Whose Planet Is It Anyway?

Wednesday, November 15, 2006

Shattering Frequencies

I had a very strange experience yesterday evening. There were crackling sounds coming from a bathroom, so I went to investigate. It sounded almost like a bowl of Rice Krispies (of the Autism Speaks variety—loud, unpleasant, and destructive noises). At first I was afraid something had caught fire, but it turned out to be the shower door spontaneously self-destructing. Cracks were spreading all over the pane for no apparent reason.

I'm still not sure what caused it. I've been told it is possible for a low-level earthquake, while not strong enough for a person to feel, to shatter glass because of the frequencies. Perhaps that's what happened—I'll probably never know.

Cause and effect can be tricky things. Here's something more to ponder about unanticipated events: A little more than a decade ago, a small group of psychiatrists, after observing that certain types of behaviors appeared to have similar neurological origins, wrote the broad concept of the autism spectrum into the DSM-IV, thereby redefining millions of people as "disordered" who would have been considered normal and healthy under the former standards.

I'll give these psychiatrists the benefit of the doubt and acknowledge that they probably never foresaw that their decision would have such devastating consequences for so many people. Most likely, they expected the newly created Asperger's diagnosis and the other autism spectrum categories to have social effects similar to those of the ADD/ADHD diagnostic categories, which made accommodations more readily available with minimal stigma. No doubt they also wanted to create a profitable new market for the pharmaceutical companies that were backing their research (these guys aren't altruists, you know; there are some seriously incestuous relationships between Big Pharma and the psychiatrists who define what a "disorder" is).

But as corrupt as they are, most of 'em aren't genocidal. They had no reason to anticipate that their vaguely defined concept of an autism spectrum would result in the social construction of a minority race of some 60 to 70 million people worldwide—people who have become victims of the most outrageous prejudice and discrimination, whose existence is routinely described as an intolerable burden to society and an epidemic, and who have been targeted by the American government and others for eugenic extermination.

They never expected to shatter millions of lives.

Labels:

34 Comments:

  • I read recently that DSM IV was more or less just cobbled together. I'll see if I can track that down again. Anyone else remember where that was?
    Best wishes
    http://whitterer-autism.blogspot.com

    By Blogger mcewen, at 3:51 PM  

  • The DSM-IV description of Asperger's was thrown together without proper thought, it was meant to be a sort of test balloon or something that researchers could use to figure out what Asperger's might be...

    It's possible that in the next iteration of the DSM that Asperger's will have been subsumed under autism, at the very least one would expect it to get a sensible definition.

    By Anonymous Camille, at 7:01 PM  

  • There's only one properly valid set of criteria for Asperger syndrome: Gillberg & Gillberg 1989; these are the only criteria actually operationsalised form Hans Asperger's own Habilitation thesis.

    DSM IV would diagnose an Aspie as autistic (true, since AS is a subset proper on the set of autistic spectrum states), and Asperger's original cases - examined under DSM IV criteria did not meet DSM IV 299.80 (Asperger syndrome) at all.

    By Blogger David N. Andrews MEd (Distinction), at 7:14 PM  

  • operationsalised->operationalised

    By Blogger David N. Andrews MEd (Distinction), at 7:21 PM  

  • form->from

    typo city just now...

    By Blogger David N. Andrews MEd (Distinction), at 7:22 PM  

  • http://www.autismvox.com/the-difference-a-diagnosis-makes/

    I mentioned the "cobbling together" process here, in part.

    By Blogger Kristina Chew, at 7:57 PM  

  • Yes, the DSM-IV Asperger's definition is apparently bogus, and many researchers are saying that. You'll notice that people with Asperger's intuitively tend to call ourselves autistic. The split between Asperger's and autism is not only hard to operationalize, but maybe also to intuitively conceptualize (e.g. two autistic adults may be identical, except for a big difference in late talking).

    As to whether it's bad that people have been given a label, that's debatable. Where the cut-off of normal vs. different should occur is debatable. That the label is medicalized and badly constructed is very much agreed with, nonetheless.

    By Blogger Joseph, at 9:57 PM  

  • Joseph: I'm not saying that labels are necessarily bad. Sometimes they're useful. It all depends on circumstances and social attitudes, which often can't be foreseen with accuracy.

