Location: United States Posts: 195 Joined: 2008-01-08
It was recently announced that the American Psychiatric Association is proposing revisions for the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is an extremely important tool when it comes to making a diagnosis.
The proposed revisions range from the possible elimination or re-ordering of certain categories (Ex: Asperger's Disorder and Disorder of Written Expression) to smaller changes across the broad spectrum of disorders included in the DSM.
I feel that it's very important for those of us with Learning Disabilities to be informed and have a chance to voice our opinions about these proposed revisions. Fortunately the APA is allowing members of the public to register on the official DSM-5 website and post comments about the revisions.
Reminds me of a "For Better Or Worse" cartoon where Elly and a friend were discussing PMS. Elly said she was glad they had given it a name; when her friend asked why, she replied "That means they believe it exists."
Blessed are the PURR in heart!
I am really excited about all the changes, because I think it will help with the insane amounts of overdiagnosis that go on, in everything.
I am kind of irritated at the Non Suicidal Self Injury "diagnosis" they are proposing. I think it's BS. Self-injury is not a diagnosis, it's a symptom of something else. You CANNOT have a self-injuring patient without some kind of psychiatric disorder. You just can't. You either self-injure cause your brain is messed up on something like depression or you are doing it for attention. None of this middle ground.
I am really pleased that they are modifying the personality disorder categories into typing them more. I fit the DSM-IV Borderline Personality Disorder diagnosis, but that just leaves doctors with this huge array of symptoms. I think the new types will help make it easier to treat because they will have a better idea of type of borderline I am.
I think it's funny that for their rationale behind the AD/HD changes they put "long lists of criteria are hard for clinicians to remember". First off, that's their job. Second off, that's why there IS the DSM.
Some of the others they have added like "Olfactory Reference Disorder", I hope doesn't come into existence. It seems kind of ridiculous and can't affect so many people in that particular way that it needs to be a separate disorder. Shouldn't that just be an Anxiety Disorder NOS?
I will definitely register and comment on some of this stuff, cause I am totally into it and think this could really change the game for dyscalculics and everyone else with a mental disorder.
Edited by classclownfish on February 15 2010 03:08 AM
I am not pleased with the fact that people with aspergers are going to be lumped in with people who have autism. One involves delays in mental development, one definitely does not. I have a hard enough time convincing people I'm not "retarded." Removing the distinction takes away the only weapon I had to combat that. While I do believe that aspergers can be considered on the autistic spectrum, i don't believe that it is practical for everyone with an AS disorder to be labeled "autistic."
So AS is basically a "social learning disorder". I can buy that. I can't buy this "I'm HFA but don't call me that" stuff. If it's the same, it's the same. Lump it together, cut out the people that don't actually need help, and help those that really do. I think calling it HFA will scare off some of this ridiculous overdiagnosing that's been going on. It is insane.
And yes, people are going to think you are "retarded". People are stupid and don't understand. They don't want to, and they never will. If you can't handle that, don't tell people you're AS. I pick who I tell I have BPD very carefully because it tends to scare people off. Your label stigmatizes you as "retarded", which I am sure can get you nothing but more help, whereas my label stigmatizes me as "crazy", "psychotic", "suicidal" and "difficult" and "not worth the trouble". Therefore, I get no help at all because people don't think I am worth saving.
No, my label is aspergers, which does not stigmatize me as retarded. The problem I have with lumping aspergers and autism together is that yes, HIGH FUNCTIONING autism and aspergers are very similar-- in fact the speech delay is just about the only difference, people with aspergers don't have one. However, there is a BROAD RANGE of abilities within autism that goes far beyond the bottom category of aspergers. Aspergers is a variation of sorts of high functioning autism, but is at the VERY TOP of the autistic spectrum in terms of level of disorder. The most affected person with aspergers is not going to even compare to someone with severe autism. Rock bottom, so to speak, is about ten thousand miles lower with autism than it is with aspergers. That is a huge difference, and furthermore now someone with severe aspergers is just going to have mild autism. The "mild" word keeps many from getting accommodations, it hindered me with my dyscalculia proceedings until I insisted my doctor remove the word from my report. The distinction between aspergers and autism, which is really only a dotted line now which I think is appropriate, separates the broad range of abilitities for people with autism, and the general normal range of abilities for someone with aspergers. We are talking two entirely separate scales of severity. How can you combine them without making the severely disabled even more disabled, in the eyes of medicine, and the mild-moderately disabled LESS disabled and therefore less likely to get help?
And no, I don't accept that people are going to stigmatize me as retarded. I am not retarded, mental retardation is not even a symptom of my disorder, and anything that blurs that line is wrong in doing so. I have an IQ in the superior range and I had doctors noting that I was verbally precocious in pre school, that is the opposite of a cut and dry autism diagnosis which involves speech and mental developmental delays. And maybe you're lucky enough that people don't know you have BPD if you don't tell them, but many people with aspergers or autism are not lucky enough to be able to hide it. So good for you that you're able to hide and that you're not interested in advocacy, but I cannot and am not willing to hide, and I am not willing to just take stigma borne from COMPLETELY INACCURATE information lying down.
Edited by twistedxkiss on February 15 2010 07:38 PM
I still just don't understand why they can't be merged and coded differently for different things. Like "Autism Spectrum Disorder Without Speech Delay" would be a separate dx from "Autism With Mild/Moderate/Severe Speech Delay". All that really matters is you get the help you need to succeed in life, right? Plus I think that merging them will cut out alot of people that have VERY mild Asperger's that barely qualify for a dx anyway, as right now they really don't have a way to differentiate between AS traits and full blown AS. Then people who actually really need help can get it. The Asperger's label is applied so liberally to every kid with a little bit of social issues that I'm starting to wonder about the validity of disorder within anyone that tells me they have Asperger's. Same with AD/HD and bipolar disorder. Maybe I am too much of an opponent of this overdiagnosing stuff, but people really need to put in perspective whether or not their "disorder" really actually impairs their functioning or if it's just convenience to explain away every little eccentricity with a medical diagnosis.
