No More "Asperger's Syndrome" 602
cstacy writes "The American Psychiatric Association is dropping Asperger's Syndrome from the upcoming edition of the Diagnostic and Statistical Manual (DSM-5) Its symptoms will be included under the umbrella of Autism Spectrum Disorder, which includes everything from severe autism such as children who do not talk or interact, to milder forms of autism. Asperger's disorder is impairment in social interaction and repetitive and stereotyped patterns of behavior, activities and interests, without significant delay in language or cognitive development. Often the person has high intelligence and vast knowledge on narrow subjects but lacks social skills. DSM-5 comes out in May and will be the first major rewrite in 19 years."
Damn... (Score:5, Insightful)
Re:Damn... (Score:5, Insightful)
It's not a disease.
About time (Score:4, Insightful)
I've worked with a number of people who share all the Asperger's traits. Rather socially awkward, some Obsessiveness, not the most physicaly gifted. Yes, I worked with scientists and engineers. But they were just different, and their traits were not a disability, it was who they were. And they are very good at doing what they do. And we all get along just fine.
The only people hurt by this decision is the Autism Speaks people, who will need to revise their statistics.
Re:sick and tired of labels (Score:5, Insightful)
You're right. The best way to do that would be to stop using names for things, that just makes everything too confusing. Instead we should write a page explaining what we're referring too each time we mention a new concept in conversation.
Labels are shortcuts. They aren't always great, sometimes they need to be adjusted, but in many cases they are necessary and useful. In fact this could easily increase understanding by pointing out that it is not a separate issue, I don't know enough about Aspergers or Autism to conclude that but I get the impression that you aren't concluding the opposite. Just trying to sound intelligent by complaining about labels.
Need more sub-definitions (Score:5, Insightful)
Shout out to the Aspie Quiz [rdos.net], go take it! - HEX
What does it matter? (Score:4, Insightful)
Why does it matter if the label changes. The people who are affected by Aspergers Syndrome/Mild Autism Spectrum Disorder, such as myself, will be the same people regardless. The DSM V is really not changing anything significant to reality.
Comment removed (Score:4, Insightful)
Re:Damn... (Score:5, Insightful)
noun
a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.
Aspergers seems to fit the definition of disease.
Re:About time (Score:5, Insightful)
The move itself is akin to splitting off persons who have compulsive tendency in their personalities from those diagnose-able with Obsessive-Compulsive Disorder, and as such seems to be a reasonable change in categorization.
This is one of the most controversial aspects of psychiatry. Human behavior is all a spectrum. All of us (well, most of us anyway) have personality traits. One may be a bit tightly wound, or a bit too laid back, or sloppy or overly neat, or insensitive or smotheringly kind. The combination of those traits make us who we are.
The classical definition of a personality disorder has been when one or more of those traits becomes a dominant part of a persons personality and becomes 'harmful' to that person or society at large. We've all seen the psychopathic boss, the obsessive person who drives family and coworkers away, the very dependent person who wrecks relationships. But when do you call it a disorder? The first time someone complains about the boss? The first divorce? The first time you get into a fight?
It's a fluid distinction. Our favorite disordered personality, Stephen P. Jobs, might well have been banished to an Ashram if we had any sort of effective treatment. Balmer and Gates might have been turned into, well, dunno, I have nothing here. Anyway, it is at the heart of how we define normal (or at least acceptable). In many ways, we don't really want to get to the point where we can treat it or even understand it.
Careful what you ask for, you just might get it.
Re:Damn... (Score:5, Insightful)
It's not a disease.
Well, not by that name any more any way.
One artificial psychiatric definition down, about 3500 to go [wikipedia.org].
Re:It's only being renamed... (Score:4, Insightful)
The percentage of Aspberger's on Slashdot is probably higher than average.
And it may be a form of Autism, but sometimes it's tough to generalize too much since that will just cause psychiatrists and others to look at the person and consider him/her "normal" compared to the cases they work with instead of handing over you to someone that specializes in cases of the milder forms.
