Why do people here assume all ASD diagnoses are correct?

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CivilSam
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28 Jan 2014, 8:21 pm

Rocket123 wrote:
daydreamer84 wrote:
Personally I think that equating self-diagnosis with a professional diagnosis made by an ASD expert is tantamount to saying that the expertise of a psychiatrist, neurologist, psychologist ect. is completely useless. It's a very anti-science or at-least anti-psychiatry point of view. I agree that all behavioral diagnoses have a subjective component and psychiatry is far from an exact science. I agree it has its problems but it's still based on a lot of good empirical data, research. It still has some value, IMO. In my opinion, saying that your own assessment of your symptoms is just as good as these doctors dismisses their authority and utility completely. There might as well not be a diagnosis of ASD. Just the same way if you could diagnose yourself with diabetes or cancer just as well as any medical doctor, those doctors would be useless. Those things are easier to diagnose and the science is more exact but that doesn't mean that there isn't any science that goes into the diagnosis of ASD.


The reason I would trust the expertise of a psychiatrist, neurologist, psychologist etc. is:
#1 – They are objective
#2 – They have a broader exposure to people with different conditions (across Axis I, Axis II, etc.) and, as such, can evaluate how far one veers from “normal”

Then again, I imagine that a patient quite easily “trick” the expert and be given any psycho diagnosis, just by acting a certain way and saying the right things.


Trying to "trick" an expert for a diagnosis is an illness in itself.


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Rocket123
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28 Jan 2014, 8:29 pm

Fnord wrote:
Why does it seem that some people assume that all professional diagnoses are erroneous?

Why does it seem that some people assume that only a self-diagnosis is error-free?

Why does it seem that some people believe in on-line tests as valid second opinions?


Are you challenging the validity and sanctity of on-line tests? Now you are going too far :lol:



Fnord
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28 Jan 2014, 8:39 pm

Rocket123 wrote:
Fnord wrote:
Why does it seem that some people assume that all professional diagnoses are erroneous? Why does it seem that some people assume that only a self-diagnosis is error-free? Why does it seem that some people believe in on-line tests as valid second opinions?
Are you challenging the validity and sanctity of on-line tests? Now you are going too far :lol:

No ... I really want to know.



Verdandi
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28 Jan 2014, 9:28 pm

Fnord wrote:
Rocket123 wrote:
Fnord wrote:
Why does it seem that some people assume that all professional diagnoses are erroneous? Why does it seem that some people assume that only a self-diagnosis is error-free? Why does it seem that some people believe in on-line tests as valid second opinions?
Are you challenging the validity and sanctity of on-line tests? Now you are going too far :lol:

No ... I really want to know.


A significant number of "online tests" are screening tools used in actual clinical environments to determine whether someone should be tested for autism, and some are even part of the evaluation process for a diagnosis. But somehow when they end up online they become ~online tests~ which of course have no validity because they are ~online~.

I haven't seen anyone assume that all professional diagnoses are erroneous.
I do not assume that all self-diagnoses are error free. I also do not assume that all professional diagnoses are error free.
I don't think those tests are valid for diagnosis, but they can be useful indicators.



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28 Jan 2014, 9:32 pm

btbnnyr wrote:
Professional diagnosis, self-diagnosis, other-diagnosis, the validities of these diagnoses, the effects of these diagnoses, plus misdiagnosis, overdiagnosis, underdiagnosis, these are all issues that should be open to discussion on WP and multiple perspectives included. WP should not enforce through censorship the specific opinions that self-diagnosis is completely valid and beneficial or that autism is definitely not overdiagnosed, two issues for which there have been no systematic studies and scarce evidence either way, so statements about them are personal opinions, and multiple opinions should be included.


I wasn't saying all of these topics should be off limits.

However there is a point where someone asserts (for example) that autism is massively overdiagnosed and therefore they're qualified to judge that many people on this forum are not really autistic despite being professionally diagnosed (for one example) that it seems to me that they're crossing a line from discussion and debate to encouraging a hostile environment which would actually discourage discussion.



CivilSam
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28 Jan 2014, 10:54 pm

So we have all been discussing the possibility of autism being over diagnosed, the legitimacy of an official diagnosis, and the legitimacy of a self diagnosis. I figured I would throw some more fire in the pot by providing an article expressing concern over how with the new ASD diagnosis people are being bumped off the spectrum.

http://www.webmd.com/brain/autism/news/ ... sm-numbers

"Of the 6,577 children who were classified as having an autism spectrum disorder under the old diagnostic criteria, researchers found 5,339, or 81 percent, would have kept their diagnosis under the new guidelines."

So that's a 19% drop.

My diagnosis came from the "new" ASD way and I personally feel dropping people off it is kind of wrong. I view that based on so what are these people supposed to do now? Will they lose benefits? Will they lose support? I guess the answers to that would be based on that communication disorder (isn't is basically aspergers?) and how much support is provided for that.

