Self Diagnosis; Why the Controversy?

[NeoPhile]

Oh - dear - Lord! "Guessing"!?!?!? No, my assessments are based upon E-V-I-D-E-N-C-E! I'm not the kind to just imagine things, and then say to myself one morning, "Hey, I think I'll have Asperger's Syndrome today, because it is, like, you know, totally trendy".

Well, what's to stop someone from claiming they're autistic spectrum when they're not? In any instance, ASD's are sometimes hard to distinguish from other neurological disorders.

"Not scientific". What do you even mean by that expression? I'm curious about it, because I don't believe that even you yourself know what that means, within this specific context.

Scientific means based on observation conducted by a scientist. You are not a scientist or a doctor, to the best of my knowledge. A psychiatrist with medical background and training has the knowledge and training to diagnose someone. He is an expert. Just like you shouldn't do your own plumbing, you shouldn't do your own psychiatric diagnosis, either. It's not official or scientific if you just do it.

Yes, the very same psychiatrists who decided, in their infinite wisdom, that Asperger's Syndrome doesn't exist anymore, and that I am now autistic. No, I'm not autistic, there is a difference.

They simply redid the way they diagnose ASD's, and it's really an improvement. Before, everyone was hung up on labels like "Aspergers" or PDD-NOS or whatever. With the new system, now you're just autistic spectrum, and you get treatment that's tailored to you. "Aspergers" and "PDD-NOS" are just terms to refer to different parts of the autistic spectrum.

What do I mean? I mean that I have come to realise that I am FAR more rational than most people I encounter, that I can think clearly, objectively, and will actually make an effort to determine what is actually TRUE and believe that, rather than just seeking out whatever it is that happens to make me FEEL better about both myself and the world, and believe THAT instead (which is what N.T.'s tend to do). How can you not understand this?

I know NT's who do just that. If we talk like the above, then we look like supremacists. NT's are equal to us. Supremacy-like talk turns people off, and it makes it harder for us to achieve the goal of equality.

As for being exceptional, yes, I am. What's wrong in admitting that? Why do I need to be self-effacing and (falsely) modest? What purpose would that serve? If I achieved something worth crowing about, why shouldn't I take the credit for it?

You and Trump.

"GUESSING"! The bloody NERVE! As though first-hand, personal lifetime experience counts for nothing, only "science" (whatever that is).

Science is based on the scientific revolution. We've used it to cure polio, fly to the moon, explain the universe around us, and do countless other things. I thought you said you were rational. It seems to me that a rational person wouldn't discount the scientific revolution.

 

[the_tortoise]

Scientific means based on observation conducted by a scientist. [...] It's not official or scientific if you just do it.

Definitely not official, but you are wrong if you think it could never be scientific unless done by a professional.

"Science"/"scientific" technically refers to a method of systematic investigation/study and analysis -- anyone can employ it and could potentially employ it very competently/successfully, regardless of whether or not they have formal training of any kind (even someone who had never heard of the scientific method could be using it successfully, in the same way a person can be successfully using formal logic principles without ever having learned/studied formal logic), any kind of experience with whatever they are investigating/studying, or any professional credentials. (What useful conclusions they could come up with would be severely limited/nonexistant if they had no experience/familiarity with whatever they were investigating/studying, but that doesn't mean their methods could not be scientific.)

I do agree that someone with extensive training and experience is more likely to be able to apply the criteria correctly....but because autism is diagnosed based on observation of behaviors alone it is a very subjective diagnosis. Even a lot of the standardized tests they give have limitations and rely heavily on subjective interpretation. For example, attaching the numbers 2 through 4 to words like "rarely" "sometimes" and "often" on a scale from 1 to 5, or the numbers 2, 3, 4, and 5 to the words "slightly disagree" "somewhat disagree" "somewhat agree" and "slightly agree" on a scale from 1 to 6 (often as the options for answering incredibly broad and poorly defined question-statement like "I am comfortable with noise") doesn't change how incredibly subjective and fundamentally qualitative (as opposed to quantitative) those words are -- attaching a completely abstract and random numerical scale to words like that doesn't magically turn them into actual units of measurement. These tests do have value and they also help to make it so diagnoses are applied more consistently, but that doesn't mean that they have the same kind of truly objective accuracy or provide the same kind of quantifiable evidence as, say, a blood glucose test.

