Aspergers Syndrome - Case Study Example

Psyc August 29, Asperger’s Syndrome: Opposing the Proposed DSM Revision Background Asperger’s Syndrome has been characterized as a high functioning version of autism that afflicts individuals of all ages, genders, and races although the problem needs to start in childhood for the diagnostic criteria to be met. With as many as 1 in every 1,000 individuals having the disorder, it is one of the most pervasive mental disorders in the general population (Firth 1991). The disorder is characterized by impairments in social functioning and in-depth interests. It’s been speculated that many famous individuals have exhibited traits of Asperger’s Syndrome, including Leonardo da Vinci and Albert Einstein, leading many to question the means by which it should be classified (Fattig 2008). While the disorder is widely prevalent, it has remained controversial among researchers. Asperger’s Syndrome has been characterized as a pervasive developmental disorder (PDD). These are psychological disorders that affect social functioning. These disorders also affect the individual’s thought processes, and this is seen in Asperger’s Syndrome as many patients diagnosed with the disorder exhibit very involved interests, often for short periods of time before moving on to another interest (NINDS 2007). While Hans Asperger first noted these characteristics in 1944, it wasn’t until nearly fifty years later that this complex of symptoms became an official diagnosis (Kilin 2006). Today psychologists continue to debate the exact classification of the disorder, with some researchers contending it is a disorder unto itself, while others contend that it is a version of high-functioning autism (H.F.A.) and argue that it should not be considered a separate disorder, but should instead be included on the autism spectrum. Still, others argue that it isn’t a disorder at all and rather a personality characteristic; these individuals point to the number of highly productive and famous individuals with the disorder and assert that its existence this late in the scale of human evolution indicates that a number of traits associated with Aspergers are actually beneficial to humanity (Clarke 2007). Proponents for the Proposed Revision to the DSM-V While Asperger’s Syndrome is currently classified as a separate mental disorder, there are formal propositions for the Diagnostic and Statistical Manual of Mental Disorders (DSM)-V to alter the classification so that it is known as a version of high-functioning autism (Carey 2010). Ultimately, classification criteria for Asperger’s Syndrome are a relatively recent phenomenon. It wasn’t until 1981 that Lorna Wing popularized the term Asperger’s Syndrome in a number of scientific papers, and only in 1991 were these papers translated into English and popularized among the United States medical community (Baskin 2006). Since then it has remained a uniquely classified disorder. Thus, there is recent precedent for significant classification changes to be made in regards to the disorder. Its recent adoption in the scientific community leads some to believe that the disorder hasn’t been fully understood in the past and its reclassification is appropriate due to additional evidence that has led to a fuller understanding of where Asperger’s Syndrome belongs. Some individuals argue that to more accurately diagnose Asperger’s Syndrome there needs to be a more specific classificatory process. The disadvantage of leaving Asperger’s Syndrome as a vaguely defined disability within the DSM, it is argued, is that this further perpetuates misdiagnosis and subsequent improper treatment. This argument proceeds that Asperger’s and Autism are fundamentally linked and it would thus be more appropriate to classify Asperger’s Syndrome as belonging to the Autism spectrum. What has been determined is that Asperger’s Syndrome has many traits associated with Autism Spectrum Disorder. Ultimately, this argument is extremely simple in that it contends that the similarities between Asperger’s Syndrome and Autism mean they should be classified together. Why Revising Asperger’s Syndrome in the DSM-V is Ultimately Misguided Even as there are significant reasons for the proposed DSM revision, a careful consideration of both sides of the argument reveals that revising Asperger’s Syndrome to fall into the category Autism Spectrum Disorder is misguided. While there are tremendous similarities, there are also elements that distinguish Asperger’s Syndrome from traditional Autism and these distinctions form a significant enough boundary that the logistic and diagnostic effects of including Asperger’s as an individual diagnosis outweigh the categorization benefits that would be gained from including it along the Autism Spectrum. Autism is generally characterized by severe social dysfunction and mental retardation; while those diagnosed with Asperger’s Syndrome exhibit social problems, in most instances they are able to lead functioning lives, and remain employable for long periods. There is also typically normal language acquisition, and the capability to maintain regular familial relations. Other salient distinguishing features between individuals with Asperger’s Syndrome and those with Autism are consistently higher IQ rates among individuals with Asperger’s Syndrome than those with Autism Spectrum Disorder. In terms of treatment options, individuals with Asperger’s Syndrome stand in stark contrast to those requiring more complex care and attention requisite of an Autism Spectrum Disorder. While this isn’t true of all people with Autism Spectrum disorder, the symptoms are markedly unique within Asperger’s Syndrome patients such that an entirely unique category has developed to distinguish it from other forms of high functioning autism. In these regards, it should continue to be kept separate. While Autism has no medical ‘cure’, the high levels of dysfunction, including delayed speech and motor skills, are such that it requires more stringently arranged medical practices; such treatment, includes high dosages of Selective Serotonin Reuptake Inhibitors (SSRIs) and substantial cognitive and behavioral therapy (‘Treatment for Autism, Autism Prognosis’ 2000). The risk of grouping individuals with Asperger’s Syndrome into the Autism Spectrum involves the possibility for over-treatment and over-compensation for a personality idiosyncrasy that is neither significantly disabling nor arguably even markedly different