Newer and Revised DSM-V Criteria w/ Severity Labels

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vermontsavant
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31 Jan 2011, 6:32 pm

buryuntime wrote:
I like the criteria but am not too fond of the severity labels.

What are they going to do, put me in a room full of people and then quiz them afterward to see if these casual observers noticed something was ´abnormal´ with me? I'm willing to bet anybody who who was previously dxed with Asperger's would be defaulted into Level One. Level Two would be composed of some PDD-NOS and HFA. Anybody considered Nonverbal or "severe" would be Level Three.
i think as ppd-nos and hfa would be level 1 and level 2 might be in between hfa and non verbal and level 3 non verbal and disinagrative disorder.that doesnt matter anyway.i think they should have 4 or 5 level i think.three levels doesnt seem like enough thers's to much middle ground



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31 Jan 2011, 6:37 pm

I don't think it's been possible to diagnose PDDNOS based on only one of the triad since DSM-IV-TR. Those people with only language impairment should have DLD I think I heard it called. Developmental language disorder. (BTW people with DLD do as badly on so-called "ToM tests" as autistic people of similar language ability. And for DLD it's REQUIRED you don't have autism.)


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DandelionFireworks
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31 Jan 2011, 7:47 pm

Well, but ToM tests are worthless anyway.

Anyway, I'm glad the criteria don't include the communication criteria for autism from the DSM-IV, because I don't meet those and I would really like not to be excluded because I'm sure I belong here.


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anbuend
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31 Jan 2011, 8:05 pm

The way I suggested doing itthey would not be mandatory. Just like none of the criteria in the second section are mandatory already. I just worry for autistic people where the bulk of the criteria they met were from the communication section who might not meet these new ones.

As for "ToM tests" that was the whole point. The studies with people with DLD flunking the same tests autistic people flunked are part of what has made it obvious they're worthless.


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DandelionFireworks
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31 Jan 2011, 10:24 pm

Okay, makes sense. Though I think if they kept the criteria, they should really change "delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)" to "delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of symbolic communication)" because everyone employs some method of communication.

The last criterion from A shouldn't be mandatory (maybe none of them should).

Also, they need to get rid of the phrase "stereotyped and repetitive." It's getting annoying and it's less accurate than they think.


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31 Jan 2011, 10:45 pm

I have been reading all the literature on autism I can get my hands on and I still have no idea what "stereotyped" means.



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31 Jan 2011, 11:06 pm

DandelionFireworks

Quote:
Also, they need to get rid of the phrase "stereotyped and repetitive." It's getting annoying and it's less accurate than they think.



Verdandi
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I have been reading all the literature on autism I can get my hands on and I still have no idea what "stereotyped" means.


I think they may be being rather repetitive with that word.

I think I found a common English explanation of "stereotyped" but I forgot what it means. I'm getting tired of that word too.

According to this it means something like "to repeat without variation".
http://en.allexperts.com/q/Autism-1010/ ... havior.htm

But if so, it seems like they're almost being redundant to say 'stereotyped or repetitive?'



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01 Feb 2011, 12:57 am

Oh, how surprising. Doctors using jargon and redundancy. :roll:

I assume "stereotyped" is referring to "stereotypy"; but since stereotypy by definition is repetitive, I really have no idea what they're getting at with that.


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01 Feb 2011, 1:26 am

I had a lot of trouble finding a definition of stereotypy.

Now I know.

I guess this is the same point of "stereotyped interests?"



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01 Feb 2011, 1:33 am

Callista wrote:
Oh, how surprising. Doctors using jargon and redundancy. :roll:


It may not be surprising, but it serves to take health out of people's hands and force them to depend on an elite group to tell them about their own bodies and minds. Do you ever think just how much power the average person cedes to his or her doctor? Just because you and I can understand jargon doesn't mean everyone can. It leaves people unable to research their own conditions, and therefore unable to make informed choices. Jargon has no place in medicine for that reason. Medicine MUST be written in the vernacular because it MUST be understandable to EVERYONE. Psychiatry does not differ from other branches of medicine in this regard.