A person observing you is more objective than you observing yourself, but whatever they conclude about your behaviors by observing you is far from truly objective evidence -- they will be influenced by their own biases and experiential limitations, their own interpretations of behavior and even by their interpretations of the diagnostic criteria ....professionals often disagree with each other not only about the most appropriate diagnosis for an individual with neurological issues/differences, but also in what the written criteria for any given diagnosis actually refers to in real life/concrete form).

And when it comes to understanding the cause of a person's behavior for the purpose of identifying the nature of neurological/psychological problems, objectivity is not always better. I might know that my lack of eye contact says nothing about my mood or intentions or whether or not I'm listening to someone, because I have subjective knowledge of my own inner thoughts and feelings and mental state ...someone else observing me is just guessing when they try to figure out the cause of my lack of eye contact, and could more easily get it wrong and assume it's because I'm a sketchy/suspicious person who's lying to them, or that I'm not listening to them, or that I'm feeling anxious or sad or embarrassed or whatever else because they do not have that subjective insight. Of course this alone doesn't mean that a person could accurately diagnose themselves with anything (and I don't think I, personally, could diagnose myself with anything no matter how many years I spent educating myself) I'm just saying that for some aspects of analyzing behavior subjectivity can be a lot more reliable/useful than objectivity.

Even professionals are doing a lot of "guessing" in the application of their knowledge and experience (technically "theorizing", which could be described as "educated guessing") -- guessing about the nature of the behaviors/symptoms they observe and are told about, guessing about which diagnostic label(s) fits a person best, guessing about the concrete/physical causes of symptoms/syndromes.

I'm not saying that self-diagnosis is always right. I'm not saying it's even usually right. (I have no idea how often it's right or wrong.) I'm not saying that the individual is the best person to diagnose themselves with anything. I'm just saying what I said. This stuff is complicated and I don't like it when laypeople are just automatically dismissed solely because they are laypeople.

 

[Mia]

Science is based on the scientific revolution. We've used it to cure polio, fly to the moon, explain the universe around us, and do countless other things.

Science is based in the scientific process, the study and integration of information, the theory or hypothesis that stands up to the test of time. Scientists may study blood or diseases or slices of brain (to name a few), or look at brain scans to come up with theories. They study human behavior as well, through trials, and long years of research and sometimes 'hands on' with patients. They come up with theories together or separately after long years of this kind of work.

They accrue information in experiments and tests, to come to conclusions, they offer theories on why something is the way it is. They provide concrete evidence through long years of research, and look at previous research and utilize that or sometimes reject it. Which changes the theory that was offered up in the past. Theory is a system of ideas intended to explain something.

Now, when they do that they might come up with something like the DSM.
The diagnostic and statistical manual for mental disorders. Something that many people have read and understand, many members here for example. If you have any background and/or understanding of psychiatry and or science in general it's not difficult to comprehend, it lists behavior, symptoms, traits, of many kinds of neurological disorders. Although in the last few years, it's been scrapped for use by psychologists when it comes to autism. Autism has been removed from the DSM, as it's not considered as a mental illness. It's now termed a pervasive developmental disorder or PDD.

This is a description of autism in children by the American Psychiatric Association, although very basic it's not difficult to understand.

Autism differs from person to person in severity and combinations of symptoms. There is a great range of abilities and characteristics of children with autism spectrum disorders — no two children appear or behave the same way. Symptoms can range from mild to severe and often change over time.

There is no medical test for autism. It is diagnosed based on observing how the child talks and acts in comparison to other children of the same age. Trained professionals typically diagnose autism by talking with the child and asking questions of parents and other caregivers.

