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The Problem With Incidence

NotHardUp1

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Definitions matter.

And they matter even more in the culture wars. As the U.S. is either confirming Kennedy as HHS Secretary or not, many will HEAR the topic of autism bandied about, but won't know anything more about it than they did before Trump's turd hit the punchbowl.

This is one online article that helps lay out the progression and its effects:


The problem is that lay people tend to think of diseases and syndromes as finite and well-defined. If you have measles, you have symptoms that identify the disease by their characteristics. But when you have a cognitive or behavioral disorder, the boundaries are often less rigid, and some discernment and evaluation may cause disagreement about what the syndrome actually is as well as who qualifies to be within a diagnostic grouping.

With autism, the definition has been steadily evolving since it was initially described in the late 19th century. It became a term in the 1940's to describe what was then perceived as "childhood schizophrenia". The family of symptoms was formalized in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in the early 1950's. As that manual has been updated over the decades and republished, the requirements to diagnose autism have broadened. Today, fewer symptoms and requirements are allowed to be present to enable a case to be categorized as autism. This has greatly expanded the number of autism cases in the population, a sort of instant explosion of statistical incidence.

As much as I regard psychiatry to be best informed about their field, it is still worth mentioning that homosexuality wasn't removed from the DSM until 1973.

Unsurprisingly, broadcast media doesn't address this more subtle aspect of incidence. If anything, they intentionally remove context and incidence from news.

And, when some social or behavioral offense like homophobia, #metoo, hate speech, or even reported anti-Semitism or racism is reported, there isn't any objective standard for evaluating changes in incidence when they occur.

The internet expanded the ability to "publish" statements via social media. If some throwback posts a comment blaming Jews for the economic collapses of 2007, and it gets republished or repeated in 10 or 10 million other sites, is it an increase in "hate speech", or it is just a Hall of Mirrors where every reflection counts as another instance?

If advocate groups can also champion a constituency to report more about any problem, then is that something objectifiable or statistically significant if it is a campaign to affect policy and influence perception?

This ramble circles back to say that we again have the confluence of a populace's disinterest in learning combining with the influence of "desktop publishing" to influence huge numbers of viewers with short attention spans. And eventually, with the law of large numbers, one of them becomes president, prime minister, or Secretary of Health and Human Services.

There is also thte problem of thousands, even millions, of individuals self-identifying as "on the spectrum" when they would NEVER qualify under a clinical diagnosis of autism. So, the apparent incidence becomes exaggerated through implication in imputing it.

Our societies started down this path in the 1950's through the 1970's, as the undermining of the status quo elevated anti-authoritarianism. This progressed via the internet to the growth of a sort of false egalitarianism of ideas, givinig ridiculous conspiracy theories a cachet of being clever by having insight to what authorities are "up to".

The question becomes how to fix stupid, and I do not mean that to refer to any autism.
 
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(paraphrased)

If some [entity] posts [hate speech], and it gets republished or repeated in 10 or 10 million other sites, is it an increase in "hate speech", or it is just a Hall of Mirrors where every reflection counts as another instance?

Every act of violence, whether physical, verbal, or posting online is nonetheless an incident. The origin(s) of the hate does not diminish the act of its replication or promotion.
 
Every act of violence, whether physical, verbal, or posting online is nonetheless an incident. The origin(s) of the hate does not diminish the act of its replication or promotion.
That gets to the core of the issue. If one person's speech is replicated over and over, is there really more hate in the world?

Acts, not words, should carry more weight than rhetoric does. Policing speech that doesn't not directly engender violent acts is a self-defeating proposition. The laws in Canada and Great Brittain are bringing about their own reactionary backlash, increasing some other website rather than governing it or reducing it. Outlawing speech is no better than book banning.

As with the autism proliferation, is there more autism simply because the bar was lowered and more marginal behaviors are swept into the bucket?
 
Every act of violence, whether physical, verbal, or posting online is nonetheless an incident. The origin(s) of the hate does not diminish the act of its replication or promotion.
The intent is the same whether you’re authoring yourself or if you’re reposting. In both cases you’re intending to send out a hateful message.

I can’t believe that was even a question.
 
One hater equals one hater. If the same hate is repeated and embraced by a million people, that's the same hate a million times. Yes, that's more hate in the world. Hate is a conscious choice made by an individual. Autism is not a conscious choice. Identifying more autistic people does not increase autism. This is a false equivalency.

I fail to understand how a torrent of hate, lies, bigotry, disinformation, conspiracy frauds, and fascist Nazi propaganda, is being compared to a greater understanding of autism and how it impacts those of us affected.

What evidence is there that those self-identifying as being autistic would not qualify for a clinical diagnosis? There are plenty of resources available now and plenty of evaluations that can be found online that give indications of autism. They're the same evaluations used by clinicians. It is a long, expensive, difficult process to even get an appointment with someone who can evaluate autism for an "official diagnosis". It is mostly not covered by insurance and not available.

I find this whole screed rather offensive, actually.
 
As much as I regard psychiatry to be best informed about their field, it is still worth mentioning that homosexuality wasn't removed from the DSM until 1973.
And even then, I think it was probably a controversial move. I remember seeing a debate on marriage equality that was originally aired not long after that. I don't remember it, but I do recall noting at the time that a lot of the stupid arguments of the 1970s were still being used decades later. And one person--a psychiatrist, I think--had some feeling that being gay would be considered a problem in future editions of the DSM. Or something like that.
 