    As for where the cut-off of normal vs. different should occur, in a recent comment on Andrea's blog, David pointed out that very few people are within the "normal" range for everything. So when labels are used to identify differences, that shouldn't result in people being described as abnormal. And I don't think we need a clear cut-off point, either. People should be able to self-identify with whatever they find most comfortable, just as we do with ethnic identity, sexual orientation, and the many other social categories into which people regularly sort themselves without benefit of expert definitions or clear dividing lines.

    By Blogger abfh, at 12:32 AM  

  • O.K. social attitudes often cant be seen with accuracy.
    So, when some people self identify themselves with the term autism, they may be doing so to connect with others who see themselves as just different rather than diseased or needing their behavior fixed.
    Unfortunatly Big Pharma and psychologist are descibing the number of people with autism in order to describe an epidemic.The claim of an epidemic goes to furthur the agendas of those selling treatments that are not only ineffective but dangerous and even deadly. It also spreads the propoganda that encourages societal injustices all the way from negative srereotypes to eugenic extermination, justification for murder, etc.
    There is no way to take all the people off psychiatric meds. At least not until there is an practical alternative. However, psychological evaluations dont seem practical at all.They ALL seem to create negative stereotypes.
    My question is this: Is the situation too out of hand to have a reasonable expectation for accomidations for (for instance education,and enviroments that are more adapted to autistc chairacteristics,and vocational supports etc.)? Thats how I was hoping it could help me.
    Before they actually used the term autitic to describe me, I was never considered a nerd. The labels that were used to describe me were dumb,stupid,thick,retarded and sometimes crazy or lazy when those terms were a conveinient way to see me.The trouble with replacing those terms with autism is that while it seperates a person or some people from these labels,the seperation allows others to remain with those labels when they arent right for anyone.I dont want to escape a negative label only to validate the labels worth in describing others.That is never productive.
    I also think that overly associating autistic people with specific skills or talents may sometimes allow for people to claim that autitics who cant achieve the same things,just arent trying. There are too many variables to consider to EVER claim that a person isnt trying.Behavioral treatments for autistics certainly wont lessen with such thinking. I cant see how its ever productive.
    Maybe parents can just identify their kids as autistic so they can understand and accept them better.
    However for me, if there is no practical expectation that can come from my having the label, and the number of people with the label is furthering terrible agendas, they can consider me cured and Ill go back to being seen as someone who just cant or wont achieve much.

    By Blogger Ed, at 9:14 AM  

  • And another thing. (since Ive already gone past my opportunity to be breif) Im writing here because Im always hoping I have something to contribute as well as learn but just to clairify: I can indentify very well what the supports I need that relate to who I am as an autistic person. Getting those supports is a challenge but I know what they are and in my case they can make all the difference for me. AND I plan to shatter alot of other peoples of negative stereotypes!O.K. now Im finished.

    By Blogger Ed, at 10:11 AM  

  • Ed: You're right, labels like "retarded" shouldn't be used for anyone because they are completely negative and have no useful purposes. Joel wrote a very good post about why autistic activists should not describe other people as retarded.

    And yes, the number of people with autism spectrum labels is being used to further the claim of an epidemic, but I don't think it's possible to go back to the way things were before. There has been so much "autism awareness" propaganda in recent years, many of us couldn't "pass," even if we wanted to. And it won't be long before there are genetic tests for autism, which will make it very easy to identify us.

    Assimilation never has been a good defense against prejudice. In the early days of Nazi Germany, some people thought they were safe because they were only part Jewish and had been raised as Christians. They soon discovered how wrong they were; the Nazis even took nuns who had Jewish ancestry out of the convents and put yellow stars on their habits and sent them to the concentration camps.

    You're absolutely right that we need to keep on fighting against the negative stereotypes.

    By Blogger abfh, at 12:00 PM  

  • This comment has been removed by a blog administrator.

    By Blogger Ed, at 12:55 PM  

  • This comment has been removed by a blog administrator.

    By Blogger Ed, at 1:19 PM  

  • O.K. I think I understand better now. Thats why I deleted the last two comments.Thanks

    By Blogger Ed, at 1:39 PM  

  • I'm sorry if this post was confusing. I haven't been sleeping well for the past week, and my language skills are not at their best.