Scientists do not clearly understand what causes autism spectrum disorder. Several factors probably contribute to autism, including genes a child is born with or environmental factors. A child is at greater risk of autism if there is a family member with autism. Research has shown that it is not caused by bad parenting, and it is not caused by vaccines.

https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder​

 

[xudo]

I started researching this seriously not long ago and found this is the only thing that is consistent. The only part that doesn't fit is math. I'm slightly dyslexic and hate math and numbers.

I have AS, and I also have mild dyslexia and severe dyscalculia. Being good at maths is not a given

 

[Chris Russell]

Every person is different, you don't have to be a math wiz to be an aspie. I can read people fairly well and understand/give humor and those are not traits an aspie usually has.
I'm very sorry to hear about your mother.

A doctor killed my Mother. I have trust issues...
I have been "told" at some point I have it all.
None were right. How can they just throw out this or that? Let's see if this works....?

I started researching this seriously not long ago and found this is the only thing that is consistent. The only part that doesn't fit is math. I'm slightly dyslexic and hate math and numbers.

As others have said, Asperger's doesn't mean 'maths genius' or 'obsessed with dates'.... our peculiar logic can manifest in many different different ways; geometry is a common one... I struggle with simple addition (I get the numbers mixed up) but I can 'see' angles everywhere and can easily judge distances and volumes by eye...

 

[orphan]

I see. Algebraic math.
Yes, hard to imagine why guessing would be useful.
Spatial maths are easy.
I can look at a set of stairs and know the tread and rise down to the 1/16th inch.
Or... "know" where to hit the cue ball to make it masse.
Or... shape my golf shot.
ect. But can't seem to add 2+2.
makes perfect sense?
#frust

 

[Manuheleku]

Science is based in the scientific process, the study and integration of information, the theory or hypothesis that stands up to the test of time. Scientists may study blood or diseases or slices of brain (to name a few), or look at brain scans to come up with theories. They study human behavior as well, through trials, and long years of research and sometimes 'hands on' with patients. They come up with theories together or separately after long years of this kind of work.

They accrue information in experiments and tests, to come to conclusions, they offer theories on why something is the way it is. They provide concrete evidence through long years of research, and look at previous research and utilize that or sometimes reject it. Which changes the theory that was offered up in the past. Theory is a system of ideas intended to explain something.

Now, when they do that they might come up with something like the DSM.
The diagnostic and statistical manual for mental disorders. Something that many people have read and understand, many members here for example. If you have any background and/or understanding of psychiatry and or science in general it's not difficult to comprehend, it lists behavior, symptoms, traits, of many kinds of neurological disorders. Although in the last few years, it's been scrapped for use by psychologists when it comes to autism. Autism has been removed from the DSM, as it's not considered as a mental illness. It's now termed a pervasive developmental disorder or PDD.

This is a description of autism in children by the American Psychiatric Association, although very basic it's not difficult to understand.

Autism differs from person to person in severity and combinations of symptoms. There is a great range of abilities and characteristics of children with autism spectrum disorders — no two children appear or behave the same way. Symptoms can range from mild to severe and often change over time.

There is no medical test for autism. It is diagnosed based on observing how the child talks and acts in comparison to other children of the same age. Trained professionals typically diagnose autism by talking with the child and asking questions of parents and other caregivers.

Scientists do not clearly understand what causes autism spectrum disorder. Several factors probably contribute to autism, including genes a child is born with or environmental factors. A child is at greater risk of autism if there is a family member with autism. Research has shown that it is not caused by bad parenting, and it is not caused by vaccines.

https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder​

Psychiatry is an art, not so much a science. It is also filled with artists who aren't that good. Like the psychiatrist I fired because all he wanted to do was prescribe meds that my regular doctor was already prescribing.

 

[Chris Russell]

I love Science. It is in many ways the pinnacle of Humanity's achievements. Having said that, ASDs are not something that Science talks about with any great confidence. The brain is simply too complex, and Autism too varied a set of characteristics, for meaningful comparison and therefore conclusions, beyond the simplest categorisation. I have a 'diagnosis' from a 'recognised Autistic Spectrum Service' but I knew - the moment I heard that awfully named 'Triad of Impairments' explained - that this is what it was that had haunted me my entire life - and that was years before I got a piece of paper 'confirming' it. I think that the official diagnosis was never really necessary for me... but it was for others around me: My husband. My family. My employer.

