Paper about the limitations/lack of clarity in dsm 5 severity levels

[the_tortoise]

Brief Report: DSM-5 “Levels of Support:” A Comment on Discrepant Conceptualizations of Severity in ASD

Has a useful graph.

It was written before the DSM came out, apparently, but the concerns are still relevent as no quanitification seems to exist/have been developed. (That I am aware of -- if anybody knows otherwise, please share!)

Alternatively, if forthcoming DSM-5 text clarifies that the diagnostic modifier should indicate “level of support” for ASD symptoms alone (i.e., should not overlap with functional impairment), the issue then becomes how to quantify and qualify that going forward.

Is it possible to even do that, though? Given that ASD symptoms can be influenced by context? (And considering situations where a person could have comorbid conditions with overlapping symptoms that may have been present since birth?)

 

[Catana]

I've come to believe that the DSM is worse than useless, in every possible way. There isn't a single thing you can pin down as being so concrete that there can be no questions about how to interpret it. Here's an idea that boils it down for me. Someone (it may have been on this forum) talked about being told that there's an 80% chance that they're autistic. Can you imagine someone being told by a doctor that there's an 80% chance of they have cancer?

 

[TheFreeCat]

Agree with @Catana . This is crazy.

First, how many of us were abused? That changes things. Who has "pure ASD" anyway? Shows like Atypical make it seem like we all do. Just straight up ASD. Some do, but soooo many I met have PTSD and OCD and other things as well.

Further, this shows "by considering level of support required," the whole scenario is geared toward the Industry. Helpers and workers and who gets what and who do we exclude?

Oh, @Catana ---- I also wanted to say it is not just the DSM. How many people do you know that are dxed with a physical illness and upon going to a better Dr for a 2nd opinion find it's not even true? In a Capitalistic Medical Model, there are A LOT of "mistakes." Perhaps even more than in the mental health world........

 

[the_tortoise]

I'm not convinced that the level of support thing is intented to do anything but signify levels of support, I just think it could be done better if you introduced quantitative measurement -- which as far as I'm aware has never happened. So one clinician's level 1 could be another clinician's level 2, one clinician's level 2 could be another clinician's level 3.