Board index › General Discussion › General Autism Discussion

Adult diagnosis: do doctors really know what they are doing?

Page 6 of 8 [ 120 posts ]  Go to page Previous  1 ... 3, 4, 5, 6, 7, 8  Next

Previous topic | Next topic

btbnnyr
Veteran
Veteran

User avatar

Joined: 18 May 2011
Gender: Female
Posts: 7,359
Location: Lost Angleles Carmen Santiago

11 Aug 2015, 9:35 pm

ToughDiamond wrote:
btbnnyr wrote:
I think many people want autism to be an identity-based diagnosis when it is an impairment-based diagnosis instead.


What is an "identity-based diagnosis" ? I always thought the diagnosis was based on impairments, with points deducted for good coping skills to facilitate the denial of benefits and services.


In my view, identity-based diagnosis is when someone who can't identity concrete impairments sees autistic traits in themselves, perhaps from incidentally reading about autism, then researching it a lot, thinking of autism as an identity that they think they should be labeled with, and don't like it when doctors don't view autism as identity and don't label them with autism. But they can't be diagnosed or referred by doctors due to their traits also being common personality traits, them behaving within normal variation, and not identifying concrete impairments. This is why I suggested that people who do want referral come up with a short list of impairments, which will help the process more than a long detailed list of common traits.


_________________
Drain and plane and grain and blain your brain, and then again,
Propane and butane out of the gas main, your blain shall sustain!


Rocket123
Veteran
Veteran

User avatar

Joined: 15 Dec 2012
Age: 61
Gender: Male
Posts: 2,188
Location: Lost in Space

11 Aug 2015, 10:15 pm

btbnnyr wrote:
This is why I suggested that people who do want referral come up with a short list of impairments, which will help the process more than a long detailed list of common traits.

Just curious. How does the process you are suggesting "work" when one's biggest impairments are associated with one or more co-morbids (e.g. anxiety, depression, OCD, etc.)?

I ask, because I would never (ever) say that my impairments in social interaction cause me problems. From my perspective, that stuff (social interaction) is way overrated.



ASPartOfMe
Veteran
Veteran

User avatar

Joined: 25 Aug 2013
Age: 67
Gender: Male
Posts: 35,809
Location: Long Island, New York

11 Aug 2015, 10:33 pm

Rocket123 wrote:
btbnnyr wrote:
This is why I suggested that people who do want referral come up with a short list of impairments, which will help the process more than a long detailed list of common traits.

Just curious. How does the process you are suggesting "work" when one's biggest impairments are associated with one or more co-morbids (e.g. anxiety, depression, OCD, etc.)?

I ask, because I would never (ever) say that my impairments in social interaction cause me problems. From my perspective, that stuff (social interaction) is way overrated.


Social differences/impairments overrated?. In my fantasy word it is. In the real world it should be overrated but instead is the most important aspects others judge you by. A massive disadvantage for me.


_________________
Professionally Identified and joined WP August 26, 2013
DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


ASPartOfMe
Veteran
Veteran

User avatar

Joined: 25 Aug 2013
Age: 67
Gender: Male
Posts: 35,809
Location: Long Island, New York

11 Aug 2015, 10:45 pm

btbnnyr wrote:
I think autism as identity is not good, perhaps people who use it have a weak identity to begin with and need some other thing like autism to identity with.


An autistic identity is better then "loser" "oddball" and other negative labels/identities we had due to lack of knowledge. Do people abuse "identity"? Of course. So what we do is define everybody by the those that use it in the wrong way, thereby letting the few abusers ruin what could have been a potentially good thing for a lot of people. I don't know why this still upsets me, as we let the few define and ruin things for many things besides autism.


_________________
Professionally Identified and joined WP August 26, 2013
DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


btbnnyr
Veteran
Veteran

User avatar

Joined: 18 May 2011
Gender: Female
Posts: 7,359
Location: Lost Angleles Carmen Santiago

11 Aug 2015, 10:58 pm

Rocket123 wrote:
btbnnyr wrote:
This is why I suggested that people who do want referral come up with a short list of impairments, which will help the process more than a long detailed list of common traits.

Just curious. How does the process you are suggesting "work" when one's biggest impairments are associated with one or more co-morbids (e.g. anxiety, depression, OCD, etc.)?

I ask, because I would never (ever) say that my impairments in social interaction cause me problems. From my perspective, that stuff (social interaction) is way overrated.


But you said many times on wp that you don't understand aspects of social interaction.
Not understanding social interactions can be an impairment regardless of whether you think social interaction is overrated.