Three things I think are true:

1. A person with Asperger's will research their supposed diagnosis at least twice as enthusiastically and as thoroughly as any professional who's job it is to refer them for assessment.

2. A person with Asperger's will recognise the Triad of Impairments as a key aspect of their personality very early on in their research.

3. There is no 'litmus test' for Asperger's... However scientifically and carefully assessments are carried out, the result is still an opinion.

If it helps to think of yourself as an Aspie - if it allows you to tackle problems in your life, and to frame your behaviour and your experiences; if it makes things better... why not?

 

[Chris Russell]

Jeeze - just look at all these well though out interesting and logical arguments, set out in clear structures with thoroughly good spelling and grammar... (Practically unheard of on internet forums....) You realise a psychologist could probably diagnose the lot of you based just on that!

 

[NeoPhile]

Psychiatry is an art, not so much a science. It is also filled with artists who aren't that good. Like the psychiatrist I fired because all he wanted to do was prescribe meds that my regular doctor was already prescribing.

Psychiatry is a science. It is based on empirical evidence and observation. Do you even know what art is? It's saying something indirectly visually or through sound to make things people enjoy. How could you say that psychiatry is an art like music or painting?

 

[Chris Russell]

I see. Algebraic math.
Yes, hard to imagine why guessing would be useful.
Spatial maths are easy.
I can look at a set of stairs and know the tread and rise down to the 1/16th inch.
Or... "know" where to hit the cue ball to make it masse.
Or... shape my golf shot.
ect. But can't seem to add 2+2.
makes perfect sense?
#frust

You've reminded me of my college days when I had a bit of a reputation at pool - I couldn't form a bridge properly, so I would put the ball down off of 3 cushions to avoid it. Apparently, that's showing off... Still couldn't keep score though!

 

[NeoPhile]

Definitely not official, but you are wrong if you think it could never be scientific unless done by a professional.

"Science"/"scientific" technically refers to a method of systematic investigation/study and analysis -- anyone can employ it and could potentially employ it very competently/successfully, regardless of whether or not they have formal training of any kind (even someone who had never heard of the scientific method could be using it successfully, in the same way a person can be successfully using formal logic principles without ever having learned/studied formal logic), any kind of experience with whatever they are investigating/studying, or any professional credentials.

So could I use science to explain quantum theory alongside the likes of Stephen Hawking and Edward Whitten? Of course I couldn't. I haven't been trained in their discipline well enough.

 

[the_tortoise]

So could I use science to explain quantum theory alongside the likes of Stephen Hawking and Edward Whitten? Of course I couldn't. I haven't been trained in their discipline well enough.

You could certainly use science to try to explain quantum theory. The likelihood of you succeeding is, as you say, very low -- completely nonexistant if you have no prior understanding of physics (although I suppose if you started from that point and counted learning all about physics as part of "using science to explain quantum theory" then maybe you could, once you'd reached a specialized level of knowledge -- how would I know? I don't know you, for all I know you're a genius and your potential as a physicist would be mind-blowing.). But that doesn't mean you couldn't be using the scientific method in your efforts.

I fundametally disagree with the idea that people without formal training can't ever develop the same/a similar level of understanding as those with formal training. It's certainly more difficult to access materials and resources necessary to learn, but not always impossible -- it depends on the subject/field and the individual person's circumstances.

 

[Manuheleku]

There is a reason why when you get a degree in a science you go to the Department of Arts and Sciences. Some disciplines are more science than art, for instance Physics. Some are more of an art than science. Psychology. Psychology, unless you are talking genetics, biological or similar aspects that you can touch, feel, see, or otherwise empirically determine is an art. A psychiatrist "sees" symptoms in a person thru the mask of the person being observed and his own mask of observation based on supposition. More like an artist dealing in the abstract. Where "facts" can change on a whim.

