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Schizotypy: A look at childhood observations
Page 1 of 1 [ 16 posts ]
11 Feb 2014, 7:59 pm
As I developed a pretty bad psychotic episode at 14 (which was, due to incomplete information, diagnosed as schizotypal personality disorder), I wanted ot look at some of my psychoticist traits as observed from childhood.
From an observation from a child neurologist dated 25 Jan 1990:
Quote:
She was subsequently placed in pre-school and it was noted that she would get up and wander about the classroom. She would also have tantrums when there were any limitations put on her wanderings. She also did not play appropriately with children her age. Her parents also noted that she had inappropriate laughter. They say that she is a child who is always on the go and quite active. She is consistently inconsistent with her attention. At times, she will cooperate well with them and then, at other times, there is no way of addressing her attention.
From a behavioral evaluation in my very first IEP, dated 11/15/1989:
Quote:
At times she follows directions and (illegible) listens as well as at other times she doesn't. Beneficii seems to be very inconsistent in all her behaviors. It appears that she may have difficulties with short-term memory skills. She is easily distracted, has a short attention span and perseveration.
There was also mention of difficulties with processing information, language difficulties, and "problems with thought processes" as mentioned in a medical report dated that same day.
From a psychological evaluation ordered by the school, dated 10/01/1992:
Quote:
Although physicians have consistently identified unusual patterns in beneficii's development, the specific diagnoses have been inconsistent.
The impression I get from the research is that difficulty coming up with a diagnosis in the face of clear symptoms of mental illness is often a sign of a pre-psychotic state. The report continues:
Quote:
The testing was conducted during three one-hour sessions. Beneficii entered testing willingly, and rapport was easily established. She was ostensibly cooperative, but she was readily distracted by external and internal stimuli throughout testing. Beneficii was unable to screen aural or visual stimuli or inhibit responses to them. Her thinking tended to be tangential, and confusion within her own thought processes was apparent. Beneficii also struggled to interpret social information, and her perceptions reflected considerable confusion. Her social behaviors were somewhat stilted, and little expression of affect was evident. Sustaining concentration was difficult, and internal stimuli appeared to disrupt beneficii's short-term auditory memory. As items became increasingly difficult, beneficii became increasingly active and distractible. The child's use of language was also notable. Her verbalizations tended to be concrete and descriptive, although she seemingly understood abstract concepts. Dysfluencies impeded the flow of her communication as she attempted to express herself. Beneficii also struggled to label objects or to apply expressive vocabulary. For example, when asked how a shoe and shirt were alike, she responded that they were "wearing stuff" (comment: I'm pretty sure that's how I'd still answer it, though perhaps with better wording) and when asked to define clock, she responded "a place, a place that has time."
Quote:
Personality assessment was based on standardized and projective tests, interview and behavioral observations. Through self-report, beneficii communicated a realistic awareness of about herself. She identified intellectual strengths within herself and noted her difficulty with social relationships. Erika tended to focus her attention on extraneous information that was significant only to her. Perseveration in her thought processes limited her ability to respond to socially relevant information. As structure decreased, her tangential thinking increased, and thinking became increasingly contaminated. Beneficii exhibited a tendency to focus attention on content which embodied tension, conflict, or turmoil, and the presence of these factors seemed to increase her own level of internal arousal.
That last part weirds me out just reading it, but it remains true to this day.
Quote:
Beneficii did not produce an adequate number of responses to the Rorschach cards to allow for valid interpretation of her record. However, on the 10 responses that she produced, a clear pattern of perceptual distortion was evident in the high frequency of responses with negative form quality. She was limited in her ability to articulate determinants, and her verbalizations reflected disorganization in thoughts. Beneficii's comments during inquiry revealed a propensity to rely on movement and achromatic color. Beneficii tended to respond to her private internal thoughts rather than to the constraints of the stimuli. Highly unusual content further substantiated her personal and idiosyncratic pattern of response to environmental stimuli. Both linguistic deficits and cognitive distortions impeded her ability to respond to this test.
From the conclusion:
Quote:
Beneficii exhibits evidence of perceptual distortion and cognitive disorganization. Without externally imposed structure, beneficii tends to respond to her own internal stimulation. Under these circumstances, her ideations become increasingly detached from external realtiy.