_________________
Drain and plane and grain and blain your brain, and then again,
Propane and butane out of the gas main, your blain shall sustain!


btbnnyr
Veteran
Veteran

User avatar

Joined: 18 May 2011
Gender: Female
Posts: 7,359
Location: Lost Angleles Carmen Santiago

11 Aug 2015, 11:05 pm

ASPartOfMe wrote:
btbnnyr wrote:
I think autism as identity is not good, perhaps people who use it have a weak identity to begin with and need some other thing like autism to identity with.


An autistic identity is better then "loser" "oddball" and other negative labels/identities we had due to lack of knowledge. Do people abuse "identity"? Of course. So what we do is define everybody by the those that use it in the wrong way, thereby letting the few abusers ruin what could have been a potentially good thing for a lot of people. I don't know why this still upsets me, as we let the few define and ruin things for many things besides autism.


I don't view autism as an identity regardless of what alternative identities there are.
I don't think of autism vs. loser or any other negative identity as alternatives.
They could go together too, or none might apply.
People may view autism as identity and prefereable to other identities, but diagnosis is not based on any of these potential identities.


_________________
Drain and plane and grain and blain your brain, and then again,
Propane and butane out of the gas main, your blain shall sustain!


Norny
Veteran
Veteran

User avatar

Joined: 31 Dec 2013
Gender: Male
Posts: 1,488

11 Aug 2015, 11:53 pm

The majority of people can identify with autistic traits and thus identify with autism and that's fine, so long as they don't have a strong desire to be diagnosed for the sake of being labelled, or alternatively self-diagnose and claim to others that they are autistic, as that implies official diagnosis.

When somebody seeks an autistic identity, they may spread false ideas that perpetuate within the community so long as others agree with them, because that solidifies their identity (bias). Applying typical traits to the label, in absence of concrete impairments, is probably the best example of how this could happen. Especially if there happens to be one or two professionals that share similar opinions.

I'd presume that when first learning about autism, the stronger one can relate to the diagnosis, the more likely they are to feel attachment to the label. That seems natural to me, but there should be a point where this stops, and the diagnosis/label only be considered for impairments as is intended. Needing the label to feel good is not healthy.


_________________
Unapologetically, Norny. :rambo:
-chronically drunk


kraftiekortie
Veteran
Veteran

Joined: 4 Feb 2014
Gender: Male
Posts: 87,510
Location: Queens, NYC

12 Aug 2015, 12:20 am

How many people actually seek out an "autistic" identity? Not that it's a shameful thing--but I don't see people lining up to go on the autistic bandwagon?

I think people are seeking something tangible to explain their autistic-like symptoms.



Rocket123
Veteran
Veteran

User avatar

Joined: 15 Dec 2012
Age: 61
Gender: Male
Posts: 2,188
Location: Lost in Space

12 Aug 2015, 12:28 am

btbnnyr wrote:
But you said many times on wp that you don't understand aspects of social interaction.
Not understanding social interactions can be an impairment regardless of whether you think social interaction is overrated.

I oftentimes divide social interaction into two different categories:
- Ad hoc conversation (I think the term people use is, “socializing”)
- Discussions with purpose (e.g. conversation whose sole purpose is to exchange information)

While I am terrible at ad hoc conversation, I am pretty good at discussions with purpose -- particularly in situations (such as the working environment) when I can ask someone a series of questions in order to obtain information (it can be almost like an interrogation).

Anyhow, I can minimize the impairments I have with ad hoc conversation by simply avoiding it in the first place. Or, if I happen to be in a situation that involves ad hoc conversation, I can choose just to be quiet and observe.

It’s sort of like being bad at baseball (while I am a fan of the game, I am not adept at playing). So, instead of participating, I simply watch.

I have no idea if this makes sense (or not).



DeepHour
Veteran
Veteran

User avatar

Joined: 1 Jun 2014
Gender: Male
Posts: 82,664
Location: United Kingdom

12 Aug 2015, 12:32 am

kraftiekortie wrote:
How many people actually seek out an "autistic" identity? Not that it's a shameful thing--but I don't see people lining up to go on the autistic bandwagon?

I think people are seeking something tangible to explain their autistic-like symptoms.


^ Your last sentence is very apt, and I agree with the sensible general approach you tend to bring to this issue, Kraftiekortie.

There is a persistent, recurring suggestion from some quarters in this forum that an Autistic Spectrum diagnosis is in some way sought out as a 'cool' thing to have. I don't really get that.



kraftiekortie
Veteran
Veteran

Joined: 4 Feb 2014
Gender: Male
Posts: 87,510
Location: Queens, NYC

12 Aug 2015, 12:33 am

It does make sense, Rocket.



btbnnyr
Veteran
Veteran

User avatar

Joined: 18 May 2011
Gender: Female
Posts: 7,359
Location: Lost Angleles Carmen Santiago

12 Aug 2015, 12:50 am

Rocket123 wrote:
btbnnyr wrote:
But you said many times on wp that you don't understand aspects of social interaction.
Not understanding social interactions can be an impairment regardless of whether you think social interaction is overrated.