    By Blogger abfh, at 5:49 PM  

  • Ed sed:

    “O.K. social attitudes often cant be seen with accuracy.”

    Indeed…

    “So, when some people self identify themselves with the term autism, they may be doing so to connect with others who see themselves as just different rather than diseased or needing their behavior fixed.”

    Yes.

    “Unfortunatly Big Pharma and psychologist are descibing the number of people with autism in order to describe an epidemic.The claim of an epidemic goes to furthur the agendas of those selling treatments that are not only ineffective but dangerous and even deadly. It also spreads the propoganda that encourages societal injustices all the way from negative srereotypes to eugenic extermination, justification for murder, etc.”

    Well, to be fair, Ed, it’s mainly psychiatry and clinical psychology taking the behavioural expression of difference and turning it into pathology; educational psychology is (at least in theory) less likely to do that.

    “There is no way to take all the people off psychiatric meds. At least not until there is an practical alternative.”

    This would pose a problem, taking everyone off psychiatric medications. Firstly, there is the issue of whether someone actually needs the medications in the first place. Secondly, there is the issue of how someone who doesn’t need such medications ends up on them. Thirdly, there is the issue of was there a need that isn’t there now, regarding medication use. Fourthly (and this one you point out clearly), there is the issue of what would be the best practical alternative(s) to medication.

    “However, psychological evaluations dont seem practical at all.”

    I do psychological evaluations… I’ve done quite a number over the five years I spent in my postgraduate training. And – given the restriction of range of convenience that is applied to the medical model of anything that a clinical psychologist might have to get involved in when dealing with people – it is very hard to see what practical measures can actually be suggested by clinical evaluations. This is down to a focus on a medical model; purely and simply that. I’m in educational psychology, and we have this different approach: interactionistic perspectives, where influences on behaviour are found in maybe quite unexpected places. In my two research projects for my MEd, I investigated the issue of structural impediments to effective learning and to effective demonstration of learning. In the small-scale project, I looked at the incongruity of someone with clear ability to get a university degree being unable to even get to start one in a Finnish university. The thesis project examined the case of a clearly able person actually in a Higher Education Institution who was not doing well, despite the fact that he was able to learn.

    In the first case, the issue turned out to be that of Finnish entrance examinations being mostly an unreliable assessment tool and that of their also being inappropriately structured, scored, weighted and interpreted. In the second case, a huge element of the issue there was this same lack of reliability in the entrance examination and then on top of that, a whole host of organisational pathologies that conspire to create barriers faced by those who end up experiencing specific higher-educational learning difficulties. Without the inclusion of a five-level analysis of what was happening with the guy in the thesis project, it would have been a waste of my time and his doing the evaluation. As it happened, he turned out to be an Aspie, and so I made that diagnosis as a psycho-educational one, and I made it to the degree of reliability required for a research diagnosis. The diagnosis was then explained to the client in that case (yes, we work with real people educational psychology… not lab-rats): he was informed that the diagnosis was more about his situation than it was about him being ‘mad’ or anything that could be seen as being a pejorative label. In his case, he was well aware of what he couldn’t do so well, but he really did need to know what he was likely to be able to succeed in; so we looked into that in terms of the sorts of cognitive strengths that the psycho-educational assessment turned up. He’s now (on his own decision) quit the polytechnic and gone on to look at some of the options available that will help him to get to where he really wants to go with his academic career: environmental science rather than environmental engineering. The guy in the first case – given his assessment results (he had been diagnosed already as Aspie) – went on to question the local university as to what went wrong… turned out to be the book-test part of the exam (the least important in terms of knowing and understanding, since it relies only on memorising what the book says, without actually evaluating what it says). He then revised for the exam paying more attention to the book part, and got into the university.

    “They ALL seem to create negative stereotypes.”

    Sadly, this is not about psychology as much as it is about professionality and professional pride. It’s endemic in clinical psychology, given the model. In educational psychology, we should look for what there is that creates the best possible picture of the client’s abilities and needs… and I certainly do that. Sadly, I’m aware of too many in the UK and in the US who skimp on their work, and this can only be bad for the reputation of psychology and terrible for the effect it can have on the life experience of the client.

