Is Aspergers overdiagnosed?

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Numbers alone don't mean overdiagnosis. They could mean better diagnostic practice.

TONS of people are undiagnosed, misdiagnsed or informally diagnosed through the use of screening tools. The process of a diagnosis is A) Costly B) consumes professional man power C) the need is perhaps not obvious, particularly in adulthood D) Post code/Zip Code Lottery to access such professionals

The barriers to access diagnosis are vast and numerous and increase more so with other factors.

Women are a vast marginalised population, I suspect they actually are far more prevailant on the asperger end of the spectrum than is actually realised and the professionals are only just waking up to the possibilties of their being a vast marginalised population that have a lot to gain from being empowered by such knowledge of themselves.

My mom thinks it's the environment, not better diagnoses. She thinks what is happening in the environment is causing autism in children like kids getting sick so it interferes with their development and their minds take different pathways and it puts them on the spectrum. She thinks that's what it did with me. I kept getting ear infections and fevers and it slowed down my development and then I quit making sounds and then I was speech delayed when I got my hearing back. But I did have autistic tendencies.

Thanks for your reply.

From what I understand of your statement, treatment for a condition that you don't have could lead to suffering, possibly in the form of over-prescribed medication or receiving unnecessary treatment (the medication I think is the worst case scenario.. talk therapies are probably not going to cause any problems). Hence, over-diagnosis is bad. Is that correct?

If so, then I do think that you have a point. If someone is prescribing medications that a patient does not need for a condition that a patient does not have, then that is unfortunate indeed. Hopefully someone will have the sense to see that treatment is not working. However, it is a price to pay if you want to have any sort of diagnostic process at all.

So I guess the argument then comes down to... which do you feel is worse, someone who has a condition going completely untreated? Or someone who is being treated for a condition that they don't have? It's a classic false-positive vs false-negative scenario.

I've heard this theory before but I've looked and looked for corroboration and not been able to find it.

I did find one study that said that the increase could be accounted for by improved diagnostic methods, but I don't remember which year it was done.

Not disagreeing. I don't know enough to agree or disagree.

Yes, it is my point (and other additional point that "false positives" could create - self-fulfilling prophecy).

OK, I missed that other point.

Do you have any examples of a self-fulfilling prophecy? I'm asking, not to be difficult, but more just because I'm curious. Self-fulfilling prophecies certain appear often enough in literature, but I'm wondering more specifically about the effects in terms of a misdiagnosis.

As long as the diagnosis is accurate, surely it is not a bad thing that diagnosis is increasing? It seems quite difficult to get diagnosed with AS as an adult. Compare that to the ease with which I have been innacurately diagnosed with many different labels by psychiatrists.

A psychiatrist can see someone for 10 minutes and diagnose bipolar disorder, a personality disorder, schizophrenia. Women are more likely to get a BPD diagnosis, black people more likely to get a schizophrenia diagnosis, white men more likely to get an antisocial pd diagnosis. From what I have read of ASD diagnosis it requires much more thorough techniques by specialists in ASD. Instead of psychiatrists dishing out their favourite label apparently on a whim.

Accuracy is all I want. The correct diagnosis. Only then will I have a chance to reconcile my feelings, behaviours, competencies with what society tells me is normal.

Real cases, no (. However, I can easily imagine like it can occur - if a therapist says you that you, let's say, have a strong need of routine, you can feel even more uncomfortable in new situations (because you "know" that you will have difficulty with that) and you will have a even stronger need of routine.

Last edited by TPE2 on 18 Apr 2011, 7:14 pm, edited 2 times in total.

This is an Autism forum. I don't know how to say it correctly, but the world operates by stereotypes and pseudoscience far more than Autistics are cable of comprehending.

Many people who have been tested have commented that the psychologist thought they had it the moment they walked through the door. The psychologist may have thought the same thing about every other person that walked through that door.

Whenever a new mental disorder becomes more well known, over-diagnosis is the norm.