What are your opinions?


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28 Jan 2014, 11:16 pm

One of the differences between self-diagnosis and professional diagnosis is that self-diagnosis does not give the person enough observations of themselves from the outside. It is verry merry berry hard to leave one's own head. Watching a video of oneself is not enough, hearing other people talk about oneself is not enough, I am still inside my head when these things occur. Meanwhile, the diagnostic criteria are written to be matched from the outside by someone who is not inside the mind of the person being evaluated for autism. For eberryone, there is a lot more stuff going on inside than can be broadcast to the outside, so matching these torrents of inside data influenced by all kinds of inside processes up against rather vague outside criteria has significant potential to produce false positives. It is bester to have someone else with detailed understanding of the vague criteria and diagnostic eggsperience with different people match up the outside data with the outside criteria. The process also includes matching up inside data with inside criteria in the form of self-report questionnaires.

Saying things like this and my earlier post about professional diagnosis is not a hate-filled attack on people who are self-diagnosed, and neither is the opinion that self-diagnosis is generally not as valid as professional diagnosis.


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28 Jan 2014, 11:53 pm

I personally do not trust psychologists because they failed to see earlier a lot of my issues stem from my handicaps as a "root cause." It was my own experience that taught me that. I believe many psychologists in fact are not trained to deal with the emotional needs that stem from handicaps or other minority issues..

That being said someone may come here for support and community over diagnoses as they are pretty high functioning and being within their 40s -80s+. They may still feel and observe stress but diagnosis may not change this the quality of life. But community support may help though.

Also, people in their 40+ years have pretty good hindsight too and this lends into their
"insights" into their own behaviors. Psychology takes this same process and "pulling" out understanding of behavior after all only in a formalized setting.



Last edited by Briarsprout on 28 Jan 2014, 11:59 pm, edited 1 time in total.

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28 Jan 2014, 11:58 pm

Briarsprout wrote:
I personally do not trust psychologists because they failed to see earlier a lot of my issues stem from my handicaps as a "root cause." It was my own experience that taught me that. I believe many psychologists in fact are not trained to deal with the emotional needs that stem from handicaps or other minority issues..

That being said someone may come here for support and community over diagnoses as they are pretty high functioning and being within their 40s -80s+. They may still feel and observe stress but diagnosis may not change this the quality of life. But community support may help though.

I think a lot of psychologists just stereotype people out of laziness. That is why females are underdiagnosed and people who are hard to define just get shoved in a box and neglected. I've also experienced this with medical doctors and optometrists.


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29 Jan 2014, 12:03 am

^^^^

I concur this frequently happens. On top of that, we know that people go under diagnosed in the US due to $$ issues etc or barriers to healthcare. Plus, we know that many people were born before high functioning autism was diagnosed.

As to more people being diagnosed currently yes this is to be expected as there is more awareness and public recognition. In turn people begin to see their own behaviors in context and receive help if needed.

This is true for any described diagnoses within DSM etc. For example, we don't go around saying depression is over diagnosed.....or post traumatic stress is over diagnosed...learning disabilities over diagnosed (US/Canada definitions)....



Last edited by Briarsprout on 29 Jan 2014, 12:43 am, edited 4 times in total.

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29 Jan 2014, 12:08 am

btbnnyr wrote:
One of the differences between self-diagnosis and professional diagnosis is that self-diagnosis does not give the person enough observations of themselves from the outside. It is verry merry berry hard to leave one's own head. Watching a video of oneself is not enough, hearing other people talk about oneself is not enough, I am still inside my head when these things occur. Meanwhile, the diagnostic criteria are written to be matched from the outside by someone who is not inside the mind of the person being evaluated for autism. For eberryone, there is a lot more stuff going on inside than can be broadcast to the outside, so matching these torrents of inside data influenced by all kinds of inside processes up against rather vague outside criteria has significant potential to produce false positives. It is bester to have someone else with detailed understanding of the vague criteria and diagnostic eggsperience with different people match up the outside data with the outside criteria. The process also includes matching up inside data with inside criteria in the form of self-report questionnaires.


btbnnyr - You articulated quite well why I never self-diagnosed. This also probably explains why I -- at times - question my diagnosis. Thank you.



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29 Jan 2014, 12:13 am

btbnnyr wrote:
One of the differences between self-diagnosis and professional diagnosis is that self-diagnosis does not give the person enough observations of themselves from the outside. It is verry merry berry hard to leave one's own head. Watching a video of oneself is not enough, hearing other people talk about oneself is not enough, I am still inside my head when these things occur. Meanwhile, the diagnostic criteria are written to be matched from the outside by someone who is not inside the mind of the person being evaluated for autism. For eberryone, there is a lot more stuff going on inside than can be broadcast to the outside, so matching these torrents of inside data influenced by all kinds of inside processes up against rather vague outside criteria has significant potential to produce false positives. It is bester to have someone else with detailed understanding of the vague criteria and diagnostic eggsperience with different people match up the outside data with the outside criteria. The process also includes matching up inside data with inside criteria in the form of self-report questionnaires.

