who are promoting ADHD as a form of autism, I will remind you that there are a lot of agendas in the academic world, and one agenda, promoted by the so-called "autistic community," is to "normalize" autism. This is accomplished by stretching criteria to make everything a form of autism.

This is also a stupid thing. Unfortunately, the "autistic community" has entrenched itself such that any criticism is automatically "oppression" at the hands of "neurotypicals." It's stupid, agenda-oriented science, it's academically dishonest, and it's entirely political. I have no interest in it.

But the criteria for the diagnosis of Asperger's or Autism does indicate some cases are mild/high functioning and some are severe/low functioning.

Difficulty with social skills is only one trait that is looked at when diagnosing ASD. Someone who has no social skills isn't going to be diagnosed as Autistic -unless- other criteria are met as well. And when other criteria are met, someone who has only a little trouble with social skills can still be diagnosed as Autistic. It's not as black and white as you're painting it to be.

I wasn't talking about academic agendas, I was talking about scientific research. I don't know exactly what changes will be presented in the new DSM, I just mentioned something I've read about. I never claimed to be an authority. I'm not interested in debating the possibility or being dissed for passing it along. Have a good one.

Jr1985
04-03-11, 07:42 PM
Evidence of the link between AS and ADHD:

http://www.ncbi.nlm.nih.gov/pubmed/17201617
http://www.ncbi.nlm.nih.gov/pubmed?term=Comorbidity%20of%20Asperger%20syndrome %3A%20a%20preliminary%20report
http://www.ncbi.nlm.nih.gov/pubmed/19515234

Evidence of shared genetics between AS and ADHD:
http://www.ncbi.nlm.nih.gov/pubmed/18221348

madelefant
04-03-11, 07:43 PM
My doctor has actually never given me a diagnosis although he has prescribed medications for ADHD. I have always felt I must be slightly autistic. For me my biggest problem is being overwhelmed by stimulation and having difficulty integrating them. Visual information disrupts all other senses. I think this is because I am actually a visual thinker. In other words external visual input disrupts the internal.

Fortune
04-03-11, 08:27 PM
To be honest, I doubt the autistic community puts much thought into the link between ADHD and autism. At least, I have not come across any. Everything I have read comes from professionals and research, not politically driven agendas - some of which was linked above.

The majority of diagnostic criteria for all psychological and neurological conditions exist in the general population - anyone who understands the DSM-IV should know this. Dizfriz posted an explanation of how ADHD's symptoms are a matter of severity, because just about everyone who does not have a condition that causes these symptoms displays some of them at a subclinical threshold. It is when they reach that clinical threshold that they fit the criteria. Similarly, many people have some autistic traits but not enough for a diagnosis with an ASD (PDD).

Yes, a lot of people engage in meaningless rituals. But these rituals are actually part of the diagnostic criteria for Asperger's Syndrome:

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objectsPerhaps I should have said "nonfunctional" but sometimes I lose the correct word and fill one in that sounds right. My point is that something someone might interpret as mild OCD could very well be a match for one of the criteria for AS - as is true in my case.

As for the autistic community treating any ~criticism~ as if it were neurotypical oppression, how about an example of that criticism?

Here's an article on Schizoid Defenses (http://www.integrativetherapy.com/en/articles.php?id=43). This excerpt discusses an autistic woman (Donna Williams) in a particular way:

My premise is this: In the schizoid condition, the person lives in a world of isolation created by withdrawal from others; the person also lives in a matrix of unintegrated life experiences, while at the same time attempting to cope with the real world. He or she lives between—suspended as it were—because there is no sense of where to settle and what to call “me.”

The withdrawal, along with the dissociated parts of the self, remains compartmentalized. For example, in recounting her autistic state, Williams (1993) described living in a world of perpetual blindness, deafness, and muteness even though she could see and hear and had the ability to speak. She used her withdrawal and dissociative states for protecting and sustaining her life.

Such an autistic encapsulation is a protection of the child, and when maintained into adulthood, it constitutes a fixated, protective dynamic in the Child ego state. Being able to identify ego states, and especially Child ego states, has helped me to work with this early archaic position and to deal with the primary process that is inherent in the schizoid condition.This describes Donna's sensory condition as a dissociative defense mechanism, and I think it is implying that this is maladaptive. In other words, being autistic is presented as some kind of personality error on her part, and not something intrinsic to how she experiences the world.

What it does not do is give Donna William's words their proper context: She has severe sensory integration issues. She describes her visual processing issues in this blog post (http://blog.donnawilliams.net/2011/04/02/visual-perceptual-disorders-in-children-with-autism/) and says many were resolved with dietary changes and Irlen lenses. She also talks about her "meaning deafness" on that page (a form of aural agnosia) and elsewhere discusses her selective mutism. These have nothing to do with schizoid defenses - they are how her senses functioned, and yet her words are directly misrepresented to support an entirely different point.

For another example, this study about daydreaming in autistic people (http://www.nature.com/news/2006/060508/full/news060508-3.html). By interpreting brain scans while engaged in switching tasks from doing something to doing nothing, researchers determined that autistic people do not daydream.

This study apparently did not acknowledge the difficulty that many autistic people have with transitions (an executive function issue), nor did they apparently ask any autistic people if they daydream (apparently, quite a few do, and quite routinely).

Much of the research about autism going back to Kanner and Asperger misrepresent autistic people in terms of observations interpreted from a strictly external perspective. I can't imagine if anyone found that there were hundreds - thousands - of articles, studies, and books written about people like them that didn't really describe them at all, that they wouldn't criticize this. I think criticism is the only rational response. It is not a claim that NTs are oppressing autistic people* - although, you have to admit? It's not as if autistic people are treated kindly in all situations. I mean, how many have been institutionalized and said institutionalization made things worse? How many autistic children have been murdered by their parents (and their parents got off lightly)? How many autistic children get to adulthood and find it difficult to impossible to live independently due to lack of support, because most support is geared toward children?

If anything, I should think client self-advocacy would be welcomed, not emotively scorned as a political agenda.

* Actually, I would argue that such a volume of research and literature that actively misrepresents a particular demographic in so many ways while completely discounting said demographic's ability to speak for themselves is a sign of oppression. It may not be a conscious, deliberate act and simply a matter of ignorance that so many believe their observations should carry more weight than anything people can say about themselves, but the consequences are oppressive. If the dominant belief about autistic people, for example, is that autistic people are not capable of empathy (even though they are, but not the way NTs are), or that autistic people are not aware of people as people (even though they are, even if they appear not to), then it becomes much easier to present autistic people as "barely people."

madelefant
04-03-11, 08:36 PM
My understanding of the DSM is that a certain number of the symptoms must occur together. Not specifically the severity of each individual symptom.

Fortune
04-03-11, 08:43 PM
My understanding of the DSM is that a certain number of the symptoms must occur together. Not specifically the severity of each individual symptom.

This thread (http://www.addforums.com/forums/showthread.php?t=93678) is the thread I referred to regarding symptom severity.

And I believe that the symptoms are supposed to meet a certain severity level (that is, they cause impairments) to count.

Trooper Keith
04-03-11, 08:44 PM
My understanding of the DSM is that a certain number of the symptoms must occur together. Not specifically the severity of each individual symptom.

The DSM requires the symptoms to be clinically notable, not just slightly sort of kind of present if you stretch it the right way.

Trooper Keith
04-03-11, 08:47 PM
Actually, my psychiatrist suggested that diagnosing AS and ADHD, when the symptoms of both are met, is good clinical practice, and I tend to agree with her.

I will have to look into best practices on this particular combination.

