http://www.usatoday.com/story/news/...changes-diagnosis-manual/1739301/?sf7603612=1 I can hear the goons weeping silently into their anime pillows.
I'm guessing I'm the only one who finds this offensive, so carry on. (Not that Adree gives a fuck about being an offensive dickweed.)
High-functioning autism, as that's basically what Asperger's is being merged into. It's unclear if HFA differs from Asperger's in any meaningful fashion, but I guess the APA has decided that it doesn't, thus this change.
Well, that's what it's been all along. The stigma of Asperger's isn't the syndrome itself. It's the people who self-diagnose as an excuse to be antisocial troglodytes. "Autism" is less likely to be self-claimed by an individual because in a lot of minds, it still conflates with "retarded". Whereas saying "I can't help being an asshat, I have Asperger's Syndrome" has been the battle cry of internet turdmonglers for years now.
Not really sure how to react to this, as someone who has (professionally diagnosed, as it happens) Asperger's Syndrome. I mean, in one sense it doesn't mean anything - my mind is my mind, and what people choose to call it isn't going to make a jot of difference to how it actually operates. On the other hand, after a number of years now of differentiating myself from those with more severe autism, it feels a bit weird to describe myself simply as a high function autistic. The main concern I have is how far it'll lead people to disbelieve my diagnosis and encourage the conflation of all autistic people in the public mind into one Rain Man cliche, even more than is already the case? Will people now go "well you seem normal enough, you can't be a proper autistic?". Or worse still, will they say "but I heard Asperger's syndrome doesn't exist any more" I assume I am thereby cured or something? The autistic spectrum is a sensible diagnostic idea that fits much better to how people actually are, but the public at large tend to prefer discontinuous categories rather than smooth spectra.
Don't feel that bad... I laughed, and I actually have Asperger's (and, y'know, was diagnosed with it by an actual medical professional). And oh lord, do I agree with Nute on the "Self-Diagnosing antisocial troglodytes" angle... those asshats create an unfair social stigma for people who actually have been diagnosed with high-functioning autism. They also do a beautiful job of misrepresenting Asperger's / Autism, too, since it's a lot more than just 'I can't read social cues.' That said, there's quite a bit of fun involved in taking those faux-Aspergers people to task. "No, you don't have Asperger's Syndrome. I have Asperger's. You have 'I'm an asshole' Syndrome. I can see how you got confused, since there's 'ass' in both of them." Oh, and I agree with everything Meserach said. He put things into words a lot better than I did.
I'm betting this will have close to zero effect on how many people even understand what Asperger's and autism are in the first place.
The interesting thing about Asperger's and being an asshole, in my personal experience, is this: I was totally an asshole a lot before my diagnosis, and nothing as singularly AS my diagnosis has helped me to be less of one. Anyone who takes a diagnosis of Asperger's (self diagnosed or otherwise) and uses it as a shield from criticism is doing it wrong. What my diagnosis has helped do is realise where my instincts aren't the best, what cues I'm missing, how to cope better under stress, and generally how best to imitate a regular person. Some people feel as though they shouldn't have to do this, but the reality is that everyone moulds themselves based on the social environment around them, and all people on the autistic spectrum have to do is work a lot harder at it. Maybe that sucks, but we all play the hand we're dealt. And the base reality is, it's doing it that way or being, well, an asshole. And it isn't much fun to be an asshole, even if you were to find a community of fellow assholes to hang out in.
Basically, what Mese said. As far as I've ever known, Asperger's has been HFA, just a very mild form, and it has a few unique bits, but it's still autism at the core. The only people who will give a shit are the self-diagnosed people looking for an excuse for why nobody likes them. They'll re-self-diagnose with BPD or APD or something and fuck them anyway (this is the official stance of anyone actually diagnosed on the autism spectrum). People will still refer to Asperger's as that, and it'll just be classified as HFA for official purposes. I doubt most people will even know the DSM V exists, most don't even know the DSM IV exists, and the people who would be confused about "no more Asperger's" don't know what it is to begin with, really. NOW LET US GET BACK TO LAUGHING AT GREASY AARONGOON TEARS.
I like what you're aiming at, but I'm not sure they can. I'm not sure autistics and hipster are compatible as we lack the pre-requisite irony.
The DSM V, last I heard,is also getting rid of the schizoaffective diagnosis. What the everloving fuck. Yes, a lot of doctors give a diagnosis of SZA with they're not sure what's going on with a patient, but it's a legit diagnosis unto itself. I have symptoms of both bipolar disorder and schizophrenia. That's what SZA is. Calling it a "schizophrenia spectrum disorder" does not include the affective (mood) aspect AT ALL. Calling it "bipolar disorder with psychotic symptoms" doesn't work, either, because a lot of schizophrenia/SZA symptoms are NOT psychosis. Sorry, as both a psych patient and as a psychology major, the DSM committee is pissing me off. Grrr.
I have zero experience in any form whatsoever with this kind of stuff, but presumably the DSM's authors, editors, contributors, and backing association have the cred to make this determination, notwithstanding how anyone else feels about it.
A great deal of the DSM is created through politics and compromises. It's not perfect by a long shot. A lot of experienced doctors have problems with stuff in the DSM, too. It's not just a few patients, trust me.