    “My question is this: Is the situation too out of hand to have a reasonable expectation for accomidations for (for instance education,and enviroments that are more adapted to autistc chairacteristics,and vocational supports etc.)? Thats how I was hoping it could help me.”

    Ah, yes… to be honest, I’d say that it is more geared to what you are looking for in the UK – at least, more so than in the US (on the basis of some of the things I’ve read and heard about how laws are being flagrantly broken by many US ‘educational businesses’ – which is what a corporate college is).

    “Before they actually used the term autitic to describe me, I was never considered a nerd. The labels that were used to describe me were dumb,stupid,thick,retarded and sometimes crazy or lazy when those terms were a conveinient way to see me.The trouble with replacing those terms with autism is that while it seperates a person or some people from these labels,the seperation allows others to remain with those labels when they arent right for anyone.I dont want to escape a negative label only to validate the labels worth in describing others.That is never productive.”

    I agree entirely. This labelling thing can be useful if – and only if – the label is going to be beneficial to the person upon whom it is placed. Labels like ‘lazy’ or ‘thick’ have no use in educational terms (although I frequently refer to JBJr as being ‘thick’; he is… he’s decided to ignore everything he did in his education and to let go of his innate intellectual ability in order to become JAFAVSSAOTI… ergo, he qualifies as per what the definition of ‘thick’ is: wilfully unable to learn). When a student gets called ‘lazy’, that should never be seen as a pathology of the student… it’s more about him/her having become demotivated, and that is another issue entirely… one which the organisation is responsible for.

    Personally, I’m of the opinion that the pejorative nature of labels used in educational settings will only disappear when medicine gets its arse out of the business of educational professionals, and when educational professionals stop deferring too willingly to medical professionals… it’s getting to the point where teachers are refusing to teach some kids without that kid going on psychotropic medication. That’s bad news, in just the same way that medicalising autism/dyslexia/etc is.

    “I also think that overly associating autistic people with specific skills or talents may sometimes allow for people to claim that autitics who cant achieve the same things,just arent trying. There are too many variables to consider to EVER claim that a person isnt trying.”

    I agree absolutely.

    “Behavioral treatments for autistics certainly wont lessen with such thinking. I cant see how its ever productive.”

    As ‘treatments’, no. Behavioural methods are efficacious, and there is a lot of evidence for them (when they are used appropriately), but they should be part of a whole package of methods/techniques combined with one purpose only: to form as naturalistic a framework as possible around that person in order to facilitate his/her development in terms of important skills (which is way different from Lovaas’ idea that he could make autistic kids ‘normal’ by shaping their behaviour; Lovaas’ work had practically fuck all to do with what Skinner was doing, and it’s actually hinted at in Ferster’s paper about being at Columbia and how Skinner treated Ferster and this other guy who – if one reads the paper between the lines – seems to be Lovaas; Skinner seems not to have liked either Ferster or Lovaas!). Proper behaviour analytical work focuses on creating an environment that uses natural reinforcements; the use of M&Ms, mist-sprays and skin-shock devices is not natural…

    “Maybe parents can just identify their kids as autistic so they can understand and accept them better.”

    If there were a less flawed explanation of autism, one that wasn’t as medicalised and as negative as the ones currently in use, that would be possible; whilst ever the main paradigm for understanding autism is medical and negativistic, that is going to remain unlikely (and that in turn makes the whole CAN/GR/ASAT type of responses to autism more likely than they ought to be).

    “However for me, if there is no practical expectation that can come from my having the label, and the number of people with the label is furthering terrible agendas, they can consider me cured and Ill go back to being seen as someone who just cant or wont achieve much.”

    Indeed… the medical nature of a label will ensure this scenario.

    “And another thing. (since Ive already gone past my opportunity to be breif) Im writing here because Im always hoping I have something to contribute as well as learn but just to clairify: I can indentify very well what the supports I need that relate to who I am as an autistic person.”

    Hell, Ed… I’ve seen what happens with ‘brief’… Nothing ‘brief’ is going to be very good… As for the contribution you hope to make… you’re doing it, man. Just by contributing to the blogs and putting in what you get from your experience and allowing it to be challenged and see how that viewpoint holds up. You make a good contribution to the debate. As for your clarification, I’m behind that notion 100%. This is what the empowerment projects are about (I’m the consultant ed-psych to one such project committee/work-group in Finland).