It seems a bit silly and potentially dangerous to question whether someone is a "True Aspie (TM)", just because they aren't as severe as yourself. Just because someone doesn't perfectly fit a collection of subjective diagnostic criteria, or is capable of making friends and knowing that other people have thoughts and feeelings different to their own, does not mean that they don't have profound difficulties due to other autistic symptoms. It invalidates their difficulties if you accuse them of being a fraud. "You're not a True Autistic(TM), pull yourself together!" is what it suggests to me. So some people aren't as severe as you, big deal, it's not a competition.

You're hilarious. I am not autistic. I have no intention of keeping the "autism club" exclusive. What I have is an intention of curbing a trend that I see developing, which is to diagnose everyone and anyone with any kind of social ineptitude as autistic. It pathologizes normal variations in human functioning.

Fortune
04-03-11, 09:02 PM
And just for the sake of posterity, those two articles I referenced (the daydream study and the schizoid defense paper) were articles I found while looking for other things. That is to say, finding misrepresentations is so easy google practically threw them at me.

daveddd
04-03-11, 09:09 PM
Evidence of the link between AS and ADHD:

http://www.ncbi.nlm.nih.gov/pubmed/17201617
http://www.ncbi.nlm.nih.gov/pubmed?term=Comorbidity%20of%20Asperger%20syndrome %3A%20a%20preliminary%20report
http://www.ncbi.nlm.nih.gov/pubmed/19515234

Evidence of shared genetics between AS and ADHD:
http://www.ncbi.nlm.nih.gov/pubmed/18221348

im not getting in the middle of this, but these articles seem to suggest that adhd is a common comorbid with autism




like depression and anxiety and social anxiety are very common comorbids with adhd

Fortune
04-03-11, 09:11 PM
im not getting in the middle of this, but these articles seem to suggest that adhd is a common comorbid with autism

like depression and anxiety and social anxiety are very common comorbids with adhd

I don't think anything comorbids with anything like ADHD comorbids with autism.

Except maybe sensory processing disorder and autism.

That said, I do not know whether ADHD is really a part of the autism spectrum. Although, I am convinced there is more of a connection there than I think is currently accepted.

daveddd
04-03-11, 09:12 PM
22% of adhd kids met the criteria for aspergers

i think depression is more common in adhd

Fortune
04-03-11, 09:15 PM
22% of adhd kids met the criteria for aspergers

i think depression is more common in adhd

Edit: You're turning the diagnoses around. One of the studies stated 78% of children who were diagnosed with PDDs met the criteria for ADHD.

Also, depression as a mood disorder is something of a natural consequence of having to deal with something like ADHD or Asperger's Syndrome, especially undiagnosed. Two developmental disorders occurring together that frequently is kind of interesting.

Trooper Keith
04-03-11, 09:17 PM
To be honest, I doubt the autistic community puts much thought into the link between ADHD and autism. At least, I have not come across any. Everything I have read comes from professionals and research, not politically driven agendas - some of which was linked above.

Said professionals may have agendas (though I don't know them in particular, so I can't say this with any authority). Many do. It's one of Barliman's main concerns with the state of the scientific field in general.

The majority of diagnostic criteria for all psychological and neurological conditions exist in the general population - anyone who understands the DSM-IV should know this. Dizfriz posted an explanation of how ADHD's symptoms are a matter of severity, because just about everyone who does not have a condition that causes these symptoms displays some of them at a subclinical threshold. It is when they reach that clinical threshold that they fit the criteria. Similarly, many people have some autistic traits but not enough for a diagnosis with an ASD (PDD).

Correct. This is, essentially, what I am saying. I am not denying that the OP has symptoms that are associated with autism. I am saying that there is a dangerous trend to "push the envelope" of what we consider autistic and non-autistic.

Yes, a lot of people engage in meaningless rituals. But these rituals are actually part of the diagnostic criteria for Asperger's Syndrome:

I am aware of the diagnostic criteria for Asperger's disorder.

Perhaps I should have said "nonfunctional" but sometimes I lose the correct word and fill one in that sounds right. My point is that something someone might interpret as mild OCD could very well be a match for one of the criteria for AS - as is true in my case.

Yes, except I would not consider that a symptom of "mild OCD" any more than I would consider it a symptom of "mild Asperger's disorder." Having compulsive tendencies, which, in essence, means utilizing the ego defense called "undoing" as a standard defense, does not OCD make.

Here's an article on Schizoid Defenses (http://www.integrativetherapy.com/en/articles.php?id=43). This excerpt discusses an autistic woman (Donna Williams) in a particular way:

This describes Donna's sensory condition as a dissociative defense mechanism, and I think it is implying that this is maladaptive. In other words, being autistic is presented as some kind of personality error on her part, and not something intrinsic to how she experiences the world.

I had intended to avoid bringing analytic theory into this discussion because it opens a whole new can of worms. Since you brought it up, however, I'm more than willing to play ball, given that this is my theoretical orientation.

No, it describes Donna's sensory condition as a schizoid defense, which is characterized by flight into fantasy and withdrawal from the outside world. This is, essentially, spot on. In fact, the schizoid defenses (fantasy, withdrawal, and internal compartmentalization) are sometimes referred to as an "autistic reflex."

The analysis here is essentially spot on. In many cases, autism is a disorder of schizoid withdrawal. Autism is, in its essence, a neurotic level manifestation of an extreme and pathological reliance on schizoid defenses. This is a pervasive personality characteristic that is entirely egosyntonic and therefore difficult-to-impossible to treat.

This does not, however, constitute a "personality error." It represents a personality type. Schizoid personality arrangement is a less common though still prevalent personality arrangement which is typified by defenses of withdrawal and fantasy. That doesn't make any kind of moral judgment at all. See, for example, another thread where I defended a person with narcissistic personality because narcissism, like schizotypy, does not constitute a moral failing. Narcissism is typified by the utilization of the defenses of idealization (of self) and devaluation (of others). That is just an arrangement of personality, not a failure to be a good person. In exactly the same way, a schizoid arrangement does not make for a moral failing. Nor does psychopathy, and so on.

You are the one who is shoe-horning moral judgments into diagnostic process. O'Reilly-Knapp does not make a moral statement in that article. She is describing a phenomenon in terms that you may not understand, but that doesn't mean she's moralizing. You are reading subtext that is not there, likely due to either a lack of understanding of the perspective (analytic theory requires much more than an overview of Freud in a 101 class), or because you are resistant to the concept.

To speak to the latter alternative, you may be resistant to the concept due to the prevailing and growing tendency towards biological reductionism. That is, you moralize personality traits, and then you describe them as biological in order to mitigate the responsibility for the development of said personality. You are the one who says that schizoid defenses are a "personality error." Then, in fear, you justify it by saying "but it's nobody's fault, really. It's biology!" When in fact the schizoid defense exists all across the personality level spectrum, from healthy to psychotic (as an aside, another disorder that people love to pathologize is schizophrenia, which is the psychotic manifestation of the same defense which is utilized in autism). You're ascribing judgment values to psychoanalytic characteristics, then, in fear, you resist the idea that those characteristics might arise from some mechanism other than childhood experience.

What it does not do is give Donna William's words their proper context: She has severe sensory integration issues. She describes her visual processing issues in this blog post (http://blog.donnawilliams.net/2011/04/02/visual-perceptual-disorders-in-children-with-autism/) and says many were resolved with dietary changes and Irlen lenses. She also talks about her "meaning deafness" on that page (a form of aural agnosia) and elsewhere discusses her selective mutism. These have nothing to do with schizoid defenses - they are how her senses functioned, and yet her words are directly misrepresented to support an entirely different point.