It appears that this evaluator said I met 2 of the schizotypal trait factors: unusual experiences (to include the perceptual distortions and unusual thought content) and cognitive disorganization (the tangentiality and confusion within thought processes, as well as evidence suggesting possible thought interference). As well, there seems to be some evidence throughout other reports for introvertive anhedonia and impulsive nonconformity (which I will get to in a future post). (The love for tension, though, may be evidence of impulsive nonconformity.)
_________________
"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin
12 Feb 2014, 4:41 am
I noticed that several times that autistics who got miss-dx once very often get over the old reports and what happened over and over again to understand why this happened. I did the same and hoped it would help me in any way, but I'm not that convinced about it anymore. I think it has to do with the fact that autistics have difficulties processing informations and also emotions. NTs told me that after a certain amount of time if something bad happened it wouldn't hurt that much anymore, but for most autistic ppl this just doesn't seem to work. The have the need to understand what happened and to process it intelectually.
I analized what happened to me in the psychiatry over and over again and I understand it maybe better now, but not totally, but I also couldn't way it helped me. It made me paranoid and I also couldn't really move on. I was stuck in that situation. I have no solution for that, but I noticed that you write here about it a lot. I have the feeling that you are still not over it and still hope to gather new information and new knowledge who is supposed to help you in any sort of way.
_________________
"I'm astounded by people who want to 'know' the universe when it's hard enough to find your way around Chinatown." - Woody Allen
12 Feb 2014, 4:52 am
Raziel wrote:
I noticed that several times that autistics who got miss-dx once very often get over the old reports and what happened over and over again to understand why this happened. I did the same and hoped it would help me in any way, but I'm not that convinced about it anymore. I think it has to do with the fact that autistics have difficulties processing informations and also emotions. NTs told me that after a certain amount of time if something bad happened it wouldn't hurt that much anymore, but for most autistic ppl this just doesn't seem to work. The have the need to understand what happened and to process it intelectually.
I analized what happened to me in the psychiatry over and over again and I understand it maybe better now, but not totally, but I also couldn't way it helped me. It made me paranoid and I also couldn't really move on. I was stuck in that situation. I have no solution for that, but I noticed that you write here about it a lot. I have the feeling that you are still not over it and still hope to gather new information and new knowledge who is supposed to help you in any sort of way.
I analized what happened to me in the psychiatry over and over again and I understand it maybe better now, but not totally, but I also couldn't way it helped me. It made me paranoid and I also couldn't really move on. I was stuck in that situation. I have no solution for that, but I noticed that you write here about it a lot. I have the feeling that you are still not over it and still hope to gather new information and new knowledge who is supposed to help you in any sort of way.
Actually, that evaluator never mentioned schizotypy, but it was clear he was inferring it via references to perceptual distortion and cognitive disorganization.
I'm not that sure if schizotypal personality disorder was that big of a misdiagnosis. Considering the bizarre, dangerous behavior I engaged in in response to my delusions that brought me under the control of the authorities, and a lot of the bizarre, at times incoherent statements I made in the aftermath, I do wonder.
What I'm realizing is that many different mental health professionals have their own views of nosology and the like and I want to try to get as many perspectives as I can, considering the widespread controversy that exists in psychiatry regarding nosology.
_________________
"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin
12 Feb 2014, 6:32 am
beneficii wrote:
What I'm realizing is that many different mental health professionals have their own views of nosology and the like and I want to try to get as many perspectives as I can, considering the widespread controversy that exists in psychiatry regarding nosology.
Psychiatric dx are nothing more than categories and sometimes you fit better in one than in another and very often it's just a matter of interpretation.
Since my Tourette got worse (under stress I experience resently) I watched some videos about it. Usually I don't deal with my tics and also don't have to because they are just minor, but once in a while they get annoying. What I noticed is how much Tourette I really am. I don't mean the tics, I mean the associated behaviour, like hyperactivity, some OCD behaviour and so on and also often symptoms that are associated with schizotypal. I am somehow on the autistic spectrum, but I also asked myself how much can actually be explained through the other factors? I guess there is no reall right answer, since categories in the psychiatric system are somehow just invented.