Change the definition, no more problem! (Score:5, Insightful)
I know the trolls are lining up to post "Ass-burgers is fake anyway, I met an Ass-pie once, and he was fine."
So let me say this first: If you've met an Aspie and dismissed the condition because that person "seemed fine", then please consider that what you didn't see was the countless hours of practice and stress and anxiety of being able to pretend to be that way; the habitual exhaustion from the effort of doing so; the depression and abysmal self-esteem from never, never understanding the people around you or being able to tell whether people actually like you or not. The years of teasing and abuse, the subsequent years of retrospectively realising all the other things which were teasing and abuse at the time but we couldn't tell at the time. The incessant Impostor's Syndrome, which only gets worse the higher you rise -- if you can move forward in your career. Who speak nineteen languages, but get scurvy because they forget to eat. No, seriously: people whose executive dysfunction requires the scheduling of bathing and eating, or else a rigid routine, where even slight interruptions can trigger a panic attack. The meltdowns and fear and frustration and despair.
And you don't see the ones who don't "seem fine". Who weren't as fortunate as those of us who got a series of lucky breaks and have been able to work around our disabilities and take advantage of our strengths. The ones who killed themselves in despair or ended up on the streets or were institutionalised or are housebound on antidepressants and anti-anxiety meds.
The DSMV changes to the Autism Spectrum diagnoses have been widely stated by the people writing them to be for the purpose of excluding people from being diagnosed on the spectrum. Because when people started actually looking at how many people had an ASD, it turns out to be much more than anyone thought.
Obviously it can't be because so many people were swept under the carpet for all those years, so it must be a problem with the definition. Hey, if we change the definition of Cancer to exclude any condition of the skin, that means that all those people with melanomas must be cured, right?
Re:Damn... (Score:5, Insightful)
The really sad part is that I know from personal experience just how different Asperger's and true autism are. I had a good friend for many, many years that I sadly lost contact with that had Aspergers. A little awkward, but one of the most highly intelligent people I know. On the other hand, I also have an immediate family member that does fall on the autistic spectrum, and over several decades we've all been through the highs and the lows as a family.
Aspergers may be on the austisic spectrum, but they're nothing alike in real terms.
I also know first-hand how a label can effect self-confidence. I have Tourette Syndrome, very much controllable, but everyone's first frame of reference is that damn Rob Scheider movie. You've gotta laugh, but it does get awkward sometimes. I don't want to imagine how much anxiety highly ingelligent, high functioning but socially-anxious Aspergers sufferers are going to go through when they start being labelled autistic.
This is doing them a great disservice.
Re:C'mon, idiots. (Score:5, Insightful)
Fact of life: if there are never any problems, and your task is keeping a service up, you may be fired because some bean counter will think you are a waste of money.
Re:Change the definition, no more problem! (Score:2, Insightful)
That's not a psychological condition, it's the human condition. And if, as an "Aspie", you deal with it by trying to figure it out intellectually instead of succumbing to alcohol, drugs, obesity, wild sex, or other self-destructive behavior, you're ahead of most other humans on this planet.
Re:sick and tired of labels (Score:4, Insightful)
Hundreds of millions of years ago. It's been an unbroken chain ever since.
Re:Met them (Score:5, Insightful)
Think of it this way:
You go in to the clinic because your spouse is worried about your health.
You're 50 lbs overweight and your cholesterol and blood sugar are too high.
Do we have a separate diagnosis for the person who's 100 lbs overweight? Does it matter what the label is?
You should be paying attention to what the psychologist, psychiatrist, social worker, your family, and what you yourself identify as your particular constellation of problems.
The label is useless and explains nothing. You don't have Aspergers, or Autism, or Autism Spectrum Disorder, you have a constellation of social cognitive problems that represent part of who you have been. The causes are probably unknown and may be unique to you or your family, just like the causes of someone else "with Aspergers" are unknown and probably unique to them or their family.
Do you want a ruler with one line on it that says "long"?