Are there biological origins for those conditions that have been demonstrated to have existed prior to the development of the defensive function? To get slightly off topic, there is another frightening trend in psychology right now, which is to look at biological states as they are in the present, and then assume those biological states existed before and caused the condition. It neglects the fact that the brain is plastic and very much still developing in children, and that the utilization of the autistic defenses may very well cause the development of those sensory systems to go askew.

I propose that the biological condition linked with aural agnosia could be caused by the utilization of schizoid defenses during the period of time in which aural senses are maturing.

For another example, this study about daydreaming in autistic people (http://www.nature.com/news/2006/060508/full/news060508-3.html). By interpreting brain scans while engaged in switching tasks from doing something to doing nothing, researchers determined that autistic people do not daydream. This study apparently did not acknowledge the difficulty that many autistic people have with transitions (an executive function issue), nor did they apparently ask any autistic people if they daydream (apparently, quite a few do, and quite routinely).

How is this relevant? Daydreaming is a form of schizoid defense, but it is not the same as psychic withdrawal. It is not the same as retreat into fantasy. It is a mild form of the fantasy defense, it is not what O'Reilly-Knapp is talking about.

That schizoid personalities retreat into fantasy (and quite routinely) is not a surprise to anyone. That autistic individuals retreat into fantasy, to me, seems self evident.

That brainscans demonstrated that such retreats don't happen is irrelevant to me, because I remain skeptical, at the core, that biological determinism is worthwhile at all.

Much of the research about autism going back to Kanner and Asperger misrepresent autistic people in terms of observations interpreted from a strictly external perspective.

Much is observational. I am happy that the trend has turned toward assessment interview for the development of case reports. Bear in mind, most autistic people are incapable of engaging in an analysis. You cannot analyze the mind of someone who does not respond to spoken word. The concept of there being autistic individuals who are not profoundly retarded and incapable of communication is a new one.

If I wanted to put on my tinfoil, I would say that this is a result of the psychiatric community's wanting to characterize everything in terms of bullet points and symptom lists instead of looking at personality or subjective experience. I strongly believe that a large majority of so called "mild autists" are in fact schizoid personalities, with no actual pathology other than their maladaptive ego defenses.

* Actually, I would argue that such a volume of research and literature that actively misrepresents a particular demographic in so many ways while completely discounting said demographic's ability to speak for themselves is a sign of oppression. It may not be a conscious, deliberate act and simply a matter of ignorance that so many believe their observations should carry more weight than anything people can say about themselves, but the consequences are oppressive. If the dominant belief about autistic people, for example, is that autistic people are not capable of empathy (even though they are, but not the way NTs are), or that autistic people are not aware of people as people (even though they are, even if they appear not to), then it becomes much easier to present autistic people as "barely people."

Once again, I refer to the above: I do not believe most "mild" or even "moderate" autistic individuals suffer of any malady other than a neurotic reliance on schizoid defenses.

Autism has traditionally been reserved for people who are utterly incapable of interacting with the outside world, people who remain stuck in the "unconscious phantasy" of very early childhood, failing to develop any object relations outside the self, and potentially failing to develop any object relations at all. Given that this is the case, and that the entire concept of an "autistic spectrum" may well be a fancy name for "people with varying degrees of reliance on schizoid defenses," I think it is entirely justified, especially for early researchers who were describing something that does not look at all like the "new" definition of autism, to use only outside observation as their basis of analysis.

"True" autists, meaning those who are completely uncommunicative and withdrawn into the self, without any object relations or interaction with the outside world, are incapable of speaking for themselves because they never develop language. This "new breed" of autism, seemingly characterized by shuffling one's feet and looking at the ground, does not resemble the classical meaning of the word at all.

daveddd
04-03-11, 09:37 PM
Edit: You're turning the diagnoses around. One of the studies stated 78% of children who were diagnosed with PDDs met the criteria for ADHD.

Also, depression as a mood disorder is something of a natural consequence of having to deal with something like ADHD or Asperger's Syndrome, especially undiagnosed. Two developmental disorders occurring together that frequently is kind of interesting.

depression anxiety and social anxiety are often found in children along with adhd


not just reactive to adhd or autism



and often overlooked

Jr1985
04-04-11, 02:57 AM
I will have to look into best practices on this particular combination.
What is your expertise?

You're hilarious. I am not autistic. I have no intention of keeping the "autism club" exclusive. What I have is an intention of curbing a trend that I see developing, which is to diagnose everyone and anyone with any kind of social ineptitude as autistic. It pathologizes normal variations in human functioning.
I know ;)

I wasn't referring to you specifically, sorry. But people don't usually seek a diagnosis just for fun, or because they have a normal variation in human functioning. Mostly because they aren't functioning very well at all, despite outward appearances.

Btw, you say you're suspicious of people diagnosed as adults. Well I imagine children who are particularly intelligent/creative can find ways to hide and/or compensate for their difficulties. Also, AS/ADHD wasn't very well known when these adults were children.

Trooper Keith
04-04-11, 03:07 AM
What is your expertise?

I'm a mental health counseling student. My theoretical orientation is mainly psychoanalytic, and my research interests are primarily personality types and, surprise, psychodynamic etiologies of disorder. If I were to claim expertise in anything, which I am not so bold to do, it would be in psychodynamic perspectives on personality arrangement.

In my defense, regarding not being up on the current best practices, the educational establishment tends to paint in broad strokes (I haven't specifically studied these two disorders in tandem). In general, it's bad diagnostic practice to diagnose everything that fits, as it's much better to diagnose the best fit and limit the number of diagnoses. It's also possible that this is a psychiatry thing. Psychiatrists have a motivation to diagnose both (they can treat ADHD), whereas as a therapist I have no need for dual diagnoses when a single diagnosis can cover all the symptoms.

I wasn't referring to you specifically, sorry. But people don't usually seek a diagnosis just for fun, or because they have a normal variation in human functioning. Mostly because they aren't functioning very well at all, despite outward appearances.

I agree. But for it to be autism, it must have begun manifesting before age 3, meaning the impairment must have been there since before age 3. Adulthood is a long way for someone with crippling functional deficiencies to go without being assessed for a disorder.

Btw, you say you're suspicious of people diagnosed as adults. Well I imagine children who are particularly intelligent/creative can find ways to hide and/or compensate for their difficulties. Also, AS/ADHD wasn't very well known when these adults were children.

I agree with this too. Though as I said in my previous post, I'm skeptical of Asperger's disorder as anything more than a schizoid personality arrangement.

Fortune
04-04-11, 04:23 AM
I wasn't referring to you specifically, sorry. But people don't usually seek a diagnosis just for fun, or because they have a normal variation in human functioning. Mostly because they aren't functioning very well at all, despite outward appearances.

Btw, you say you're suspicious of people diagnosed as adults. Well I imagine children who are particularly intelligent/creative can find ways to hide and/or compensate for their difficulties. Also, AS/ADHD wasn't very well known when these adults were children.

Getting diagnosed with ADHD in the 70s depended entirely on whether your doctor knew what it was, which as I have learned, my family doctor at the time did not.

Getting diagnosed with AS in the 70s depended on time travel, as it didn't even exist as a proposed diagnosis until 1981, when Lorna Wing published a paper based on Hans Asperger's work. This wasn't incorporated into the ICD-10 until 1993 or the DSM-IV until 1994.

There's no empirical or reasonable basis for suspicion of people diagnosed as adults: A lot of people slipped through the cracks, especially in the 80s and earlier, and still slipped in the 90s as many were unfamiliar with the diagnosis. Adults born before 1980 are considered by some to be a lost generation (http://www.iancommunity.org/cs/articles/very_late_diagnosis_of_asperger_syndrome) because no diagnosis was available. Lacking any sound research that a lot of adults are being misdiagnosed with AS and ADHD, and having research that a lot of previously undiagnosed adults are being properly diagnosed sort of addresses the whole thing, anyway.