_________________
"I'm astounded by people who want to 'know' the universe when it's hard enough to find your way around Chinatown." - Woody Allen
12 Feb 2014, 11:17 am
Quote:
Since my Tourette got worse (under stress I experience resently) I watched some videos about it. Usually I don't deal with my tics and also don't have to because they are just minor, but once in a while they get annoying. What I noticed is how much Tourette I really am. I don't mean the tics, I mean the associated behaviour, like hyperactivity, some OCD behaviour and so on and also often symptoms that are associated with schizotypal. I am somehow on the autistic spectrum, but I also asked myself how much can actually be explained through the other factors? I guess there is no reall right answer, since categories in the psychiatric system are somehow just invented.
I think the time is coming soon when psychiatric diagnoses will be based more on functional neuroimaging and genetic tests than on observing behaviour. At this point, we'll probably reorganize a pile of diagnostic categories.
12 Feb 2014, 12:17 pm
Raziel wrote:
beneficii wrote:
What I'm realizing is that many different mental health professionals have their own views of nosology and the like and I want to try to get as many perspectives as I can, considering the widespread controversy that exists in psychiatry regarding nosology.
Psychiatric dx are nothing more than categories and sometimes you fit better in one than in another and very often it's just a matter of interpretation.
Since my Tourette got worse (under stress I experience resently) I watched some videos about it. Usually I don't deal with my tics and also don't have to because they are just minor, but once in a while they get annoying. What I noticed is how much Tourette I really am. I don't mean the tics, I mean the associated behaviour, like hyperactivity, some OCD behaviour and so on and also often symptoms that are associated with schizotypal. I am somehow on the autistic spectrum, but I also asked myself how much can actually be explained through the other factors? I guess there is no reall right answer, since categories in the psychiatric system are somehow just invented.
Don't know. Schizotypy is more of a personality trait construct than a diagnosis, though.
_________________
"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin
12 Feb 2014, 12:25 pm
Ettina wrote:
Quote:
Since my Tourette got worse (under stress I experience resently) I watched some videos about it. Usually I don't deal with my tics and also don't have to because they are just minor, but once in a while they get annoying. What I noticed is how much Tourette I really am. I don't mean the tics, I mean the associated behaviour, like hyperactivity, some OCD behaviour and so on and also often symptoms that are associated with schizotypal. I am somehow on the autistic spectrum, but I also asked myself how much can actually be explained through the other factors? I guess there is no reall right answer, since categories in the psychiatric system are somehow just invented.
I think the time is coming soon when psychiatric diagnoses will be based more on functional neuroimaging and genetic tests than on observing behaviour. At this point, we'll probably reorganize a pile of diagnostic categories.
I'm pretty skeptical we can accomplish this anytime soon, due to the complex and interrelated of nature of psychiatric symptoms. Basically, my understanding of psychiatric symptoms is that there starts a small disturbance in the patient's neurology due to a variety of factors, genetics, stress, etc., and this subtle disturbance begins to manifest itself to the patient as the patient starts to go through their daily life, resulting in attempts to cope/adapt for the patient. These attempts to cope/adapt may lead to more dysfunction. Back and forth these effects snowball until you have a psychiatric disorder.
Basically, psychiatrists still need to take into full account the subjectivity side of the equation when it comes to the psyche; they will still need to look at things like "rationality, world-view, symbolization, self-awareness, and personal identity," as mentioned here. They need to know the patient's history, psychosocial factors, and yes, the way the patients sees the world.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
_________________
"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin
12 Feb 2014, 3:14 pm
beneficii wrote:
Basically, psychiatrists still need to take into full account the subjectivity side of the equation when it comes to the psyche; they will still need to look at things like "rationality, world-view, symbolization, self-awareness, and personal identity," as mentioned here. They need to know the patient's history, psychosocial factors, and yes, the way the patients sees the world.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
I've the feeling that psychiatrists take their dx-categories way too serious. I also agree about the subjectivity about psychiatric disorders and think this should always kept in mind when dealing with patients as a psychiatrist or therapist. I don't take it that serious anymore what they tell me what I'm supposed to have and all of them think that they are right and the others wrong. Disorders are overlapping and also schizotypal PD is just a PD in the DSM, in the ICD it's called "schizotype disoder" and part of the schizophrenic spectrum.