I'm not saying these aren't real problems, I'm just saying any label is useless.
I say this as someone who has worked on the DSM. Ignore it. It's not what matters.
Re:sick and tired of labels (Score:5, Insightful)
Actually, there is. Millions of years ago, life began in the oceans. Life (on Earth) hasn't ended yet, so there has not been an opportunity for it to begin again.
Eggs and sperm are both alive. Pretending life begins at some point in pregnancy is just hand-waving designed to repress women and ignore the horrors of pregnancies that have gone wrong.
Re:sick and tired of labels (Score:4, Insightful)
Re:Damn... (Score:5, Insightful)
And I suppose people with sickle cell disease [wikipedia.org] are merely suffering from prejudices as well? After all, it's a "genetic difference" as well.
I did notice you were careful never to actually say that diseases cannot be genetically based, so I assume you are willing to grant that some are. If you're willing to grant that sickle cell disease is indeed a disease, as I would assume you are, then you'd need to draw the line at some place, but where? We would both agree that having a different eye color is not a disease, but I think we may differ, in that I tend to lean more towards believing the non-politically correct idea that if a genetic mutation leaves you significantly less capable of functioning, whether due to mental or physical differences, it would be a disease. Of course, at least to me, "disease" is purely descriptive of a condition, and in no way prescribes a behavior or response.
For instance, to quickly clarify what it does not necessarily mean, it does not mean that they are necessarily at a disadvantage. Sickle cell disease confers malarial resistance, and at least in the case of my friends with Asperger's, they have exceptional abilities to recollect minute details from long ago (whether that's a learned skill or a trait of the way their brain is wired differently, I couldn't say with certainty, of course, but I believe the latter). I don't see a reason to pity anyone in those positions, since they are people who must make the most of themselves, just like everyone else.
Additionally, it does not mean that they are inferior people. We define ourselves, and who a person is is more than just their body and mind. We are all born with things we need to work through, and whether that's a weak chin, dashing good looks, a bald spot, or Asperger's, we either choose to allow ourselves to be defined by them, or we choose to define ourselves despite them. That rests entirely on us and is entirely of our own doing. It's our own fault if we allow them to define us.
Long story short, just because someone has a genetic difference that may classify as an error (which isn't the case here, since Asperger's is hereditary) does not mean that THEY are an error, so people should stop treating "disease" like it's some sort of dirty word and call things what they are. This mentality of coddling people by using useless terms isn't helpful to anyone, and it gets in the way by delaying recognition and response. Instead, be honest. If I'm going bald, say I'm going bald. Dancing around semantics isn't helpful to anyone.
Re:About time (Score:5, Insightful)
Re:Damn... (Score:5, Insightful)
Re:Damn... (Score:4, Insightful)
Aren't all definitions artificial?
Re:Damn... (Score:1, Insightful)
There's an easy cure to 95-98% of autism cases: break the idiotic alignment of financial incentives that causes the massive fraudulent overdiagnosis of these "spectrum disorder" conditions.
Re:Damn... (Score:3, Insightful)
I doubt it. I considered myself to have mild autistic traits before I knew about Aspergers. Self diagnosers will self diagnose.
Re: Damn... (Score:3, Insightful)
The problem is, provided that he really is an aspie, that he can't be taught these things. Social interaction for instance is highly dependent on being able to "read" peoples facial expressions at a glance. If he is some kind of autistic, he's simply unable to do that. With training and skill he might be able to do it by thinking and reasoning about it, but he will never do it on the fly, which is effectively the same thing as not being able to, because it's too slow. Besides that, having to do this will burden him with a significant cognitive load, which will bring other problems.
Hopefully whatever difficulties he has won't impair him too much, but thinking it can be "cured" by training is overly optimistic, if probably natural for a parent.
Disclaimer
IANAD etc, however all opinions are sourced from such.
I don't have Asperger's Syndrome. (Score:4, Insightful)
I'm unsympathetic and uncommunicative because I don't like you and I think you're all twats.