What evidence is there that those self-identifying as being autistic would not qualify for a clinical diagnosis?

It's been a speculation with me whether I'm somewhere on the autism spectrum (specifically, if the label were still officially used, Asperger's). A psychologist had told me point blank he thinks autism is a strong possibility for me. But he values accuracy, and he doesn't have enough evidence to support that diagnosis. I think he indicated it's childhood information.
 
It's been a speculation with me whether I'm somewhere on the autism spectrum (specifically, if the label were still officially used, Asperger's). A psychologist had told me point blank he thinks autism is a strong possibility for me. But he values accuracy, and he doesn't have enough evidence to support that diagnosis. I think he indicated it's childhood information.

It's not just childhood information.

 
The intent is the same whether you’re authoring yourself or if you’re reposting. In both cases you’re intending to send out a hateful message.

I can’t believe that was even a question.
I have no problem believing it. When we discuss Israel's war and atrocities in the Levant, anything said anti-Israel can be exaggereated to be anti-Semitic. The opposittion to the state of Israel's policies, or even its existence, is not tantamount to hating Jews, or fearing an internatitonal Jewish lobby that influences economies, governmets, and policies.

Every time I have mentioned visiting synagogues with my late friend, or others I have socialized with, I have never felt nor expressed animus against Jewish people nor even regarded them as a race as much as a religion. Yet in the thread about the Israeli Hamas War, I was contacted by a Jewish member here who instantly threatened me via private message and called me an anti-Semite. He as much as swore a vendetta. We had never had a cross word for probably ten years on the forums together, quite the contrary.

Yet he viewed anti-Israel politics as anti-Semitic. How many times is that mischaracterization repeated across the internet, and even reported to the Anti-Defamation League and others as "hate speech".

This whole game of guilt by accusation is as big an evil as the forces it opposes, as it squelches reason with hysteria and hyperbole. In the case of Jewish interactions, there isn't even a word in common use to describe the reverse animus if a Jewish sect posts slander against Arabs, or non-Jews.

As overt sectarian violence recedes in the U.S., there seems to be an attempt to redefine racism to a thought crime, which would feed this guilt by accusation trend that has been adopted now for at least a decade in the gotcha game.

In many ways, our society is more egalitarian and mixed than it ever has been in its five centuries, yet shrill voices still clamor that its worse when it is manifestly obvious that it is not.

Is there greater wealth disparity than ever before? Absolutely, but it is hardly only visited upon minorities.

And the incidence of all sorts of things is avoided to refocus attention on the exceptions, not the rules of what average citizens actually experience. It's true of autism. It's true of gun violence. It's true of gays, transexuals, and many other groups selectively cited.
 
It's not just childhood information.

As I best recall--and just speaking about my personal situation--the psychologist did indicate an issue with diagnosing me was some lack of childhood information. A MA level therapist said something similar. I think if an on-line quiz was adequate, both could have either referred me to such a quiz, or been able to diagnose (or rule the possibility of ASD out).
 
As I best recall--and just speaking about my personal situation--the psychologist did indicate an issue with diagnosing me was some lack of childhood information. A MA level therapist said something similar. I think if an on-line quiz was adequate, both could have either referred me to such a quiz, or been able to diagnose (or rule the possibility of ASD out).

The quizes are just a place to start. Sorry to have bothered you then.
 
The quizes are just a place to start. Sorry to have bothered you then.
No bother. And I'm sorry if I seem to get a bit cranky--the whole "maybe/maybe not--we can't say for sure!" thing has been frustrating at times.

I have done some sort of on-line quiz in the past, which suggests "possible." But a firm answer one way or the other would be nice.
 
I have done some sort of on-line quiz in the past, which suggests "possible." But a firm answer one way or the other would be nice.
Was that something a clinic or doctor created? It just sounds like more of the self-diagnosis trend that has permeated ADHD, bipolarism, Asperber's, autism, fibromyalgia, and others.
 
Was that something a clinic or doctor created? It just sounds like more of the self-diagnosis trend that has permeated ADHD, bipolarism, Asperber's, autism, fibromyalgia, and others.

Follow the link I posted.
 
Was that something a clinic or doctor created? It just sounds like more of the self-diagnosis trend that has permeated ADHD, bipolarism, Asperber's, autism, fibromyalgia, and others.
It's been a long time since I did that on-line quiz, so i can't remember who created it. But it was on-line, and I assume that it probably looked at the time legitimate. It was something for self diagnosis that i found myself.
 
And it can be noted that even professional diagnosis could be problematic... The psychologist who won't diagnose me one way or the other has also ranted a bit about valuing accuracy in diagnosis--and how it something that only one other person (also a psychologist) in the office values.
 
And it can be noted that even professional diagnosis could be problematic...
100%

My criticism is for those who have never gotten professional analysis and try arm-chair self-diagnosis.

As I shared a few years back, I found night and day difference between my two counselors in 2016 & 2017. That said, it is easy to go astray on the basis of a couple of symptoms, in both mental health and medical. Doctors can also misdiagnose based on too few questions, too little interest, bias against a class of patients, symptoms that do not present in a familar manner, and confirmatiton bias.

The patient can do all that, too, and then some. The main thing for a patient is to insist on getting the service and treatment you deserve, which can be literally impossible with our system and limited access.
 
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