 

[Full Steam]

You could certainly use science to try to explain quantum theory. The likelihood of you succeeding is, as you say, very low -- completely nonexistant if you have no prior understanding of physics. But that doesn't mean you couldn't be using the scientific method in your efforts.

I fundametally disagree with the idea that people without formal training can't ever develop the same/a similar level of understanding as those with formal training. It's certainly more difficult to access materials and resources necessary to learn, but not always impossible -- it depends on the subject/field and the individual person's circumstances.

Additionally, amateurs only need to understand the small range that affects us, whereas professionals need to understand the whole gamut and history of the science.

 

[Bolletje]

There is a reason why when you get a degree in a science you go to the Department of Arts and Sciences. Some disciplines are more science than art, for instance Physics. Some are more of an art than science. Psychology. Psychology, unless you are talking genetics, biological or similar aspects that you can touch, feel, see, or otherwise empirically determine is an art. A psychiatrist "sees" symptoms in a person thru the mask of the person being observed and his own mask of observation based on supposition. More like an artist dealing in the abstract. Where "facts" can change on a whim.

What you're missing in this metaphor is that there's a huge scientific component to psychiatry. Psychiatrists are doctors. And while the process of basing a diagnosis based on the patient's story, behavior and tests may seem like art, it's all based on hard science. Patients' stories and behaviors might change, but the principles of brain chemistry and neurophysiology don't.

When the psychiatrist had seen a collection of symptoms he's not immediately diagnosing the patient. First, he has to consider what could be causing the symptoms. Could be neurological, could be an infectious disease. Could be drugs, alcohol or medication.
The causative agent also has a huge effect on if and how the patient can be treated, once a diagnose has been made. It's hard science.

And back on topic: I'm not a fan of self-diagnosis. I would never do it and I always recommend my friends and acquaintances to seek professional diagnosis as well. But if someone wants to do it, I don't mind much. I just take the diagnose with a grain of salt. I've met so many people that have misdiagnosed themselves with either a diagnosis on the spectrum or a psychiatric disorder, who, as a result, didn't receive the appropriate mental health care they should have. Or people that diagnose themselves and proceed to use it as an excuse for everything.

Of course I only notice the negative outliers. I'm probably biased as a result of being in the medical profession as well.
I'm not saying you don't have ASD if you haven't been diagnosed by a health care professional, I'm just saying I would personally want an official diagnosis because I feel it's almost impossible to be objective enough to diagnose myself. Even if I am almost a doctor.

 

[Manuheleku]

What you're missing in this metaphor is that there's a huge scientific component to psychiatry. Psychiatrists are doctors. And while the process of basing a diagnosis based on the patient's story, behavior and tests may seem like art, it's all based on hard science. Patients' stories and behaviors might change, but the principles of brain chemistry and neurophysiology don't.

When the psychiatrist had seen a collection of symptoms he's not immediately diagnosing the patient. First, he has to consider what could be causing the symptoms. Could be neurological, could be an infectious disease. Could be drugs, alcohol or medication.
The causative agent also has a huge effect on if and how the patient can be treated, once a diagnose has been made. It's hard science.

And back on topic: I'm not a fan of self-diagnosis. I would never do it and I always recommend my friends and acquaintances to seek professional diagnosis as well. But if someone wants to do it, I don't mind much. I just take the diagnose with a grain of salt. I've met so many people that have misdiagnosed themselves with either a diagnosis on the spectrum or a psychiatric disorder, who, as a result, didn't receive the appropriate mental health care they should have. Or people that diagnose themselves and proceed to use it as an excuse for everything.

Of course I only notice the negative outliers. I'm probably biased as a result of being in the medical profession as well.
I'm not saying you don't have ASD if you haven't been diagnosed by a health care professional, I'm just saying I would personally want an official diagnosis because I feel it's almost impossible to be objective enough to diagnose myself. Even if I am almost a doctor.