If anything, having conversations about whether people who are looking for support on a support forum really have what they have is rather contrary to the idea of a support forum. No one can tell from forum posts what other people's circumstances really are, and it is difficult to communicate the full depth and breadth of factors that might contribute to a diagnosis, and easy for misunderstandings to develop based on limited information.

The OP's post, for example, is lacking a lot of detail - while he described a few things and said his therapist suggested he might have slight Asperger's, none of us know what else is going on in his sessions, and his therapist may not even be offering a diagnosis, or may be offering a tentative diagnosis. Or what she is seeing is minimal compared to what is going on for the OP and he may actually have something more severe and have developed strategies to mostly hide it. Or it doesn't matter because he posted here looking for support.

I think the "diagnosing people as autistic for social ineptitude" comment is a straw man. I doubt that's the case, and I doubt anyone in this thread has been or is close to being diagnosed for social ineptitude.

Jr1985
04-04-11, 07:44 AM
I'm a mental health counseling student. My theoretical orientation is mainly psychoanalytic, and my research interests are primarily personality types and, surprise, psychodynamic etiologies of disorder. If I were to claim expertise in anything, which I am not so bold to do, it would be in psychodynamic perspectives on personality arrangement.
That explains a lot. How ironic that one of your hangups in this discussion is an apparant lack of empirical evidence. :rolleyes:

I had wondered why you spoke with such authority, yet seemed to lack knowledge in some fairly well known areas.

Amtram
04-04-11, 09:07 AM
KMiller, you usually bring a lot of good information to the table, but I'm guessing that the vehemence of your posts here is probably related to how closely involved you are with the subject at hand. I have no doubt that you have some pretty good information to share, but few people will pick up on it if they feel like they have to go on the defensive because of your tone!

When I first looked at the OP, I too felt a little of that urge to smack the doctor upside the head. Most of my life, being unable to properly explain the particulars of my ADD and the difficulties it created, had people tell me, "Oh, I forget/lose things all the time! Maybe I have a little ADD!" It trivializes a very real problem, and it's one of the few things that gets me angry right from the get-go.

When it comes to any psychiatric/neurological condition, you don't "have a little" of it. You may have a subset of the symptoms. You may be on a higher or lower point on the spectrum of affect and/or functionality. Your diagnosis may be primarily or even exclusively a single condition, or it may be complicated by one or more comorbid conditions, also subject to a range of severity.

If the OP's doctor had said he suspected a mild case of Asperger's, or symptoms of possible autism, or even highly-functional autism syndrome, I don't think quite so many visceral responses would have been provoked. One of the reasons that the number of diagnoses of ADD and ASD has gone up has been because we are now aware that the symptoms can express themselves in individuals who seem to function passably well in society - perhaps not happily or successfully all the time, but not so obviously different that anyone thinks they need some kind of professional assistance.

The other reason the number of diagnoses has gone up is that improved understanding of symptomology has led to more diagnosed cases not only in children, but in adults. I don't want to sound like I'm picking on you, K, but I've personally experienced the adult diagnosis even though the symptoms actually were present all along, but without any recognition or treatment in the interim because the prevailing scientific understanding was flawed and incomplete. From where I stand, it makes perfect sense that adults who've had "personality defects" all their lives are only recently able to put a name to their problems.

However, as many of us have experienced, there are still doctors out there who fall a little short on understanding specific conditions, and cling to outmoded ideas (some to the point of continuing to deny these conditions exist at all) or explain them to us in ineffective and improper ways.

One of the things we need to do here as a community when faced with this kind of flawed perception is to share our knowledge and experience in ways that others can understand and use for self-advocacy. Not all of what we know is hard facts, because the scientific understanding is far from complete. Our experiences as individuals are not cut and dried representations of the presentation of any specific diagnosis. Together, though, and shared in level-headed discussion, they really do help everyone to better understand their own individual hurdles and how to get over them.

Lunacie
04-04-11, 09:37 AM
>>
Correct. This is, essentially, what I am saying. I am not denying that the OP has symptoms that are associated with autism. I am saying that there is a dangerous trend to "push the envelope" of what we consider autistic and non-autistic.

>>

I propose that the biological condition linked with aural agnosia could be caused by the utilization of schizoid defenses during the period of time in which aural senses are maturing.

>>

Much is observational. I am happy that the trend has turned toward assessment interview for the development of case reports. Bear in mind, most autistic people are incapable of engaging in an analysis. You cannot analyze the mind of someone who does not respond to spoken word. The concept of there being autistic individuals who are not profoundly retarded and incapable of communication is a new one.

>>

Once again, I refer to the above: I do not believe most "mild" or even "moderate" autistic individuals suffer of any malady other than a neurotic reliance on schizoid defenses.

Autism has traditionally been reserved for people who are utterly incapable of interacting with the outside world, people who remain stuck in the "unconscious phantasy" of very early childhood, failing to develop any object relations outside the self, and potentially failing to develop any object relations at all. Given that this is the case, and that the entire concept of an "autistic spectrum" may well be a fancy name for "people with varying degrees of reliance on schizoid defenses," I think it is entirely justified, especially for early researchers who were describing something that does not look at all like the "new" definition of autism, to use only outside observation as their basis of analysis.

"True" autists, meaning those who are completely uncommunicative and withdrawn into the self, without any object relations or interaction with the outside world, are incapable of speaking for themselves because they never develop language. This "new breed" of autism, seemingly characterized by shuffling one's feet and looking at the ground, does not resemble the classical meaning of the word at all.

So, you think that the people who put together the DSM were blurring the lines between Schitzoid personality and Autism?

That is an interesting possiblity, and could inspire some intersting discussion, just the possibility that most of these mental disorders are more-so related than not-so.

As long as you present this idea as a possibility rather than a bona-fide and proven fact, there shouldn't be a problem.

Scooter77
04-04-11, 10:43 AM
Wow, what an amazing thread, fascinating reading.
Can I put in my 2 cents as a female adult dx'd in my 30's with ADHD, Aspergers and Social Phobia.

I wasnt' dx'd as a kid because ASD wasnt dx'd when I was a kid, especially not in girls. In fact, even as an adult, the first 2 Dr's I saw told me that ASD is only seen in boys and if I really was aspie I'd be programming their computers for them...This was just in the last few years....

I grew up in a rather dysfunctional home where my mum took me to have my tarot cards and crystals read, rather than to a paediatrician.
At 13 she took me to the GP and put me on the contraceptive pill to manage my 'mood swings'.......
And I had a good home life, my parents wanted what was best for me (in their own way) but they didnt know any better and no-one told them anything else.
I was the smart but lazy kid, always in trouble, always doing stupid things, and always getting caught for it.
I was expelled twice, suspended multiple times, and I was selectively mute for most of my teenage years....selectively doesnt mean by choice.....

I wasnt 'mild', I was over looked because I was female and I dont "look" autistic.

Just today, I took my partner to a medical appt and his dr questioned the accuracy of my dx after literally 2 minutes of an interview about my partner!
My partner doesnt LOOK bipolar - but he is and noone argues it.

I don't LOOK autistic, I dont ACT autistic, and if you met me you'd question my dx. But you are NOT in my head, you dont know that I physically can not sway from instructions, that I cut my garden grass with scissors because I need the edges to look straight, that I cant eat at the table with my family because their chewing noises drive me potty, that I run most things past my counsellor because I've learnt my judgement is not the same as other peoples, or that no person other than partner has touched me (not even my mother) for the last 10 or so years because I find physical contact incredibly overwhelming....
You dont know any of that by looking at me, and I've spent the last 30 years learning how to keep it secret so I'm not about to tell you.....but it's real, and it causes significant impairment in ALL areas of my life.....regardless of whether or not it looks that way to you....

