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View Diary: I Love An Asperger’s Child (133 comments)

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  •  Diagnosis is a mess (15+ / 0-)

    and those that have to write the DSM will even tell you that.  The problem is that the etiology of various disorders is so poorly known, that they end up making bucket categories of symptoms instead of disease processes as is the case when diagnosing something like a blood disease or whatever.  An Autism Spectrum Disorder kid clearly has symptoms of poor socialization and interpersonal communication, and so do kids with something else going on that leads to social withdrawal.  But the causes may be completely different. One is autistic, with a differently wired brain, and the other develops elaborate fantasies perhaps related to some emotional regulation problem unrelated to neural wiring... and for some reason anger rages out of control.  The same symptoms too lead to different people being lumped together with diagnoses that actually may well have nothing to do with underlying causes.  Diagnoses are also a mess because when it comes to behavior, not only is the brain so complex that there's usually not a single reason for anything to go wrong, but brain plasticity and the effects of environment can lead to such disparate outcomes.

    “If the misery of the poor be caused not by the laws of nature, but by our institutions, great is our sin.” Charles Darwin

    by ivorybill on Sat Dec 15, 2012 at 09:32:49 AM PST

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    •  Agreed (9+ / 0-)

      I didn't mean to imply judgment of those tasked with defining disorders and making diagnoses.  I think the emphasis on clinically observable criteria is probably as responsible as they can get.  I feel, though, that as someone who very probably has AS, the neurotypical folks on the other side (trying to define and diagnose) are missing a whole lot just when it comes to describing and understanding the condition.  And, as you suggest, outward behavior can have complex determinants.

      Plus I've read some about psychopathy and the laudable attempts to understand and define it.  Perhaps a good summary of the arbitrary quality of definitions and diagnoses is given by Robert Hare (developer of the 20-point diagnostic scale) himself, observing that the definition of psychopathy is somewhat determined by the fact that they mostly study psychopaths in prison, and that if they studied them on the Vancouver stock exchange they might come up with a different array of traits.  

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