I'm not arguing with the fact that psychiatrists are doctors. They are also artists. Just how subjective the science is is evident in all of the prevailing theories which get bounced around from time to time and get replaced with other theories. Theories are not hard facts. Now, it is true that there are hard empirical ways to diagnose brain conditions, however talking to someone for 45 minutes and administering a battery of IQ and motor skills tests and the same form questionnaire that I can answer on the Internet is not hard empirical data. Until a diagnosis can be made with a brain scan, I will continue to have my views on the subject. As I will expect you to hold your views which seem valid to yourself.

 

[Manuheleku]

My biggest argument here is that I can not expect any psychiatrist, doctor or otherwise, to diagnose a 58 year old man who has learned how to cope in a Neurotypical society with an IQ hovering in the 150 plus range, before Aspergers was even a thing to make ANY sort of diagnosis based on the scenario I presented in my above post. I've been walking my shoes for a hella long time, nobody within 4 total hours time, most of it administered by an intern, is any more capable than I am after years of research and a son who was diagnosed with Aspergers by a doctor before Aspergers became "not a thing" who made the comment "the apple doesn't fall far from the tree."

 

[xudo]

Or people that diagnose themselves and proceed to use it as an excuse for everything.

Sadly, I've seen this happen a hell of a lot, and mostly with ASD. I don't know why that is.

Of course I only notice the negative outliers. I'm probably biased as a result of being in the medical profession as well.
I'm not saying you don't have ASD if you haven't been diagnosed by a health care professional, I'm just saying I would personally want an official diagnosis because I feel it's almost impossible to be objective enough to diagnose myself. Even if I am almost a doctor.

I agree. If you want to self diagnose, then who am I to say you can't. For me personally, I would always want an official diagnosis because not having one would make me feel like a fraud. Also, where I live at least, having a diagnosis means being able to access help and support.

 

[Bellatrix]

Well, what's to stop someone from claiming they're autistic spectrum when they're not?

Gee, I don't know. Reality perhaps?

In any instance, ASD's are sometimes hard to distinguish from other neurological disorders.

So what? "Hard" does not equal "impossible". Do your research, like I did.

Scientific means based on observation conducted by a scientist. You are not a scientist or a doctor, to the best of my knowledge. A psychiatrist with medical background and training has the knowledge and training to diagnose someone. He is an expert. Just like you shouldn't do your own plumbing, you shouldn't do your own psychiatric diagnosis, either. It's not official or scientific if you just do it.

Comparing psychiatry with plumbing. Well, no, although there may exist in your mind a superficial resemblance, they actually are not quite the same thing. The approach that I used was to impartially examine the psychological and physical characteristics and attributes that I actually have (ex. sensitivity to sound, inability to tolerate most people - I'm generalising here), examine the various psychological conditions that are now recognised to exist in the country within which I live, examine my personal history, up to and including (for example) the manner in which I was treated by others, my obvious and clear inability to understand nuance, body language... look, I guess you will just have to take my word for it when I say that I have Asperger's Syndrome. God knows I wish I did NOT have it, because I HATE having it!

They simply redid the way they diagnose ASD's, and it's really an improvement. Before, everyone was hung up on labels like "Aspergers" or PDD-NOS or whatever. With the new system, now you're just autistic spectrum, and you get treatment that's tailored to you. "Aspergers" and "PDD-NOS" are just terms to refer to different parts of the autistic spectrum.

I was, and am not, "hung up" on a label. Do you think that the apparent increase in numbers for those who have these conditions is due to it being "trendy"?

I know NT's who do just that. If we talk like the above, then we look like supremacists. NT's are equal to us. Supremacy-like talk turns people off, and it makes it harder for us to achieve the goal of equality.

So you know N.T.'s who are deluded and deceptive. So what? I'm not N.T. I'm not a "supremacist" either, just someone who recognises that the way that N.T.'s do things does not work for me. I cannot live in N.T. society, because it is all about greed, duplicity, superficiality, and being competitive. I can't live that way, it's impossible for me.

You and Trump.

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