I have had many 'professionals' say I'm not ASD or its very mild - in their opinion.
Their opinion means jack when I have no level of intimacy, not with myself, nor with any person around me, because I am not capable of regulating myself or other people in my life, I am not able to draw boundaries between where I end and other people begin. And let me assure you, that is an incredibly difficult way to live - whether you see it or not.

The result of being over looked - severe social phobia, other people destroy me daily. And yes, I am an intelligent person and in accordance with the DSM, I know it's irrational.

So, may I say
ADHD and ASD commonly co-occur, as do other dx's.
SOME researchers question if ASD is a mutation of ADHD - which is not proven in any way so please leave my head attached!
SOME researchers question if there is a spectrum of disorders that more accurately incorporate depressive, anxiety, developmental in the one bundle......as in - the vulnerability is there, manifestation of symptoms depends on environmental factors.

There is a HUGE difference between OCD and ASD, although they can externally look very similar.
ASD follows rituals/thoughts/whatever because we have to, because it's just not right unless it's done that way, it's not so much a negative thought process - it's just the way it's supposed to be done....
OCD follows rituals that reduce distressing cognitions - which I'm not explaining well because I'm not OCD but it's very different.
Both are distressing, but for very different reasons. Behaviour is similar, cognition is different.

"But for it to be autism, it must have begun manifesting before age 3, meaning the impairment must have been there since before age 3. Adulthood is a long way for someone with crippling functional deficiencies to go without being assessed for a disorder"

S**T YES - AND IT SUCKED, AND IT STILL SUCKS EVERY DAY!! BUT IT HAPPENS!

Dizfriz
04-04-11, 11:28 AM
The term mild has a place in the DSM as a specification of severity. Usually these are listed as Mild, Moderate and Severe.

These are not used however for ADHD or the Autistic spectrum however, at least as far as I can tell.

Sometimes a family is told that their child is normal but on the autistic or ADHD end of the normal range to help them understand that their child has symptoms of ASD but not enough for a diagnosis. I have seen this be a lot of help in getting the parents to understand how to work with their child.

With ADHD; mild, moderate or severe is useful to help parents pick appropriate strategies to work with their child.

With mild, behavior management is often adequate but with severe, medication is almost always indicated.

On diagnosis of ASD,: one of the problems is that Early Childhood Intervention (ECI), who most often screens for ASD in the states, cuts off service somewhere around 3 or 3-1/2 (from memory). After that many kids get missed as the schools often do not have the training to screen for it especially with the older children. I once picked up a high school senior with a lot of the symptoms but no one had ever mentioned the possibility to the parents.

I suspect that many are not diagnosed until adult years. Even then, the symptoms have to be shown to occur in the very early years of childhood. This is not a later onset disorder.


Just my thoughts on the subject.

Dizfriz

Jr1985
04-04-11, 11:47 AM
@Dizfriz - the DSM-V, to be released in 2013, is merging Aspergers into Autistic Disorder, which will have different grades "mild, moderate, severe". Presumably people diagnosed with AS will be considered mild or moderate.

Dizfriz
04-04-11, 11:54 AM
Jr1985

A couple of small items:

Kmiller: "Slight Asperger's" is not a real diagnosis.

Jr1985 No, but "Mild Autistic Disorder" will be. Mild Autistic Disorder is not in the DSM-IV as a diagnosis. I don't know what is proposed for the DSM-V. Perhaps this is what you meant.


Also

KMiller; I'm a mental health counseling student. My theoretical orientation is mainly psychoanalytic, and my research interests are primarily personality types and, surprise, psychodynamic etiologies of disorder. If I were to claim expertise in anything, which I am not so bold to do, it would be in psychodynamic perspectives on personality arrangement. Jr1985 That explains a lot. How ironic that one of your hangups in this discussion is an apparant lack of empirical evidence.

I had wondered why you spoke with such authority, yet seemed to lack knowledge in some fairly well known areas. Jr, no one, even one in the field, can have in depth knowledge about all of the relevant material.

I might suggest that you pick specific things you feel Kmiller has spoken without empirical evidence or without knowledge in a specific area then post these disagreements along with the relevant facts so he and others can reply. Solid information is the key here and it is what makes these conversations interesting.



Dizfriz

Dizfriz
04-04-11, 12:03 PM
@Dizfriz - the DSM-V, to be released in 2013, is merging Aspergers into Autistic Disorder, which will have different grades "mild, moderate, severe". Presumably people diagnosed with AS will be considered mild or moderate.

Thanks, I had written my post to you before I saw this reply. This is the kind of discussions I like, fact on fact.

Dizfriz

Trooper Keith
04-04-11, 12:16 PM
So, you think that the people who put together the DSM were blurring the lines between Schitzoid personality and Autism?

I think the people who put together the DSM redefined schizoid personality in a way that it had not been previously described, and that a side effect of their reliance on "checklists" a lot of people started meeting a lot of criteria for a lot of things that they previously would not have. This is not a matter of DSM-IV but rather of DSM-III. While the DSM-III model is extremely useful and effective, it has some rather serious flaws. One of these flaws is that "checklist" diagnoses reduce the understanding of the person's subjective experience. Another problem is that it pathologizes what may be a "normal" behavior or variation as a "symptom" and then sees these behaviors in all cases as symptomatic of something. Someone can't focus as acutely as others? Must be a symptom. Someone has a belligerent disposition? Again, a symptom. And so on.

My contention here is that schizoid personality (a type of personality, not to be confused with the schizoid personality disorder, which is dysfunctional) is characterized by the same symptoms that the current community may consider "mild autism," because the symptoms are there. The whole concept of "mild autism" is foreign, because historically autism refers to non-communicative withdrawal before age 3. Now that it seemingly refers to anyone having difficulties with socialization, there is a "trap" that schizoid personalities, who otherwise have no afflictions, and whose condition may be treated psychotherapeutically (by learning new ego defenses, if the schizoid defense can be made egodystonic), are instead branded "autistic" and then sent on their way.

That is an interesting possiblity, and could inspire some intersting discussion, just the possibility that most of these mental disorders are more-so related than not-so.

Among the problems with the DSM model is that it makes everything seemingly related because of symptom overlap. It ignores clear and naturally occurring tendencies that have been observed and documented for more than a hundred years in favor of checklists. Again, I love the DSM and find it very useful clinically, but it has done away with a huge body of knowledge in favor of a medical definition of empiricism.

As long as you present this idea as a possibility rather than a bona-fide and proven fact, there shouldn't be a problem.

I make arguments as assertions not because I'm stuck up my own *** and believe I am the final word, but because that is, in my opinion, the best way to present them, rather than equivocating. You will notice, even in this thread, that when I am wrong, I admit to it and my stance changes accordingly. It does animate people and cause for good debate, wouldn't you say?

Lunacie
04-04-11, 12:28 PM
I think the people who put together the DSM redefined schizoid personality in a way that it had not been previously described, and that a side effect of their reliance on "checklists" a lot of people started meeting a lot of criteria for a lot of things that they previously would not have. This is not a matter of DSM-IV but rather of DSM-III. While the DSM-III model is extremely useful and effective, it has some rather serious flaws. One of these flaws is that "checklist" diagnoses reduce the understanding of the person's subjective experience. Another problem is that it pathologizes what may be a "normal" behavior or variation as a "symptom" and then sees these behaviors in all cases as symptomatic of something. Someone can't focus as acutely as others? Must be a symptom. Someone has a belligerent disposition? Again, a symptom. And so on.