Nevertheless, people with the condition are under-diagnosed. The condition may be over-diagnosed in the general population, but it's probably under-diagnosed in the people who actually have it.

The danger, is that false diagnosis will be used as evidence to infer that EVERY DIAGNOSIS is false, and that their is no such thing as Autism.

Oh, okay. I see what you mean. I suppose it could happen. I can't think of any real reason why it couldn't. I know people are capable of many things when they believe something is true.

Under diagnosis or being diagnosed with a disorder other than an ASD when you may in fact have an ASD can also be a problem. It can, in a way, set a person up for failure by providing the wrong kinds of treatment or treatments that may not be completely effective.

This is why I am going to ask for my existing Diagnosis of social anxiety to be reassessed. If it does not turn out to be an ASD then fine but if I do have an ASD and it goes undetected...that can be a problem especially as my 'issues' (whatever they may be) are affecting my life, my ability to form friendships and relationships and also my ability to work.

I want a correct diagnosis so I know exactly what I am working with and can tailor my treatments to suit my needs.

I agree with much of your post, but I would suggest that making generalizations like this is the road to inaccuracy. It might be that this sort of deconstruction (world operating by stereotypes and pseudoscience) impinges fairly directly on one of my interests, but more it's a thing I've run into where I see that while autistic people may have troubles with comprehension of certain kinds of concepts, that individuals don't all have trouble with comprehension of the same list of concepts.

So, if you have a concept you want to communicate, just try to explain it clearly. You don't have to project assumptions on anyone as part of your explanation. I think the reader can work out whether they understand it or not and whether they need to ask for clarification.

I'm not aware of any good way to determine whether AS is overdiagnosed relative to the entire population of the planet.

At this site, though, there seem to be a lot of people who are very interested in the question, because so many people post this same topic and the same claims.

Since Autism Speaks is soliciting donations, their claims aren't necessarily credible, and if their claims about the prevalence of autism spectrum disorders have shifted so dramatically that makes their claims even more suspect. Their site says that

but there is no indication of the methodology used to make that estimate, or whether that number was even came to in a scientific way.

I would not claim that autism spectrum disorders were overdiagnosed without being aware of many many people who I was reasonably sure had been professionally affirmatively misdiagnosed. Surely some affirmative misdiagnosis happens, but I am not familiar with many people, let alone many people who have been diagnosed, and I both don't have the credentials to professionally diagnose and don't know of enough people who have been incorrectly diagnosed by their respective psychologists to make the claim that a significant percentage of the people to have been diagnosed were diagnosed incorrectly.

The fact that many undiagnosed people have posted here who believed that they had AS yet also claimed to have not met the criteria isn't indicative of the frequency of professional affirmative misdiagnosis.

Are there many people here who have done that? I've seen lots of people who are undiagnosed, but believe they do have AS, and want to get diagnosed. But not many who believe they have AS yet say they don't meet the criteria. And how could anyone know if they met the criteria or not without going through professional diagnosis? We all do the quizzes, but they don't tell us anything, except that the quizzes think we may have AS. And if they'd gone through the diagnosistic procedures only to be told they didn't have AS why would they still believe they did have it?

As most of us seeking diagnosis are adults, and these increased diagnosis figures seem to relate to children, it seems likely that there are many many adults with AS out there who are undiagnosed. It seems to make sense to me that the people who have found their way here who think they have AS are pretty likely to actually have it, or be on the spectrum somewhere.

A undiagnosed person with AS has AS as much as a diagnosed person.
They have as much right to seek a diagnosis as the person who already has a diagnosis did.
They are just on the other side of the fence. But its the same path.

Its gone 2am, and I probably am making little sense here.

I'm not sure if Asperger's is overdiagnosed or underdiagnosed, but I know it is very often misdiagnosed. Diagnosing someone with Asperger's because they are shy about talking to people is like diagnosing someone with narcissistic personality disorder because they can't admit they are wrong. Everyone has traits of every diagnosis to some degree or another. Why not diagnose people with the disease of being fallable human beings and get over it?