from typical neurological functioning. In this regard, it’s clear that there is a need for a separate categorization of Asperger’s to aid in its diagnosis, as grouping the two disorders as one runs the risk of overcompensation in treatment, as well as creating an inordinate sense of helplessness in individuals that possess the ability to live full and entirely functional lives. Arguing that the treatment should be tailored to the unique needs of the patients is a noble claim, but in practice psychiatric diagnosis is often influenced by DSM-V categorization and as such it’s highly important to make certain that disorders are classified as accurately as possible. Especially compelling are reports that individuals have been understood to ‘grow’ out of Asperger’s Syndrome (Wallis 2009). Studies show that as many as 20% of individuals diagnosed with Asperger’s Syndrome in childhood no longer met the criteria as adults (Wallis 2009). It’s with this understanding that too stringently linking Asperger’s Syndrome with Autism Spectrum Disorder can potentially further compel individuals with such social impairment to believe that their condition is a core part of their being rather than learning and formulating the social skills necessary to live more functional lives. Another important consideration is the relative levels of stigma that are associated with a diagnosis of Autism Spectrum Disorder compared with Asperger’s Syndrome. Currently, Autism Spectrum Disorder has the connotation of being a form of mental retardation among the general public, with many individuals not wanting to admit to possessing Autism. Asperger’s Syndrome affects individuals of all genders and races, with the disorder slightly more prevalent in males than females. Estimates of the number of individuals with Asperger’s vary with different reports placing the figure at .26 per 1,000 individuals to as high as 4.28 to every 1,000, general figures estimate the number of be around 1 to every 1,000 members of the population with Asperger’s Syndrome (Klinn 2006). These statistics are relevant because with such a relatively common rate of diagnosis, Asperger’s Syndrome has become an accepted characteristic among members of the population. Still, the issue isn’t one of a battle between disorder frequencies, indeed Autism Spectrum Disorder ultimately has higher rate of diagnosis, but a simple one of perception of a large segment of the population – 1 to every 1,000 members – that does have Asperger’s Syndrome, many of which would refrain from openly accepting a diagnosis of Autism. Consider, a 2009 movie titled Adam depicted an individual with Asperger’s Syndrome in a romantic context and highly functional light; in more stringently linking Asperger’s Syndrome to Autism, Asperger’s patients believe that the previous public perceptions of the disorder would be too firmly linked and altered towards the general public’s perception of Autism. Through personal experience and intimate connections with Asperger’s Syndrome patients this sentiment has been understood first hand. This argument has also been noted in recent articles on perception of Asperger’s Syndrome (Adams 2010). While many psychiatrists and researchers may not agree with this argument, it is a fact of public perception that labeling affects perception, of which DSM-V categorization indirectly contributes. Similarly, large support groups of individuals with Asperger’s Syndrome have organized; referring to themselves as ‘aspies’, these individuals are oftentimes proud of their diagnosis of Asperger’s Syndrome. It follows that changing the diagnostic categorization from Asperger’s Syndrome to Autism Spectrum Disorder would result in a decreased number of individuals willing to readily admit to possessing the disorder, a fact that would result in fewer individuals seeking treatment options. The point is that these individuals would be less willing to accept their categorization as Autistic. Conclusion It is necessary to recognize the symptoms of Asperger’s Syndrome as they can pose a significant challenge for the individual and the individual’s family. The patient’s lack of empathy and intense interests can pose a social challenge for family members, and by recognizing these challenges in the individual, family members can aid them in alleviating their social discomfort. While there is no outright cure for the disorder, with the understanding family members, medicine, and a positive and proactive approach to life the individual can in most instances live a full and happy existence. It’s for these reasons it is important for all people to be open and accepting of Asperger’s Syndrome, and altering the diagnostic criteria to fall under Autism Spectrum Disorder runs the risk of creating misdiagnosis and increasing stigma. Works Cited Adams, H. (2010) ‘DSM-V: Aspergers Syndrome to Be Eliminated; Some Aspies Upset.’ http://www.associatedcontent.com/article/2695965/dsmv_aspergers_syndrome_to_be_eli min ated.html Asperger H; tr. and annot. Frith U (1991) [1944]. "Autistic psychopathy in childhood". in Frith U. Autism and Asperger syndrome. Cambridge University Press. pp. 37–92. Baskin JH, Sperber M, Price BH (2006). "Asperger syndrome revisited". Rev Neurol Dis 3 (1): 1–7. Carey, B. "Revising Book on Disorders of the Mind ." New York Times 10 Febraury 2010. Clarke J, van Amerom G (2007). "Surplus suffering: differences between organizational understandings of Aspergers syndrome and those people who claim the disorder". Disabil Soc 22 (7): 761–76. Fattig, M. (2008) ‘Famous People with Asperger’s Syndrome. Disabled Word. http://www.disabled-world.com/artman/publish/article_2086.shtml Klin A (2006). "Autism and Asperger syndrome: an overview". Rev Bras Psiquiatr 28 (suppl 1): S3–S11. National Institute of Neurological Disorders and Stroke (NINDS) (2007-07-31). "Asperger syndrome fact sheet". http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm. Piven J, Palmer P, Jacobi D, Childress D, Arndt S (1997). "Broader autism phenotype: evidence from a family history study of multiple-incidence autism families" (PDF). Am J Psychiatry 154 (2): 185–90. PMID 9016266. http://ajp.psychiatryonline.org/cgi/reprint/154/2/185.pdf.  ‘Treatment for Autism, Autism Prognosis’ (2000). HealthCommunities.com. http://www.neurologychannel.com/autism/treatment.shtml Wallis C (2009-11-02). "A powerful identity, a vanishing diagnosis". The New York Times. http://www.nytimes.com/2009/11/03/health/03asperger.html. Read More