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01 Feb 2011, 6:59 pm

Sometimes you can't write it in everyday language, though. There are some terms in medicine that just don't have everyday equivalents. For example, if I were to mention a "beta blocker", many people would know what I'm talking about; but there's no better way to say it in normal speech than to say, for example, "heart medication," "blood pressure medication," "anti-anxiety medication," or any number of other uses that beta blockers are used for. It's likely that the person I'm talking to won't know what the doctor knows--won't know what a beta blocker does, what receptor it blocks, what the receptor does, what the hormone that usually goes into that receptor does, what the sympathetic nervous system is... etc. And that's for a very common drug.

There are simply no non-jargon equivalents to many terms that doctors use. They have to use them in order to discuss medicine with enough precision to communicate exactly what they are thinking about.

The better approach would be for doctors to educate patients about exactly what they are talking about when they say "beta blocker" or "stereotypy". I think if doctors explained to their patients what a beta blocker does and how it works when they prescribed one, they would have patients who took their medication more reliably, knew when side effects were something to worry about, knew when to contact the doctor if something wasn't going right, knew what to expect from their illness and from their medication. But doctors don't do that. Usually there's simply not enough time.

Of course it's not necessary for a doctor to do the explaining; a nurse can do it just as well in most cases. And I mean more than just "take this pill X times a day"... There's still the time issue; nurses are quite busy too; but at least in most places it is considered normal for them to spend more time with the patient.


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ooOoOoOAnaOoOoOoo
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01 Feb 2011, 7:10 pm

According to theFreeDictionary, stereotypy is:

1. Excessive repetition or lack of variation in movements, ideas, or patterns of speech, especially when viewed as a symptom of certain developmental or psychiatric disorders.


I've always liked the sounds of certain words or phrases, will repeat them, sometimes, without thinking, sorta like a kinetic memory, only it involves words and phrases.
I do repeat stuff a lot, actually.



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01 Feb 2011, 8:12 pm

Yeah, but there are times when things could be described more understandably. I do agree that some things are insanely specialized, and that moreover, some things that are jargony are also simpler to explain than to find synonyms for. I do agree that to some extent it makes sense to use the jargon but explain it.

But surely there's a better way than, say...

Quote:
Gabapentin is a white to off-white crystalline solid with a pKa1 of 3.7 and a pKa2 of 10.7. It is freely soluble in water and both basic and acidic aqueous solutions. The log of the partition
coefficient (n-octanol/0.05M phosphate buffer) at pH 7.4 is –1.25.


That's from a PI sheet. You know, that thing the patient is supposed to be able to look at in order to understand what they're taking. You probably understand that, but I don't and I doubt most people who end up taking this drug (whatever it is, I just wanted an example, so I have no clue what this thing does) understand it any better than I do.


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anbuend
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01 Feb 2011, 9:17 pm

Gabapentin aka Neurontin is an epilepsy drug with a few other uses.


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01 Feb 2011, 9:47 pm

Well, I still have the majority of these criteria! So, okay ;)

Do you have to fit ALL of the criteria to have an ASD?


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01 Feb 2011, 9:54 pm

....it says

Three of the following for A
Two of the following for B


and then these:

Quote:
C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)
D. Symptoms together limit and impair everyday functioning.


Now that I read the proposed revision, it is much easier to see myself in the descriptions. I have always had this impulse to touch objects. When I was a kid, one of my Aunts would take me shopping. I would want to touch stuff on the shelves. It was always stuff made of glass. She would tell me not to, and would say "if you break it I have to buy it so don't touch anything!" Still, I could not resist certain items and would get upset if I couldn't hold them in my hands.
Even now there is this impulse to touch, though it was much stronger in youth. I had a fascination with textures, too, especially ones that seemed "fuzzy" to me. Especially, "fuzzy" matte finished porcelain.
Objects hold a certain fascination.

I just looked at the Severity levels and can definitely relate to:

Quote:
Rituals and repetitive behaviors (RRB’s) cause significant interference with functioning in one or more contexts. Resists attempts by others to interrupt RRB’s or to be redirected from fixated interest.

People have a hard time redirecting me from a fixated interest. I will start talking about something and my mother will get so annoyed but there will be this urge to keep on the subject, not dropping it. I have no idea why. I feel like I must keep talking about it, anyway. I am not sure if talking about something is an example of this, or by 'fixated interest' is meant actually doing something and not wanting to be interrupted.

On the Severity Level, I am definitely at Level 1, 'requiring support.'
I wonder what kind of 'support' they are referring to?