I oftentimes divide social interaction into two different categories:
- Ad hoc conversation (I think the term people use is, “socializing”)
- Discussions with purpose (e.g. conversation whose sole purpose is to exchange information)

While I am terrible at ad hoc conversation, I am pretty good at discussions with purpose -- particularly in situations (such as the working environment) when I can ask someone a series of questions in order to obtain information (it can be almost like an interrogation).

Anyhow, I can minimize the impairments I have with ad hoc conversation by simply avoiding it in the first place. Or, if I happen to be in a situation that involves ad hoc conversation, I can choose just to be quiet and observe.

It’s sort of like being bad at baseball (while I am a fan of the game, I am not adept at playing). So, instead of participating, I simply watch.

I have no idea if this makes sense (or not).


Were there no social impairments that played a role in your diagnosis then?
What the psych write in the report to justify diagnosing you or support the autism criteria?
Did the psych observe social impairments in you that you don't consider important yourself?

For someone autistic, I would have thought that it would be super easy to come up with at least social impairments, if not workplace or education ones.


_________________
Drain and plane and grain and blain your brain, and then again,
Propane and butane out of the gas main, your blain shall sustain!


DeepHour
Veteran
Veteran

User avatar

Joined: 1 Jun 2014
Gender: Male
Posts: 82,664
Location: United Kingdom

12 Aug 2015, 1:02 am

^ I'm wondering how a psych would assess 'social impairments' in a person, such as myself, who no longer engages in significant social interaction. Or would that in itself count as social impairment?



btbnnyr
Veteran
Veteran

User avatar

Joined: 18 May 2011
Gender: Female
Posts: 7,359
Location: Lost Angleles Carmen Santiago

12 Aug 2015, 1:03 am

DeepHour wrote:
^ I'm wondering how a psych would assess 'social impairments' in a person, such as myself, who no longer engages in significant social interaction. Or would that in itself count as social impairment?


If you are there interacting with the psych, then the psych can observe social impairments if you have some.


_________________
Drain and plane and grain and blain your brain, and then again,
Propane and butane out of the gas main, your blain shall sustain!


ASPartOfMe
Veteran
Veteran

User avatar

Joined: 25 Aug 2013
Age: 67
Gender: Male
Posts: 35,809
Location: Long Island, New York

12 Aug 2015, 12:34 pm

btbnnyr wrote:
ASPartOfMe wrote:
btbnnyr wrote:
I think autism as identity is not good, perhaps people who use it have a weak identity to begin with and need some other thing like autism to identity with.


An autistic identity is better then "loser" "oddball" and other negative labels/identities we had due to lack of knowledge. Do people abuse "identity"? Of course. So what we do is define everybody by the those that use it in the wrong way, thereby letting the few abusers ruin what could have been a potentially good thing for a lot of people. I don't know why this still upsets me, as we let the few define and ruin things for many things besides autism.


I don't view autism as an identity regardless of what alternative identities there are.
I don't think of autism vs. loser or any other negative identity as alternatives.
They could go together too, or none might apply.\

People may view autism as identity and prefereable to other identities, but diagnosis is not based on any of these potential identities.


Some clinicians such as Atwood diagnose based on behavioral traits instead of impairments. But a clinician should not create an identity, that is up to the individual to decide. In my case it was diagnosis first identity and thus a less negative attitude shortly thereafter. I was lucky in that I was diagnosed at the tale end of when Autism as an identity was in semi- vogue So I was able to read about others in my age group that found identity useful and found some of it was useful for me. If I was diagnosed now I would have come into knowledge of Autism in an era when identity is viewed as bad, "impairments" are the deemed only valid way to look at at Autism and my posts might not be so different from numerous posters that feel they are worthless.


_________________
Professionally Identified and joined WP August 26, 2013
DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity

“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


ToughDiamond
Veteran
Veteran

User avatar

Joined: 15 Sep 2008
Age: 71
Gender: Male
Posts: 11,939

12 Aug 2015, 1:50 pm

btbnnyr wrote:

In my view, identity-based diagnosis is when someone who can't identity concrete impairments sees autistic traits in themselves, perhaps from incidentally reading about autism, then researching it a lot, thinking of autism as an identity that they think they should be labeled with, and don't like it when doctors don't view autism as identity and don't label them with autism. But they can't be diagnosed or referred by doctors due to their traits also being common personality traits, them behaving within normal variation, and not identifying concrete impairments. This is why I suggested that people who do want referral come up with a short list of impairments, which will help the process more than a long detailed list of common traits.

I see, thanks. Was there ever a time when they would give an identity-based diagnosis?