Also, just for the record, I cannot hide my borderline, and you are completely wrong for assuming I can. I'm not trying to turn this into some kind of flame war, but don't make these assumptions about me. I cannot hide, I don't want to and I want people to understand. Thing is, they don't. And they don't want to. I am all about advocating for myself and trying to get the help I need, but the stigma for me in INSANE within the medical community AND the general public. And yes, it's all based on wrong assumptions like ALL stigma is. We all struggle. That's just the way it is.
"All that really matters is you get the help you need to succeed in life, right? "
No, not really. Being employable is pretty important, too. Life is not all about accommodations. If people think I am autistic I am going to have a hell of a time succeeding in my field. Probably getting married, too, since people think that people with autism have mental retardation-- and they would be right about that, but I have aspergers so I do not. I don't understand how mental retardation vs normal or superior functioning is not a distinguishing factor to you. Really? Seriously? These disorders are one in the same? Is social anxiety the same? After all, it causes social awkwardness, who cares if they manifest in the same way or have the same implications!
"Plus I think that merging them will cut out alot of people that have VERY mild Asperger's that barely qualify for a dx anyway, as right now they really don't have a way to differentiate between AS traits and full blown AS. Then people who actually really need help can get it"
It is not as if there is a finite number of accommodations available and if one person gets it another person isn't. Furthermore, if you qualify for the dx, the idea is that you are significantly impaired. Just like the diagnosis of any other disorder or disability. Dyscalculia is no different. If I am "barely" dyscalculic, should I not get accommodations? I still have dyscalculia same as you!
"The Asperger's label is applied so liberally to every kid with a little bit of social issues that I'm starting to wonder about the validity of disorder within anyone that tells me they have Asperger's. Same with AD/HD and bipolar disorder."
Trust me, you are wrong. My aspergers screening AND my ADHD screenings were more rigorous and in depth than my dyscalculia screening, which still involved a full battery of tests and hours upon hours of work. And perpetuating this belief is why ADHD is getting morphed into nothing -- people spread rumors about what they THINK they know about ADHD so often that people hear it so much they think it's true, when it's been false from the beginning.
"Maybe I am too much of an opponent of this overdiagnosing stuff, but people really need to put in perspective whether or not their "disorder" really actually impairs their functioning or if it's just convenience to explain away every little eccentricity with a medical diagnosis."
Who are you to say whether or not and when this is happening? And what has this got to do with aspergers vs autism?
"Also, just for the record, I cannot hide my borderline, and you are completely wrong for assuming I can. I'm not trying to turn this into some kind of flame war, but don't make these assumptions about me. I cannot hide, I don't want to and I want people to understand. Thing is, they don't. And they don't want to. I am all about advocating for myself and trying to get the help I need, but the stigma for me in INSANE within the medical community AND the general public. And yes, it's all based on wrong assumptions like ALL stigma is. We all struggle. That's just the way it is."
I don't accept that's the way it is. If that's the attitude we all took, civil rights issues would never get any better. I am not willing to accept that. I mentioned hiding vs not hiding because you told me not to tell anyone, like you, like that is going to protect me from the massive amounts of stigma I am about to face. You were wrong.
I am not out to start a "flame war," either, but given that you are going on about how some people are just "barely diagnosable" and they don't deserve accommodations when I am not aware of any professional credentials you have on the matter, and that I should just sit back and let the medical community make people think whatever they want regardless of if it is true, just rubs me the wrong way.
Edited by twistedxkiss on February 16 2010 12:31 AM
Right. Of course, but I was mostly addressing that issue since that seems to be alot of the focus on this forum. Yes, other things are going to be difficult. But that's why the ADA is there. So someone can't just NOT give you a job because you're dyscalculic or have autism or have physical disabilities or are blind or whatever.
I disagree with your statement about people with Autism being "mentally retarded", at least in the traditional sense. Nothing in the diagnostic criteria says anything about them having a lower IQ or being "mentally retarded", if that's what you mean. And I know most people know the difference between autism and mental retardation.
No I don't think all those disorders are the same. Obviously, there are significant differences. But I feel like a general "autism spectrum" label specifically coded to the individual should be able to fit most people with Asperger's/Autism. Yeah, maybe not everyone, but it never seems to work out that way for anything else.
Yes, there are a finite number of people that are "disabled" in some way that can get the help they need. In a perfect world that wouldn't be the case, but unfortunately budgeting and other such factors seem to cut out a lot of people. I am speaking mostly about therapy and such more than academic accommodations. I know this happens because I have been a victim of it many times.
"Furthermore, if you qualify for the dx, the idea is that you are significantly impaired."
Maybe in your case the doctors were thorough and did their job, but in alot of kids I know, that is not the case. Where I come from, you don't even need a psych specialist doctor to diagnose you with AD/HD. It can be a pediatrician. Hell, I was diagnosed with depression by my pediatrician just by filling out a survey. How messed up is that? Meanwhile, the medication they gave me made it worse, but that is a story for another time.
I don't want to accept it either. I don't want it to be that way, but I've also kind of decided to pick my battles. I have way bigger problems than to worry about what others may think of me. I advocate for myself when necessary, and I try not to worry about it when it's not.