_________________
"I'm astounded by people who want to 'know' the universe when it's hard enough to find your way around Chinatown." - Woody Allen
13 Feb 2014, 11:58 pm
From IEP dated 01/26/96:
From my speech-language clinician:
Quote:
When beneficii initiates the topic of conversation, she appears to have some control over her language organization. As the conversation progresses, frequent topic shifts may be noted as well as frequent questions. She has a tendency to bombard the listener with questions she does not wait to receive an answer for.
From my emotional disabilities teacher (that blonde lady who I actually remember, who first taught me the word "stress"!):
Quote:
Beneficii is an eleven-year nine-month old student in the non-categorical program who recently underwent a triennial evaluation. Results of testing and teacher reports indicate that beneficii exhibits evidence of distorted perceptions and thought processes, heightened anxiety, difficulty handling her emotions, a tendency to overpersonalize situations, and an excessive focus on internal preoccupations and on fantasy. Problems with self-image are also apparent. Overall, her behavior and responses continue to reflect a marked degree of social withdrawal and she shows significant difficulties interpreting social cues and building and sustaining appropriate interpersonal relationships.
From my autism resource teacher:
Quote:
Beneficii is a highly verbal young woman who has difficulty with her pragmatic language skills. She is able to express her needs and wants and to share information about a topic, however, what is shared is often inappropriate and/or disjointed and difficult to follow. Areas of difficulty for beneficii relate to her inability to maintain appropriate conversation for more than 2-3 interchanges on a topic that she has not chosen or that is of interest to her, as well as, the social conventions of language.
_________________
"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin
14 Feb 2014, 2:19 pm
Quote:
Basically, psychiatrists still need to take into full account the subjectivity side of the equation when it comes to the psyche; they will still need to look at things like "rationality, world-view, symbolization, self-awareness, and personal identity," as mentioned here. They need to know the patient's history, psychosocial factors, and yes, the way the patients sees the world.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
You need to look at those things with people with Down Syndrome, too. Doesn't mean we can't diagnose it objectively. We need the subjectivity for treatment, not for diagnosis.
15 Feb 2014, 1:03 am
Ettina wrote:
Quote:
Basically, psychiatrists still need to take into full account the subjectivity side of the equation when it comes to the psyche; they will still need to look at things like "rationality, world-view, symbolization, self-awareness, and personal identity," as mentioned here. They need to know the patient's history, psychosocial factors, and yes, the way the patients sees the world.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
You need to look at those things with people with Down Syndrome, too. Doesn't mean we can't diagnose it objectively. We need the subjectivity for treatment, not for diagnosis.
I think there is a huge difference compared with psychiatric dx. In psychiatry dx are made only on observed behaviour and what the patient tells he/she is thinking and feeling. In psychiatry there are tests, but also they rely on behavioural observation and the fact that the patient is objective enough to understand and recognize his symptoms. In many cases different psychiatrists will dx different psychiatric disorders.
_________________
"I'm astounded by people who want to 'know' the universe when it's hard enough to find your way around Chinatown." - Woody Allen
15 Feb 2014, 8:06 am
I agree with others. Psychologist take their categories way too seriously, sometimes act as if their tests are infallible when there is often a huge element of subjectivity (ADOS in particular as it is in the examiners judgment not only to do the scoring, but to interpret what scores mean) in some though not all tests. And even when they are purely multiple choice and objective, the meaning is a construct, not an objective fact.
It's hard not to keep going back to what's said and written about oneself. Even if it once were completely valid, a big question in my mind, our minds do change over time as does the understanding of the same information by professionals.
Trying to go with what is relevant and works in the present usually works better, if one can. Though it's really hard, because both the past and the present are confusing. And a lot of people having taught ourselves and been taught to try to analyze and figure out what is going on to survive have trouble stopping.