I liked both posts because both of your points have merit. That said, I'm sure SwitchKnitter will respond at length soon enough (edit: or not! He is under no obligation to), but each DSM seems to include at _least_ one major, er, to be extremely forgiving, "oversight", such as the infamous diagnosis of "homosexuality is a mental illness", so complete deference to supposed expertise in this instance, especially when there have been calls for decades for an international APA-dissassociated response to the DSM, would seem unwise.
Fair enough. I've been missing subtleties in conversation the last few days due to various life stressors, so missing two more shoulda-been-obvious things now isn't surprising. heheh.
Eh, don't worry too much about it. Most people that aren't involved in psychology in some way (whether as a patient, a profession, or just an interested reader) don't really know that much about the DSM... hell, for that matter, most people probably don't even know what the DSM is.
As of the last version of the DSM, being transgender is still a mental illness (gender identity disorder). The DSM V will be changing that, thankfully. There will still be a diagnosis of "gender dysphoria", but that's a genuine problem for trans* people as opposed to our trans-ness itself being an illness. So there are some good changes coming with the DSM V. Still, I feel some changes are problematic, as do many actual trained medical professionals. This stuff isn't just a matter of terminology and semantics, by the way. It's relevant for insurance purposes. For example, an insurance company could decide not to pay for an SZA patient's mood stabilizers because the patient has "schizophrenia spectrum disorder" and that's not the same thing as SZA. That will undoubtedly happen with some illnesses, although I don't know if SZA will be one of them. And when the final version of the DSM V goes to print, insurance companies are going to have to rearrange their classifications all over again. So... we'll see what happens.
As a psych major/clinical psych in training, it's a load of bullshit. It's so bad that the APA has a lot of people looking to make sure it has its own book for legit diagnosis, and the DSM V will be used for insurance purposes. The problem isn't that the doctors involved don't know what they're doing. They do. The problem is that the DSM V is, for all intents and purposes, being written by insurance and pharmaceutical companies. You know, the people who want to either not pay for a diagnosis or to make a buck off it. Whichever is easier. This is, of course, thanks to some 70% of board members having direct industry ties and that the process started with all committee members signing an NDA. Is there a pill for it? It's in. Is the only treatment lengthy therapy? Cut it or stack it in with something that gets a pill. Secrecy is the enemy where mental health goes. Of course, the DSM doesn't determine what's taught or what's going on in reality. It affects how a diagnosis is listed, it affects a name that's used, it affects insurance. Any good doctor is going to deal with the actual problem though, not the DSM listing.
So what exactly would be the DSM's big political conspiracy reason to revoke so many internet users' unique snowflake status?
Won't change a thing for them, because they're self-diagnosed and most aren't autistic, they're just asshats. Really, I don't see much difference at all for insurance purposes where autism/asperger's merger goes. Most insurance companies don't want to handle either and will continue to not handle them.
How do insurance companies even cover it (or not) now? When I was diagnosed (the legitimacy of which I wonder about - the doctor wasn't paying the most attention, and I was raised in one of those households where mental disorders that don't involve hearing voices are just a bunch of bullshit, and the degree to which I can fake it with normal people seems a little too good, but I'm also doing all of that shit with the active thinking part of my brain and no part of it is natural and I score way the hell off the charts on any test I ever take), the therapeutic options were psychotherapy (which every insurance I've ever gotten through a job already covers, so long as the person doing the therapy says you continue to need the therapy) and fluoxetine for keeping the edge off some of the depressive and compulsive side effects (and that's a $4 generic prescription pretty much everywhere, isn't it?). Should I be getting shocked in the brains or having experimental surgery or something? Because so far as I know, the most likely cause we can isolate for all kinds of autism is genetic, which tells me that if there isn't a drug that fixes it, the only way to address it would be through one form of ongoing therapy or another. Or maybe I just have kickass insurance? I want to say that it was basically the same at Aetna and BC/BS and that third place that I don't quite remember the name (The Principal? They got out of the medical insurance business after the Affordable Care Act passed, because that's when I ended up back with Aetna.). I wasn't diagnosed back when I was on TriCare - maybe they suck. For the name....I kind of like HFA better.
Your point about insurance is what I'm also hearing from my two relatives who are psychologists. The DSM does one other thing, though, they create epidemics! Like when they added and broadened Autism Spectrum disorder, which dovetailed nicely with public awareness and created the "Autism Epidemic". Thanks to that we have parents running around asking why vaccines and/or wheat gluten made their kids autistic when 25 years ago half those kids would have just been called nerds (for the high functioning) or mentally challenged (for those with the developmental delays). Don't get me wrong, kids getting help that fits the way they learn is a great thing, I just think there's been some bizarre and far reaching unintended consequences to previous DSM revisions.
Brian. If there is one person on this forum that can safely be declared autistic without any knowledge of his outside life, childhood, or observation of affect and behavior, it's you. The only question is if you're autistic or an android. Assuming your parts are organic, I can't believe you weren't born with a birthmark shaped like a puzzle piece.
I don't know what it says about you, me, Brian, or this forum that I read this post in a kind of comforting tone when in a vacuum it would seem incredibly mean.