My contention here is that schizoid personality (a type of personality, not to be confused with the schizoid personality disorder, which is dysfunctional) is characterized by the same symptoms that the current community may consider "mild autism," because the symptoms are there. The whole concept of "mild autism" is foreign, because historically autism refers to non-communicative withdrawal before age 3. Now that it seemingly refers to anyone having difficulties with socialization, there is a "trap" that schizoid personalities, who otherwise have no afflictions, and whose condition may be treated psychotherapeutically (by learning new ego defenses, if the schizoid defense can be made egodystonic), are instead branded "autistic" and then sent on their way.

Ah, it's somewhat unusual to see somone who is younger saying the old ways were better. But if we never changed how we look at these disorders, we'd still be blaming everything on our mothers, eh?



Among the problems with the DSM model is that it makes everything seemingly related because of symptom overlap. It ignores clear and naturally occurring tendencies that have been observed and documented for more than a hundred years in favor of checklists. Again, I love the DSM and find it very useful clinically, but it has done away with a huge body of knowledge in favor of a medical definition of empiricism.

It will be interesting to see how things are changed in the new version of the DSM. The best thing would be to meld what still hold true from previous knowledge with what has been learned in the last decade or so.



I make arguments as assertions not because I'm stuck up my own *** and believe I am the final word, but because that is, in my opinion, the best way to present them, rather than equivocating. You will notice, even in this thread, that when I am wrong, I admit to it and my stance changes accordingly. It does animate people and cause for good debate, wouldn't you say?

I certainly never said, or suggested, anything like that. You said it, not me. Your style certainly does lead to debate - but I don't agree that it's necessarily "good debate." That may be because I much prefer the give-and-take of discussion rather than the adversarial style of debating.

AbsentMindProf
04-04-11, 12:35 PM
With many psychological disorders, there is no clear boundary that separates "people that have the disorder" from "people who don't". If you take any of the symptoms that are diagnostic for a disorder, it will always be possible to find someone with a slightly weaker version of the same symptoms. Do you then diagnose that person also? If so, then it will -- again -- be possible to find someone else with a slightly weaker version of those traits.

No matter where you put the boundary between "clinically significant difficulties with X", there will be people JUST BARELY below the threshold. This is a widely recognized difficulty in the field of clinical psychology. For many disorders, there are borderline cases that would be diagnosed by some clinicians and not by others.

With many psychological disorders, there is an entire continuum between "severe X" and "a completely typical person with absolutely no sign of X".

It's also common for the boundaries of the disorder to expand over time. When the disorder is first recognized, it is typically because a scientist or clinician recognized a group of people that have a very similar set of symptoms. Often, these are the most severe cases. As the scientific community learns more about the disorder and longitudinal studies are done, psychologists gradually come to recognize milder and milder presentations of the disorder.

At one time (only a few years ago), very few people with Asperger syndrome were recognized as having a form of autism. Their autistic traits tend to be much milder than more severe presentations of classic autism. Psychologists recognized that AS symptoms mostly look like mild autistic symptoms and that people with AS often have great difficulties that are attributable to these symptoms (extremely high unemployment, for example).

Once psychologists start to recognize that people with milder versions of the symptoms that characterize a disorder also have significant difficulties with major life activities, they broaden the disorder to accommodate these milder presentations. Contrary to popular belief, this is not done as part of some grand conspiracy to funnel more money to Big Pharma -- it's the logical progression of clinical diagnostic practice as more data become available to inform us of the difficulties experienced by persons with milder versions of symptoms.

I'm a bit puzzled by the argument about "mild ADHD" or "mild autism". It is undeniably the case that some people with ADHD have milder presentations of the disorder than others. While there is no formal diagnostic category called "mild ADHD", it's perfectly appropriate and reasonable to say that someone has "mild ADHD", to distinguish him from someone with a more severe presentation of the disorder.

Similarly, there are people that meet the diagnostic criteria for Asperger syndrome, but just barely. It's perfectly reasonable for someone like that to say that he has "slight Asperger syndrome". I don't understand the need for 5 pages of arguing over that point. :confused:

As a final comment, I think it's entirely possible for someone to reach adult -- or even middle age -- without a psychological disorder being recognized and diagnosed. This can happen for any of several reasons:

1. Some parents have a low opinion of the discipline of psychology, preferring to believe that psychological diagnoses are just "excuses for lazyness" or that it's all just a sham conspiracy on the part of Big Pharma to make millions medicating everyone's kids.

2. The parent may have brought the child to an unqualified clinician and, therefore, received an incorrect diagnosis or, perhaps, no diagnosis.

3. The disorder may not have been widely known 20 or 30 years ago or, perhaps, only the most severe cases were recognized 20 or 30 years ago (see above discussion).

Lunacie
04-04-11, 12:44 PM
Thank you, AbsentMindProf, for that excellent explanation.

Jr1985
04-04-11, 01:01 PM
Jr1985
Jr, no one, even one in the field, can have in depth knowledge about all of the relevant material.

I might suggest that you pick specific things you feel Kmiller has spoken without empirical evidence or without knowledge in a specific area then post these disagreements along with the relevant facts so he and others can reply. Solid information is the key here and it is what makes these conversations interesting.



Dizfriz
I'm saying that it's ironic for someone, who believes in psychoanalysis, to have a problem with an apparant lack of empirical evidence.

I have been providing evidence to support my arguments, but I'm not sure it's worthwhile now. Practitioners of woo-woo aren't truely interested in evidence.

I realise this may seem like a personal attack, but I think it's very dangerous to misinform people, such as the OP, who is merely seeking advice. People should be made aware of where such information is coming from.

Fortune
04-04-11, 01:07 PM
Originally, when Leo Kanner described autism, his case studies spread the gamut of functionality - many would easily be described as "high functioning" or even as "Asperger's Syndrome." More severe cases of autism (that is, those children who were nonverbal, otherwise not communicative, and were assumed to have intellectual disabilities/general developmental delays but it is difficult to impossible to test this when the child doesn't use language) were actually diagnosed with "childhood schizophrenia." I am not sure when precisely it happened, but when there was talk of expanding the definition of autism to include "low functioning" children, this caused a lot of consternation and dismay. It's interesting how perceptions have shifted over time so that people think of Kanner's/Classic Autism as what used to be defined as "childhood schizophrenia" while the people who would actually fit in with Kanner's patients are seen as being too mild.

As for which age the symptoms show, a lot of children who are diagnosed with Asperger's Syndrome are not diagnosed until they've been in school for a few years, because while the symptoms may show, they may not be noticed. Or since they're lacking the stereotypical autistic symptoms like speech delay, other symptoms are ignored, especially by inexperienced clinicians and parents.

Now, Asperger's Syndrome is not schizoid personality disorder. Many, if not most, of those diagnosed with Asperger's Syndrome have sensory problems (which are not typical of SPD at all), and many, if not most, of those diagnosed with Asperger's Syndrome are actually willing to socialize and make friends, they're just not particularly good at it. Per Attwood (again), most people diagnosed with AS actually fit the criteria for autism (autism does not in fact require a speech delay), but they tend to appear less autistic than children who are easily identified and diagnosed at a young age (say, by kindergarten).

Anyway, as for whether AS and schizoid personality are really the same thing, I want to back up and first show how AS and SPD are not the same thing at all:

http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.1979.tb01704.x/abstract

SCHIZOID PERSONALITY IN CHILDHOOD: A COMPARATIVE STUDY OF SCHIZOID, AUTISTIC AND NORMAL CHILDREN

SUMMARY

Schizoid children (clinically resembling Asperger's autistic psychopaths), high-grade, speaking autistic children and normal children individually matched for age, sex and intelligence were compared on a variety of tests.