15 Feb 2014, 11:05 am
Raziel wrote:
Ettina wrote:
Quote:
Basically, psychiatrists still need to take into full account the subjectivity side of the equation when it comes to the psyche; they will still need to look at things like "rationality, world-view, symbolization, self-awareness, and personal identity," as mentioned here. They need to know the patient's history, psychosocial factors, and yes, the way the patients sees the world.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
http://onlinelibrary.wiley.com/doi/10.1 ... 20101/full
It's fashionable to talk about completely cutting subjectivity out of any psychiatric analysis, but subjectivity is an important part of our mental life.
You need to look at those things with people with Down Syndrome, too. Doesn't mean we can't diagnose it objectively. We need the subjectivity for treatment, not for diagnosis.
I think there is a huge difference compared with psychiatric dx. In psychiatry dx are made only on observed behaviour and what the patient tells he/she is thinking and feeling. In psychiatry there are tests, but also they rely on behavioural observation and the fact that the patient is objective enough to understand and recognize his symptoms. In many cases different psychiatrists will dx different psychiatric disorders.
The psychiatrists I've been looking at don't discount the importance of the subjective, but they make sure to really understand what the patient is saying rather than relying on a simple yes or no answer.
_________________
"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin
15 Feb 2014, 11:10 am
Waterfalls wrote:
I agree with others. Psychologist take their categories way too seriously, sometimes act as if their tests are infallible when there is often a huge element of subjectivity (ADOS in particular as it is in the examiners judgment not only to do the scoring, but to interpret what scores mean) in some though not all tests. And even when they are purely multiple choice and objective, the meaning is a construct, not an objective fact.
Ja. Psychiatrists cannot pretend that subjectivity does not play a role in diagnosis; if anything, they should embrace it and accept it as an important part of their profession. They can do a lot more for their patients that way.
Quote:
It's hard not to keep going back to what's said and written about oneself. Even if it once were completely valid, a big question in my mind, our minds do change over time as does the understanding of the same information by professionals.
Trying to go with what is relevant and works in the present usually works better, if one can. Though it's really hard, because both the past and the present are confusing. And a lot of people having taught ourselves and been taught to try to analyze and figure out what is going on to survive have trouble stopping.
Trying to go with what is relevant and works in the present usually works better, if one can. Though it's really hard, because both the past and the present are confusing. And a lot of people having taught ourselves and been taught to try to analyze and figure out what is going on to survive have trouble stopping.
I like it because it's descriptive, and it's something that my current mental health professionals don't really like to talk about.
_________________
"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin
15 Feb 2014, 2:13 pm
beneficii wrote:
I like it because it's descriptive, and it's something that my current mental health professionals don't really like to talk about.
Why don't they like to talk about it?
Just one psychiatrist explained me the subjectivity of the diagnostic system, but that was because I had an appointment with him years after he dx me and wrote that I'm sure not transsexual and that's after seeing me back than for just about 5 minutes. The rest of this time I talked to his assistend (It was in a psychiatric hospital). When I had my appointment with him years after that I already had my name change and everything and he explained me about the subjectivity of the diagnostic system. So I had the feeling he used it as kind of an excuse.
_________________
"I'm astounded by people who want to 'know' the universe when it's hard enough to find your way around Chinatown." - Woody Allen
15 Feb 2014, 5:13 pm
Raziel wrote:
beneficii wrote:
I like it because it's descriptive, and it's something that my current mental health professionals don't really like to talk about.
Why don't they like to talk about it?
Just one psychiatrist explained me the subjectivity of the diagnostic system, but that was because I had an appointment with him years after he dx me and wrote that I'm sure not transsexual and that's after seeing me back than for just about 5 minutes. The rest of this time I talked to his assistend (It was in a psychiatric hospital). When I had my appointment with him years after that I already had my name change and everything and he explained me about the subjectivity of the diagnostic system. So I had the feeling he used it as kind of an excuse.
I think that many psychiatrists don't know about things like the EASE and stuff, and probably also because I come across so normal to them, that they don't want to think about things like schizotypy. I'm repeatedly told by my psychologist that I come across as friendly, nice, and (seemingly) charismatic.
It's such a contrast with how I'm perceived online, LOL. Maybe I am socially normal, or I've learned my scripts so well that I can come across that way.
I notice, though, that even when I discuss something disturbing, I still have that kind, friendly, nice tone, so maybe it's more of a script than an expression of my internal state.
_________________
"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin
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