Re:Damn... (Score:5, Insightful)
Aspergers may be on the austisic spectrum, but they're nothing alike in real terms.
It's a spectrum! The EM spectrum is quite similar...
You can't expect people at the mild end to show the same symptoms and behaviours as those as the severe end. Let's be honest here, we're all on the autistic spectrum somewhere, and I can easily believe the slashdot crowd are skewed towards one end from the population mean.
Re:Damn... (Score:4, Insightful)
The main gripe with Aspergers being called a disease instead of what it actually is, a neurological functionality disorder.
The disorder part of it is due to people having it (like me) have certain disadvantages compared to the normal person.
A disease is something which is objectively bad.
If someone told me they could "cure" my aspergers I would be offended.
There are parts of my problem I'd like help alleviating, but loads of the things I gain from having it might get lost and I would probably be a very different person without it.
To say that AS should be cured is kinda like saying that the person questioning society should be lobotomized since they don't fit in.
Re:Damn... (Score:4, Insightful)
To see this taken out of the DSM-5 is the greatest gift any kid with it can have. No longer will they feel outcast, no longer will they have to prove themselves, to rise above the rest of society simply because of a stupid name given by a German doctor. It's too broad of a disease with only one, maybe two specific symptoms. I have tried to get this removed many a time, but they all said that I wasn't qualified, they had the ink tests.
Re:Damn... (Score:5, Insightful)
If its not a disease then you can't prescribe for it and insurance won't pay for it. Whenever in doubt of the hidden agenda, follow the money. These guides are essentially accounting code manuals, not medical in any way. It's very much the same as going to a mechanic for service and having them look up which procedures are covered under warranty.
Re:Damn... (Score:5, Insightful)
Personally, I think we should do the opposite of what you're suggesting: abandon the word "disease" for all mental differences. Stop trying to draw artificial distinctions. Stop trying to pigeonhole. Approach each one - and each person - as an individual.
When you do that, you lose most of the advantages of Western medicine--and Eastern medicine, for that matter.
A mental disease is essentially a behavior pattern. Of course each person is an individual, but certain behavior patterns routinely present themselves, and by classifying them together we gain the power of abstraction: what heals or reduces the impact of a behavior pattern (disease) for one person might work for some others; what works for twenty or a hundred people will likely work for many more. Without being able to separately classify some behavior patterns apart from the individual who exhibits them, we're stuck with a lot more trial and error. I question if it's even possible for someone to treat people who have mental diseases without, through simple process of observation, finding himself classifying behavior and responding accordingly.
Here is an illustration of how classifying mental diseases can be helpful. I dated a girl who told me she suffered from depression. And that appeared evident to me as well. She also did other things too, though. I found that when we were on good terms, I was her favorite person in the world. But if I did one thing that she didn't like, something as simple as already having plans with friends when she wanted to get together, or a comment that she took the wrong way, I was instantly on her shitlist and would remain there for a day or two. There was no in-between. She felt this way about everybody. She was very manipulative, and she'd frequently fly into hysterical rages where she couldn't be reasoned with and the only "solution" was to ignore her for a day or two.
After I broke up with her, I stumbled across a description of Borderline Personality Disorder, and it described her behavior perfectly. I told her as much, and she looked it up and agreed. She went to do a depression study, part of which involved getting an analysis of conditions, and sure enough they told her she had both depression and BPD. Since she now knows what her behavior is classified as, she also has found strategies to help her cope with it. I've spoken with her a few times since then, and I can tell that there is a difference in her, and it's a pretty drastic change for having begun only a year ago.
Without the classification, she would have lived the rest of her life being as miserable and unable to connect with other people as she had been up until then. Once the classification is there, you can call it a disease or a disorder or a condition or whatever you like, it allows us to say "We've seen this before, and here are some things to try that helped other people." The term "disease" has connotations that perhaps it shouldn't, and I don't care much about semantics so I'm not attached to any word in particular, but refusing to classify things is throwing the baby out with the bathwater.