Clinically Significant?

Post Reply New Topic

I think, if I'm reading it right, its more like "you need 2 of 4 clinically significant symptoms in this section" and also "1 of three in this other section", etc (just an example). Basically if you meet the requirements for each section, as stated, you qualify for a diagnosis. Once you qualify then the doc(whatever) assigns level one through three on overall severity.

The original description in the DSM referred to: "Full Body Movements, such as rocking, swaying, hand-flapping, etc.", which non-autistic people rarely do, and most autistic people tend to do habitually.

Only in the last edition have "fidgets" entered into the description, and I still maintain that they are not the same thing. Stimming is a reaction that attempts to soothe an overwhelmed nervous system.

Fidgeting is just an occasional, meaningless and insignificant expression of nervous energy.

EVERYBODY fidgets.

No, each individual symptom doesn't need to be clinically significant. A lot fewer people would get diagnosed if every single qualifying symptom had to be that severe.

Thanks soloha .

I understand what you are saying, will@rd. This is what I was trying to prove to the other poster. However, I can't help but be curious: Would you classify it as stimming if an autistic person stared at spinning objects for hours on end? I know some people who do that and it counts as stimming in their case.


That is exactly what I told the other person .

Thank you so much! This is exactly what I was looking for as an answer, starkid. Yeah, I guess a lot fewer people would be diagnosed .

The DSM-V diagnostic criteria for 299.00--Autism Spectrum Disorder--specifically states that not every facet has to be "severe"--only "significant."

There are three degrees of Autism Spectrum Disorder: Type I, Type II, and Type III.

Within Type I, I find that no facet of the diagnosis has to be "severe." But that all from the "A" section, and 2 out of 4 from the "B" section have to be "clinically significant."

Like I stated, I interpret "clinically significant" as being "evident." Even "evident" autism could be on the mild side.

What do you mean by "evident?" I'm just curious- the diagnostic criteria has a lot of debatable topics.

I would interpret "evident" as meaning "obvious."

Like: somebody, "obviously," exhibit difficulty in understanding sarcasm (as a child).

Of course, all this is highly subjective. One clinician might believe something is "evident"; whereas another might not think so.

I believe the DSM-V diagnostic criteria has designed to give the diagnostician flexibility.

I take "clinically significant" as meaning "significant enough to affect functioning to an obvious degree."

Throwing a tantrum, say, because your surroundings have been changed slightly, can be said to be "clinically significant." This "significantly" affects your functioning at home and at school/work.

Last edited by kraftiekortie on 27 Jul 2017, 8:48 pm, edited 1 time in total.

Right, "clinically significant" is a subjective term. I get what you mean now. So it might be "obvious" when I get attached to objects and need to carry them everywhere. It might not be obvious that I stim, but it gets very obvious during the school year when I'm under stress. Thanks

Perhaps I'm misunderstanding but I believe that a certain number, IE 2 if 4 in this given section, etc, do need to be clinically significant to get a diagnosis. Not that Wikipedia is always a good source of information, however I think the first sentence in this entry sums it up https://en.m.wikipedia.org/wiki/Clinical_significance
As stated there the gist of it is if it impacts daily life, it is clinically significant. If you have symptoms that don't impact your daily life they don't want to give you a diagnosis. This is why it's a lot harder for adults to get a diagnosis I am told. Because many adults have adapted to the point where there is not a lot of impact on their daily lives. They still have the same symptoms but they have learned to mitigate the impact on their daily lives. I struggled with this when seeking a diagnosis. I was told ny family "what does it matter? You live on your own. You have achieved a level of a success. You don't need help". But it does matter to me. It gives me a reason for all of the things that I do and the things i struggle with that have made me feel different and broken. I may have adapted to a degree but that does not mean things are easy. Keeping up the facade of "normal" is HARD. But I am not an expert and I digress...

Last edited by soloha on 27 Jul 2017, 9:54 pm, edited 1 time in total.

I'm not an expert either, and I've seen threads that are also full of very confused people about the statement "clinically significant." It is quite a subjective term as well, which doesn't help things. When does something like a special interest or stimming become "clinically significant?" It's very confusing.

I think "clinically significant" usually refers to impairment in general, not to individual symptoms. Of course the individual symptoms may cause the impairment (or they may combine to cause impairment), but I don't think they are generally the main focus when the (competent) clinician determines clinical significance.

In terms of individual symptoms, I think clinically significant means that the symptom has to be clearly related to the diagnostic criteria, or clearly "abnormal," but not necessarily impairing or severe. So just pacing when you get anxious about public speaking, for example, wouldn't qualify for restricted/repetitive/stereotyped behaviors. But spending an hour every day spinning the wheels of a toy truck would qualify because it is clearly abnormal even though it isn't severe/strongly affecting that person's life. But the overall condition does have to strongly affect the patient's life.

Clinically significant refers to symptoms. Here read this. It should clear things up
DSM IV definition of clinical significance

Wow. Or not. I've gotten deeper into reading that. It's extremely edifying but not a light read. I think they're trying to confuse themselves. Anyway, that's the standard they use.

Repetitive behaviors can manifest from jumbled and/or dulled (needing more) sensory input too.