Got DX but don't feel like I was tested properly

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The psych just talked with me for 2 hrs. There were no scientific tests. How can she have really known?

I am worried that I exaggerated things. I was the centre of attention and she was asking me if I have problems with this and that, so I might have over-emphasised things. Especially since I kind of wanted the DX. (Now I have it I'm not so sure!)

If anyone on here knows how the hell they can work it out from a chat and how they can tell / discount if you are exaggerating, I would really like to know!

That's how I was diagnosed both times. Plus the first psychiatrist talked to my mother. They know how to interpret your behaviour.

That is how most people are diagnosed, but unfortunately that means the diagnosis is subject to the psychologist's knowledge and attitude about ASD.

I couldn't be so picky as to look for someone with experience diagnosing autism in adults, because I live in the middle of nowhere, so I had to settle for the only psychologist in the next county over. He wasn't interested in asking me about important autistic traits like repetitive behavior, intense interests or sensory sensitivity, and he told my mom after my evaluation that he probably wouldn't have diagnosed me with Asperger's when that was a diagnosis because I am aware that my social skills are lacking and I managed to finish college. That is, he thinks people with Asperger's aren't capable of those things. That was 7 weeks ago and his assistant keeps giving me mixed information on whether I am going to scrape by with an ASD diagnosis.

That does seem a little quick, but perhaps it was clear to the psych after two hours of talking to you based on your behaviors and content of what you talked about. Is there going to be a detailed report? If so, you can perhaps tell from that whether they knew what they were doing. In reports, they often list the criteria, then for each criterion, they write their observations justifying whether that is met, but if not met, then they write that criterion is not applicable to you.

Usually, diagnoses involve testing + parental input over one or more visits or a combination of testing + talking sessions over time + parental input.

Thanks.

She did say there would be a report but I haven't received it yet. I hope it will be as detailed as you suggest.

At the beginning of the session she asked me if there was someone in my family she could talk to if needed. I said that my parents were against the idea but that my aunt would probably be able to come. But then at the end of the session she said she didn't need to talk to my aunt as she had already decided I have ASD.

If I was a very "obvious case" then I would understand this. But I am not. People who I have told have been quite surprised. I am very high functioning etc. So I am perturbed by how quickly she decided. Maybe she was very busy and made a snap decision. I know that they are very busy there because it is a new centre and lots of adults are going because for a long time there was nowhere like that in the area. I'm concerned about her being too busy to test me properly because this is a big thing for me. It could really change my life. I don't want to change my life based on a mistake!

I'm in the process of getting diagnosed and how my GP explained it to me, is that I will see a CPN who will decide whether it's worth going on a 2-3 year waiting list for an "official" diagnosis. My GP could tell in 10 minutes that I showed many signs of an ASD, so depending on how obvious they are I can see how a trained professional could come to that conclusion.

But I suppose it all depends on your doctor, some like to throw a diagnosis such as Bipolar or Depression at you because that way they can just shove meds at you and send you on your way (my personal experience). A second opinion couldn't hurt though if you are unsure.

Yeah, my DX did not go well either, so I can sympathize. I wrote a bit about it in this post. If it helps, I think it's easier for a psychologist to say definitively that someone is on the spectrum than for them to say that they're not. If they met with you for a few hours and saw a lot of outward symptoms, then it's probably a pretty easy diagnosis as long as they can rule out alternatives like GAD or ADHD.

It's when they don't see the outward signs that it becomes more difficult. Maybe the patient just has good coping skills. Or maybe a 1 on 1 conversation doesn't really tax them that much. Or maybe they were looking for traits that the patient doesn't have, but the patient still has plenty of traits that would qualify them for a diagnosis.

@gamerdad Thanks, that does help, although I wonder if I really show outward signs.

I would be interested to read the post you linked to but the link is not working

I feel similar doubts, although my assessment/evaluation went on for over six hours. In due course I later received a detailed report of seven pages citing which parts of my observed behavior and responses met which parts of the criteria, and detailing that all criteria was met satisfactorily, basically.

I still feel doubt and that sense of "For real?" even though I went into it feeling there was just cause to be assessed and feeling that I'd be surprised if I wasn't deemed to be on the spectrum. Yet getting that result that I am what I thought I was still made me wonder if it's truly real and was I assessed correctly. The psychologist in my case has massive experience and specializes in adult women, who can often be a problematic assessment due to learned coping skills, which I feel I have cultivated a lot of, but it's probably own issues that make me still wonder.

I can't advise how to get past this as I'm still struggling with it myself, but I guess I'm posting just to say you're not alone in getting a positive result and doubting it even if there may be no cause to doubt.

I am glad that you got a diagnosis that you "kind of wanted."

I agree with your concern. My diagnosis yielded GAD and OCD, but not the AS that I had been screened with having. The diagnostician had experience with only childhood AS/ASDs, and had me complete a multiphasic test that hasn't been determined useful in the diagnosis of AS. Otherwise, she based her AS non-diagnosis on her observations of me during three hours over two meetings. I explained my screening-test scores and lifelong masking skills (52 years), but she resisted diagnosing more than the GAD and OCD. Odd, but those are two of the most common co-morbid diagnoses for people with AS.

Anyway, I felt that same way; my screening tests were ignored and her test wasn't applicable to AS. I felt cheated.

But, you got what you were hoping for. That's great!

I don't see myself as weird, other people do. So I often feel like I don't really have AS, I'm just confused by people, and they by me, at times.

But a diagnosis is a subjective judgment about the quality of eye contact, social interest and communication and about what may be contributing, the ADOS that's the gold standard is someone observing and making a judgment how normal or atypical one is. To pretend that diagnosis isn't subjective on someone's part isn't valid, no matter how much people say it's objective. It's simply the best we can do to make the judgment. That 2 hours that was spent is what we have. There are questions you answer, questions others answer, and observations, no one can do better. Sometimes you have to move on from the label to where you want to go with your life.

I have some sympathy with this. I find myself thinking: "can it really be true? Is this all a mistake?"

I am sometimes quite sad at realizing that the distance I feel from people is the result of an actual difference between me and them. This can make me want it not to be true.

The speedy process of my diagnosis also lends itself to doubt, despite that the reassurance of the diagnostician that it was an easy diagnosis to make.

Against this are the many moments of realization that something I did, or do, is an example of behavior that would be expected with the diagnosis. These moments of recognition seem undeniable and the framework of understanding and perception provided by the diagnosis is also helpful to my wife. I don't think this would be true if the diagnosis was in error.

On the whole, the diagnosis helps to explain a great many things about me and my life that are not adequately explainable in other ways. For this reason, I don't really doubt it, despite the transient emotional pangs about it or moments of doubt.