The results suggest that children with schizoid personality disorder are distinct from autistic children on the one hand and from normal children on the other. In all cognitive, language and memory tests the schizoid children were more distractable than, the normal group. In language function they showed similar disabilities to the autistic group, though to a lesser extent. Unlike autistic children, they were not perseverative. On two tests of affect, the schizoid group used even fewer emotional constructs when describing people than did the autistics.http://bjp.rcpsych.org/cgi/content/abstract/153/6/783

Lifelong eccentricity and social isolation. II: Asperger's syndrome or schizoid personality disorder?

Several scales are described for measuring aspects of eccentricity and social isolation; in particular, for assessing schizoid and schizotypal personality and for rating abnormal non-verbal expression. The latter is shown to be reliable, and the former to have a measure of validity. There was an association between schizoid personality traits and abnormalities of speech and non-verbal expression. However, abnormal non-verbal expression, but not schizoid personality traits or DSM-III schizotypal personality disorder, was particularly likely to occur in those subjects who had evidence of neurological deficit, and childhood symptoms indicative of developmental disorder. Abnormal non-verbal expression, but not personality disorder, was also associated with other characteristic features of Asperger's syndrome, such as unusual, 'special' interests. It is suggested that Asperger's syndrome is a distinct syndrome from either schizoid or schizotypal personality disorder, but may be a risk factor for the development of schizoid personality disorder.http://imfar.confex.com/imfar/2008/webprogram/Paper2457.html

From classic Asperger Syndrome to schizoid Asperger Syndrome

Background: Autistic syndrome, especially Asperger syndrome (AS), often differs from schizoid personality in childhood. Several attempts have been made to compare these diagnostic concepts (Tantam, 1988; Nagy, Szatmari, 1986).These diagnostic categories were differentiated in terms of the level and pervasiveness of social disability (more severe in AS).

Objectives: We have proposed to connect these two diagnostic categories into one, but with or without schizotypical symptoms.

Methods: We have examined and classified close to a hundred patients with primary diagnosis of Asperger syndrome by using DSM IV TR and Gillberg criteria.

Results: We have obtained roughly a 50/50 proportion between AS with and without schizotypical symptoms. The patients with AS and schizotypical symptoms were found to have better results in psychotherapy and did not have to take neuroleptics in contrast to children with classic AS.

Conclusions: We think that in the one illness we may have observed two kinds of AS: classic and with schizotypical factors, but also with a less intensivity of the core symptoms of AS. But if these schizotypical (more introversive) symptoms lead to the better prognosis, we may label it as the spectrum of Asperger Syndrome--from AS to Introversion.So it looks like SPD and Asperger's Syndrome are fairly distinct. Although, I think an interesting possibility, given that SPD was identified I think in 1925 (although the schizoid personality in 1908), that SPD could possibly have been an early identification of the less obvious manifestations of autism - and prior to the identification of autism as its own diagnosis (and decades later, Asperger's Syndrome) I would be unsurprised if many apparently "mildly" autistic people were diagnosed with SPD, lacking a better diagnosis.

Anyway, short version: People diagnosed with Asperger's share a lot of traits with those diagnosed as autistic. People diagnosed with SPD do not typically also share those traits. If people diagnosed with Asperger's are distinct from people with SPD and skew toward the rest of the autistic population, then it is highly unlikely that people with schizoid personalities are being excessively misdiagnosed with Asperger's Syndrome. Given that AS is actually not defined strictly by social deficits, but also by other traits such as repetitive behaviors and intense focused interests, I am not sure where the idea that it is diagnosed primarily because of social issues would come from.

Fortune
04-04-11, 01:36 PM
And just for reference, Kanner's case histories: Autistic Disturbances of Affective Contact (http://neurodiversity.com/library_kanner_1943.pdf)

Case 1: Donald T.

...

At the age of 1 year “he could hum and sing many tunes accurately”. Before he was 2 years old, he had “an unusual memory for faces and names, knew the names of a great number of houses” in his home town. “He was encouraged by the family in learning and reciting short poems, and even learned the Twenty-Third Psalm and twenty-five questions and answers of the Presbyterian Catechism.”

The parents observed that “he was not learning to ask questions or to answer questions unless they pertained to rhymes or things of this nature, and often then he would ask no question except in single words.” His enunciation was clear. He became interested in pictures and very soon knew an inordinate number of the pictures in a set of <cite>Compton’s Encyclopedia</cite>.” He knew the pictures of the presidents “and knew most of the pictures of his ancestors and kinfolks on both sides of the house.” He quickly learned the whole alphabet “backward as well as forward” and to count to 100.That's just on the first page.

And in the previous post, where I said

Now, Asperger's Syndrome is not schizoid personality disorder.

I was aiming for

Now, Asperger's Syndrome is not a schizoid personality, although many with AS can be schizoid personalities, and some even fit the criteria for SPD (whether or not such a diagnosis would be appropriate in light of the AS diagnosis).

Amtram
04-04-11, 01:56 PM
I would hazard a guess, Fortune, that it would be the same place where the idea that ADD is a problem with kids who can't sit still.

In fact, just in some of these more recent posts, it seems to me that the biggest problem in characterizing and diagnosing many of these conditions/disorders may stem more from public misinterpretation of valid research findings. Not only do people like things broken down into small, easily digestible sound bites, but they also assume that listening to those sound bites make them knowledgeable about the subject.

Another problem is the crossovers between technical language and colloquial language. AbsentMindedProf pointed out that from a clinical standpoint, certain words that describe the severity of a diagnosis are perfectly acceptable - but obviously what a medical professional says and what a layperson hears can be completely different things.

And while Fortune and KMiller can look at materials that outline sets of symptoms and see the differences in diagnoses, the general public dismisses it as gibberish and falls back on the "common knowledge" that schizophrenia means split personalities, autism means kids who can't talk and bang their heads against walls, and ADD means parents are just too lazy to discipline their unruly brats. Whichever one is easiest to "understand" is the right one, and those scientists are just pharma shills trying to baffle us with their fancy-pants big words.

Fortune
04-04-11, 02:06 PM
I would hazard a guess, Fortune, that it would be the same place where the idea that ADD is a problem with kids who can't sit still.

It could be.

It's an interesting idea, but hmm. Some of my difficulties with socializing are more or less not so much "social ineptitude" as something like:

Imagine you've got someone blaring loud cacophonous music you do not like at you while someone else is aiming a floodlight at your eyes. There may also be a strong, unpleasant chemical smell, and your clothing my be all bristly on the inside. Then someone wanders up and asks, "So how about the weather?"

I seem to do relatively okay in one-on-one settings, or in more structured settings with more people where the course of discussion is pretty much laid out and I know the subject matter (or better yet, I am interested in the subject matter). I do significantly worse if things go off the "script" and end up spending far too much time trying to assemble what I want or need to say. My therapist definitely notices the difference between a subject of interest and going off the script, and this is one of the things we've talked about - how I need to script the things I want to say to some extent in order to communicate effectively. We haven't discussed my issues with real time vs. asynchronous communication yet, let alone how easy it is to talk about something I love vs. something I am much less interested in.

Things get more complex as more people are added, but the short version is that interacting with people is fairly exhausting, and it is fairly easy to slip up and say the wrong thing and not realize it because it is outside the script or not realizing it may have other meanings to the person listening, and it is difficult to gauge people's responses due to not being able to read their body language, facial expressions, and tone of voice without working them out intellectually - throw in the sensory overload above, and how exactly is socializing supposed to work?