    “Getting those supports is a challenge but I know what they are and in my case they can make all the difference for me.”

    Agreed.

    “AND I plan to shatter alot of other peoples of negative stereotypes!O.K. now Im finished.”

    No you’re not. I think you’re only just getting started. Don’t ever be finished! ;)

    By Blogger David N. Andrews MEd (Distinction), at 8:37 PM  

  • it’s getting to the point where teachers are refusing to teach some kids without that kid going on psychotropic medication.

    That's a phenomenon people should take more notice of, and it's probably best debated in an ADHD forum or something. I get the impression that schools are forcing parents to seek ADHD diagnoses for the explicit purpose of controlling some kids who might be a bit too active and hard to deal with, through medication, specifically Ritalin.

    By Blogger Joseph, at 9:32 PM  

  • Joseph: "I get the impression that schools are forcing parents to seek ADHD diagnoses for the explicit purpose of controlling some kids who might be a bit too active and hard to deal with, through medication, specifically Ritalin."

    I think you're absolutely right. The current licensing of risperidone for autism in the States is probably a step in the same direction.

    I don't think it's the right one at all.

    By Blogger David N. Andrews MEd (Distinction), at 10:35 PM  

  • ABFH,
    I hope youll be sleeping better. This post wasnt confusing at all.
    My wife can tell you anytime I respond to something I read with all that Ive written here, its because it makes so much sense.All your post do.Thats why I try to comment.
    David,
    :) Thanks, This key board cant express....Really, Thanks.Your contribution on these blogs is really helpful. When you say all that and then tell me nothing brief is ever good....that Im making a contribution....and *Im* just getting started....Ah man, O.K. I dont give up easy.I need to understand more of what you said here. The more I learn about this stuff the more Im able to express myself and the less convienient I become for some people. Honestly, the less conveinient I become for some people, the closer I get to reaching my goals that are
    actually very productive. They really dont have to choose for it to be that way but since they do,I keep learning more and they keep liking me less.Their choice.What can I say.
    My wife knows several languages.Shes a viet nam vet. She trained as a linguist in the military.(she had to tell me that when you wrote arse and shite that they werent spelling mistakes from youre typing too fast :) Anyway the reason I bring that up is she speaks several asian languages and several european. Shes lived in several other countries.She says that Finland is on a different time zone.So Ill close.
    Alot of this is worth looking up.Im going to adapt but some educational supports will be different when I through with them.I know who Im dealing with all too well.Again it doesnt have to be this way but since they choose it, by the time Im through with them Ill be able to tell others how to get what they need and I plan to!
    If I understand this, the best place to start may be to better understand why the medical model of autism is actually conflicting with what should be educational supports but arent.My mother is a teacher and shes helping me with this.Ill get her to send me more about what test are influencing that.
    Thanks again,
    Ed

    By Blogger Ed, at 11:26 PM  

  • O.K.enough of that.Back on track. The original post said that most likely they expected Aspergers and other spectrum disorders to have similar social effects to those of ADD?ADHD which made accomidations more readily available with minimal stigma.
    Then whilst Im slowly typing and maybe getting off track, Joseph brings up the point That ADD diagnosis is being abused.Schools force parents to seek the diagnosis,then they get medicated so teachers can handle them better.
    This furthers what I was hearing ABFH saying. No matter the original intent, whats going on now?
    Theyre starting to use test to identify autistics? What for? Say it aint so!
    Educational psychology is less likely to further the the bad agendas than psychiatrist and clinical psychologist that are taking behavioral differences and turning it into pathology?
    The medication thing is just comlpletely out of hand as Joseph pointed out.My body has paid too high a price for blindly listening to doctors already.Many people have also. We need to seek solutions.
    Educational psychologist look more at intrinsic perspective? So why does the other screw up this kind of thing that can be helpful?
    It needs to be more abou structural impediments to effect learning. I can use this knowlege. (my moms reading this to help us both understand)
    Negative stereotypes is less about psychology and more about professionality and prfessional pride. I know thats true! Ive seen that.
    Demotivated? I wish someone could actually test motivation. The results would REALLY tell people something they dont understand at all!Motivated/Demotivated **** ****
    Medicine should get its arse out of the bussiness of educational professionals. Good point. I can use that I nedd to figure out how to get around those who creating diversions.
    Skinner (the founder of behavioralism) didnt even like Lovvas ABA. How messed up is that? Fester Ill have to look up to know who he is.
    The CAN/GR/SAT are test that influence who? everything? Ill have to find out how understanding that may be of practiacal use to me.