Saying things like this and my earlier post about professional diagnosis is not a hate-filled attack on people who are self-diagnosed, and neither is the opinion that self-diagnosis is generally not as valid as professional diagnosis.


When I decided to go ahead and say I was "Asperger's Undiagnosed" I had spoken to several people on and offline and asked their opinions. These included multiple autistic people, my mother, my oldest friend, a friend who is a therapist, and they gave me their own perception of my behavior. Not surprisingly to me, the answer was often (not always) that it made sense or that they had thought I might be, or in my mother's case that she had been told when I was very young and chose to dismiss it.

Like, there are a lot of assumptions about self-diagnosis in threads like this, but many of them are inaccurate.

And I kind of think this is all theory about how self-diagnosis could go wrong, and it needs more empirical evidence. Because if people are basically just giving reasons why they think it might not be reliable, it's not going to be convincing to those of us who went from self diagnosed to professionally diagnosed.



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29 Jan 2014, 12:22 am

I too spoke to people who know me well....

Self diagnoses does not mean their diagnoses is wrong too. ;)

Each person must decide if an official diagnoses is worth it given their circumstances etc and also their money situation.

I believe too this is why "sell-diagnoses" is an option on these boards. The mission statement is in regards to neurological differences...diagnoses or otherwise because these differences can sometimes be not accepted in the greater society frequently.

Kudos to Alex and Team about these considerations into this area. )



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29 Jan 2014, 9:42 am

Quote:
I self diagnose myself with autism. Turns out I actually have the onset of schizophrenia and before I know it things get drastically worse.


Most professionals wouldn't do any better in that situation. Very few people with prodromal schizophrenia are accurately diagnosed before their first psychotic episode, even when they do see an expert in time. Pretty much the only cases I've heard of were people recruited for a controlled study of prodromal schizophrenia, and even then the accuracy is fairly poor.

So even if the person goes to a psychologist, chances are they'd get a diagnosis of autism or something else inaccurate, and then go on to have their psychotic episode anyway.



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29 Jan 2014, 10:09 am

I dont wanted to say, that self diagnozing will have the same rate of assurance as an professional diagnose. But whyever someone self diagnosed himself, there will be reasons behind it. Nobody diagnoses himself with autism for fun, so yes someone diagnosing himself might be wrong, but there will be definitly specific reasons for him to do so.

In the end I think the important part of the forum, is when people are asking specific questions. "I happen to have this and that specific problem: What kind of solutions do you see?" And if someone is helped, I dont see the reason why to argue about if someone "only" has a social phobia causing him to have similar problems or "real" autism.

The rest of the forum is gossip to me, that I use because I like to have some kind of communication to others, but are in real life simply disabled about it, because of my treats.

A professional diagnosis sure gives the affected one more assurance of the issue, then an self-diagnosis. But it does not make someones oppinion superior or better or whatever. There are tons of reasons, why many people simply cant have diagnosis that easily. In my country the only specialist centre for autism is in the capital city, and I needed to do 4 visits at their place, one time including with a parent of me. While parts of my diagnosis costs could have been refundend by health insurance, stuff like an hotel, food, travel costs, ... would not have been included. If I lived far away from our capital city and had minimum loan, paying all that sidecosts would have been rather impossible. As well that if I would have done it as much as possible with the health insurance, that it would have lasted about a year longer, because only very few psychiatrists working by insurance, so I had to have waited about a year until someone could have counceled with me.

And my country is western europian, so I definitly dont wanna know how far worse it might be in other countries, having worser medical standards and support.

If someone has the possibility to do an diagnosis, I´d go for it, simply to reassure yourself. But if its whyever not possible for someone, then its the way it is.



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29 Jan 2014, 12:10 pm

am a supporter of our fellow self diagnosed members being treated as equals in the autistic community,however if was to think about it-people can state they have x,y or z traits/difficulties because they are what someone experiences but technicaly they cannot say they have x,y, or z disorder/syndrome/disability, these are just formal diagnostic labels that are purely existant due to the pyschology industry; the icd and dsm for starters,and for diagnosis these obviously require a professionals support.
they are just labels,someone doesnt need one to know they have social/communication difficulties,the question we shoud be asking is why such a wide and differing autistic community is so divisive and elitist if people within it [or out] dont conform to criteria,if anything that is doing exactly what NTs are constantly blamed for doing,we cant act superior to a group of people whilst demanding NTs stop doing the same thing,it is being a hypocrite.