"Ineptitude" fails to describe it. It's sort of like saying that someone who needs a mobility device is inept at walking.

Trooper Keith
04-04-11, 02:11 PM
I'm saying that it's ironic for someone, who believes in psychoanalysis, to have a problem with an apparant lack of empirical evidence.

My assumption, based on this stance, is that you have an undergraduate understanding of psychology, which glossed over analysis and talked primarily about Freud's psychosexual theory in a segment on historical origins of psychology, and that you have no real knowledge of the work of Klein, Mahler, Kernberg, Kohut, or any other analytic researchers.

Is that accurate?

As I typically do when I run into people touting the entirely tired and old hat assessment of analysis as "woo-woo," or somehow not empirically based, I am going to link to Shedler's research (http://www.google.com/url?sa=t&source=web&cd=1&sqi=2&ved=0CB0QFjAA&url=http%3A%2F%2Fwww.apa.org%2Fpubs%2Fjournals%2Fr eleases%2Famp-65-2-shedler.pdf&ei=WQmaTa38F4GN0QH_qbT4Cw&usg=AFQjCNGBL9XvO6832HOCMwUD9n2bg9Mkzw&sig2=1hPifAWqLNDxb08gtL70xQ) and be done with it.


Fortune, I have to get to work and I don't have time to read your studies now, but from a cursory glance it appears you have confused "schizoid personality" with "schizoid personality disorder" despite my setting what I believed were very clear delineations. Congratulations, by the way, on getting the diagnosis you wanted.

Lunacie
04-04-11, 02:26 PM
My assumption, based on this stance, is that you have an undergraduate understanding of psychology, which glossed over analysis and talked primarily about Freud's psychosexual theory in a segment on historical origins of psychology, and that you have no real knowledge of the work of Klein, Mahler, Kernberg, Kohut, or any other analytic researchers.

Is that accurate?

As I typically do when I run into people touting the entirely tired and old hat assessment of analysis as "woo-woo," or somehow not empirically based, I am going to link to Shedler's research (http://www.google.com/url?sa=t&source=web&cd=1&sqi=2&ved=0CB0QFjAA&url=http%3A%2F%2Fwww.apa.org%2Fpubs%2Fjournals%2Fr eleases%2Famp-65-2-shedler.pdf&ei=WQmaTa38F4GN0QH_qbT4Cw&usg=AFQjCNGBL9XvO6832HOCMwUD9n2bg9Mkzw&sig2=1hPifAWqLNDxb08gtL70xQ) and be done with it.


Fortune, I have to get to work and I don't have time to read your studies now, but from a cursory glance it appears you have confused "schizoid personality" with "schizoid personality disorder" despite my setting what I believed were very clear delineations. Congratulations, by the way, on getting the diagnosis you wanted.

Oh, come on! You don't seriously believe anyone WANTS this diagnosis do you? It can certainly be a relief to have an answer to the question - why do I do weird things and why do I feel so different from others around me. But that is not the same thing as wanting to get this diagnosis.

It's like having someone believe you've been the victim of date rape. You don't want or need a confirmation that you've been raped, but knowing that others believe it actually happened can be a big relief.

Fortune
04-04-11, 02:38 PM
I tried to clarify my point, but I think it still stands. I dug up the studies on SPD to point out that there are identified differences that people diagnosed with AS have. These differences are not characteristic of schizoid personalities in general, even if many people with AS also have schizoid personality types, or even technically meet the criteria for SPD. They were the best objective sources I could find to refute the idea that most diagnosed with SPD are schizoid personality types.

It may very well be that neurotypicals with schizoid personality types are being misdiagnosed with AS, but I am not sure that most are able to fit criteria 2 (repetitive behavior, intense focused interests, interested in parts of objects, nonfunctional rituals), and I am think that most professionals who don't know much about AS are more likely to err on the side of "you don't look autistic enough" with someone who is genuinely autistic than they are to err on the side of "you seem autistic enough to me" with someone who doesn't seem autistic at all.

I only ever wanted correct diagnoses.

Trooper Keith
04-04-11, 06:08 PM
I only ever wanted correct diagnoses.

And I'm glad you are comfortable that you have found it. =]

fracturedstory
04-04-11, 08:10 PM
I made some attempt to read the whole thread.

Ok so maybe people that have it mild have their own difficulties but one of the main symptoms of autism is thinking you are always right and not understanding the opinions of others and to be honest sometimes when I find someone disagreeing with me I take it as an insult. That is the way I am and it's very difficult to control. So I fail to see how people can have it any worse than me.

As for being diagnosed later in life. If I was the same five year old today I would be diagnosed in less than a heartbeat. In fact, I probably would be at two. I regressed around that time. I was a very classic case of autism, so much more than the kids I see gets diagnosed with HFA which is what I have today. I could talk but didn't talk to people, was withdrawn, completely obsessed with my interests and had a severe dislike of change. I even struggled to dress myself back then. Forgive me if I feel a bit bitter about this. I was put into mainstream schools and spent a great deal in remedial classes while my whole family said horrible things about me and treated me just the same. The teachers too. My classmates just thought I was deaf and played with baby toys. I never had any type of support and still continue to have no support. What's worse is I can never work or live independently.

Compared to me people with AS have it so much easier. Sure they struggle to make friends and work, but at least they can get that far. They might have high knowledge in one or two areas whereas with me I obsessively draw planes and watch science fiction. How does one make a career out of that? And believe me I have attempted to create works of art and write my own science fiction but I never got very far with it. For one I'm very limited in my knowledge for both things despite obsessing about them.

And I have ADHD as well, at least I have many of the symptoms and do well on medication.

dancinonwater
04-06-11, 09:57 PM
There are so many posts here, its just too much for me to read, sorry! But anyway, I have to stress that its not that I have some traits of aspergers, but I have many aspergers traits but they are more mild than some people. I think for me it really is mostly that I compensate well, so my AS seems less severe than it is. But seriously this discussion isn't important, we've all shared our views, and I think that's enough.

Nitz
04-10-11, 09:37 PM
It's called a "spectrum disorder", remember?

That means that some cases are quite severe while others ... aren't.

You can have a dash of one disorder and a smidge of another one, that's called "cormorbid disorders."




Some researchers are actually looking into the possiblity that ADHD and Autism are more closely related than previously thought, in other words, the "spectrum" might be even wider and more inclusive.
Wait....Are you saying that the next DSM will label all of the non-NT of this forum autistic? :eek:

Fortune
04-10-11, 09:40 PM
Wait....Are you saying that the next DSM will label all of the non-NT of this forum autistic? :eek:

No. ADHD and ASD are two separate diagnoses in DSM-V. People are looking at possible and existing links, but that's probably as far as it goes right now.

Lunacie
04-11-11, 08:34 AM
Wait....Are you saying that the next DSM will label all of the non-NT of this forum autistic? :eek:

I have no idea how you got that from what I wrote. :confused:

branjie
04-11-11, 08:22 PM
My son is on Strattera for ADHD and is being assessed for Aspergers. He's probably like you in that he definitely has ADHD and may have Aspergers, at least has some traits. The Strattera definitely helps. It helps him focus on what he's supposed to be doing, and decreases his hyperactivity. He's definitely better on it.

dancinonwater
06-10-11, 08:16 PM
I just wanted to sort of finish this thread by saying that after doing more research on the suvkect, i am 100% positive that i have it, and we are in the process of getting an official diagnosis. Wish me luck!

Lunacie
06-10-11, 08:24 PM
I wish you great luck! Understanding the diagnosis should be a huge help for you in moving on with your life and finding the therapies and management tools that will make your life easier and better.