    By Blogger Ed, at 10:03 AM  

  • And another thing. Laws that are being abused by U.S. educational bussinesss. Some of that is going to stop.Mark my word.Its happening.
    And I dont have to have a degree or political power to help change it. All I have to do is know Im right and refuse to shut up about it.I am and I do.
    And it seems that a whole host of educational pathologies can conspire to create barriors faced by those experiancing higher-level learning educational difficulties difficulties. Im wondering if understanding this better can help me understand how some of the same barriors could impede progress at lower level learning(like where Im starting) as well.
    Educational psychologist have a different approach.They look at interactionist perspectives where influences on behavior are found in quite unexpected places.Im guessing this is related to the test you told me to ask you about sometime that evaluated the leaning skills of mexican street venders.

    By Blogger Ed, at 10:50 AM  

  • And ABFH,
    The frequencies is about nummbers.O.K. Now I see....Thats why the cut off point is so dangerous. Because if you seperate into those that are and those arent it ultimately creates like what was going on in Nazi Germany.If they had continued to divide people like that in Nazi Germany everyone eventually would have been targeted.
    Especially since Hitler himself was a part of the very race he intended to get rid of.
    Sorry it took me so much time and so many words to come up with that. Thats a really important point.

    By Blogger Ed, at 3:37 PM  

  • Thanks David and Ed for the excellent discussion. :)

    One more point I'd like to make: Teachers and school administrators do not have any legal authority to force parents to use medication on their kids. As I see it, they are getting very close to practicing medicine without a license when they try.

    But they often get away with it because many parents do not know their legal rights. If any parent reading these comments is being pressured to put a child on medication for behavioral reasons, please talk to a lawyer about your rights.

    By Blogger abfh, at 6:04 PM  

  • ABFH: "Teachers and school administrators do not have any legal authority to force parents to use medication on their kids. As I see it, they are getting very close to practicing medicine without a license when they try."

    Indeed. I actually reviewed a case like this in Finland! And it is practising medicine without a licence... even psychologists shouldn't do this (Yes, I'm against psychologist prescribing).

    ABFH: "But they often get away with it because many parents do not know their legal rights. If any parent reading these comments is being pressured to put a child on medication for behavioral reasons, please talk to a lawyer about your rights."

    Absolutely. And it's probably as well to fire a warning shot at the teacher via the LEA, in the form of a lawyer's letter stating clearly what will happen if certain legally permissible conditions are not met within a specified time.

    By Blogger David N. Andrews MEd (Distinction), at 12:07 AM  

  • Ed, I'll get round to replying to your post soon as I can... I'm starting a house move today. Some interesting points you raise.

    Back later.

    By Blogger David N. Andrews MEd (Distinction), at 3:02 AM  

  • This comment has been removed by a blog administrator.

    By Blogger Fore Sam, at 7:14 AM  

  • John, if all you want to do is post insults, take it somewhere else.

    By Blogger abfh, at 10:23 AM  

  • Was John-boy out having yet another go at me, ABFH? What's his problem? He's been obsessed with me for way too long now. It's actually gone beyond annoying of late.

    By Blogger David N. Andrews MEd (Distinction), at 5:26 PM  

  • Re the DSM V, here's the planning site.
    http://www.dsm5.org/index.cfm

    Last summer the group held a conference to discuss creating a category called Obsessive Compulsive Spectrum Disorder, which could include "Tourette's and other tic disorders, Sydenham's and other PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), trichotillomania, body dysmorphic disorder, hypochondriasis, autism, eating disorders, Huntington's and Parkinson's diseases, impulse control disorder (e.g., pathological gambling), and substance addictions."
    http://dsm5.org/conference10.cfm

    By Blogger Anne, at 1:22 PM  

  • Ack! Now they want to put us in the same category as gamblers, alcoholics and drug addicts?! Good grief. This certainly goes to show that many psychologists are so far removed from any semblance of reality that they could use a new diagnostic category just for themselves.

    If they do make this change, maybe it'll be enough to make people see how ridiculous their diagnostic categories are.

    By Blogger abfh, at 4:50 PM  

  • ABFH: "This certainly goes to show that many psychologists are so far removed from any semblance of reality that they could use a new diagnostic category just for themselves."

    Sad to say, but this is one reason why I dislike DSM intensely. It was suppoed to follow on behind ICD 10 but has failed to do so, and this is why we don't actually use it in Europe. Apart from that it's complete bollocks.

    ABFH: "If they do make this change, maybe it'll be enough to make people see how ridiculous their diagnostic categories are."

    Would be nice to think so, but I doubt very much that this will happen. There is a very real problem with the tack they're proposing to go on with this change for DSM V, and it is likely to lead to even more misdiagnosis than currently occurs (I wish I had figures to demonstrate misdiagnosis and how change in DSM has affected the prevalence of it; I'll look into it as soon as I can).

    By Blogger David N. Andrews MEd (Distinction), at 9:33 PM  

  • Well, I found something on misdiagnosis.
    ------------------------------
    http://en.wikipedia.org/wiki/Medical_malpractice#Statistics_on_malpractice_and_preventable_medical_error

    Statistics on malpractice and preventable medical error

    Main article: Medical error

    Medical malpractice claims can help identify areas where primary health care in the United States needs improvement, according to the American Academy of Family Physicians. The Academy refers to a study entitled "Learning from Malpractice Claims about Negligent, Adverse Events in Primary Care in the United States", in suggesting that the medical community can learn from tort claims. In that study, researchers looked at primary care malpractice claims settled between 1985 and 2000 in the United States. The study focused on a subset of 5,921 claims that were clear errors. The researchers found:

    * 68 percent of the errors were in outpatient settings and resulted in more than 1,200 deaths.
    * Negligence was more likely to have severe outcomes when they occurred in hospitals, but the total number of high severity outcomes and death was larger in the outpatient setting.
    * Of the 10 most prevalent medical conditions with error-related claims, no single condition accounted for more than five percent of all negligent claims.
    * Diagnostic error accounted for more than one-third of the claims.

    A recent study by Heathgrades found that an average of 195,000 hospital deaths in each of the years 2000, 2001 and 2002 in the U.S. were due to potentially preventable medical errors. Researchers examined 37 million patient records and applied the mortality and economic impact models developed by Dr. Chunliu Zhan and Dr. Marlene R. Miller in a study published in the Journal of the American Medical Association (JAMA) in October of 2003. The Zhan and Miller study supported the Institute of Medicine’s (IOM) 1999 report conclusion, which found that medical errors caused up to 98,000 deaths annually and should be considered a national epidemic.
    -------------------------
    A 2006 follow-up to the 1999 Institute of Medicine of the National Academies study found that medication errors are among the most common medical mistakes, harming at least 1.5 million people every year. According to the study, 400,000 preventable drug-related injuries occur each year in hospitals, 800,000 in long-term care settings, and roughly 530,000 among Medicare recipients in outpatient clinics. The report stated that these are likely to be conservative estimates. In 2000 alone, the extra medical costs incurred by preventable drug related injuries approximated $887 million -- and the study looked only at injuries sustained by Medicare recipients, a subset of clinic visitors. None of these figures take into account lost wages and productivity or other costs.

    By Blogger David N. Andrews MEd (Distinction), at 12:42 AM  

  • Well, I looked, and as to how those misdiagnosis figures would relate to DSM changes, I cannot say; didn't find anything yet to give a clue. I'll keep looking when I have a minute or 60.

    By Blogger David N. Andrews MEd (Distinction), at 4:27 AM  

  • I doubt that autistics will really end up in the same category as gamblers, alcoholics and drug addicts, but it's an interesting look at psychiatric nosology and the process of hashing out diagnostic criteria.

    By Blogger Anne, at 12:57 PM  

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