4 ms·

So, a big thing about mental health diagnoses in general is that they have two components: an identifiable behavioral difference from neurotypical baseline, and

So, a big thing about mental health diagnoses in general is that they have two components: an identifiable behavioral difference from neurotypical baseline, and enough difficulties and social conflict in their life that mental health professionals end up getting involved. The second part is important to keep in mind - people who are like Bill Gross and wind up happily married and running a highly successful bond fund simply do not get diagnosed at nearly the rate as an eleven year old who cannot go through a school day without a screaming meltdown. This is especially important when it comes to identifying genetic correlations with autism, since anything that negatively impacts overall functioning is going to wind up positively correlated with autism diagnoses. Nobody sane is going to argue that having an itchy skin condition means that you're more autistic, but an autist with itchy skin is more likely to have enough behavioral issues in school to meet the threshold for a mental health referral. To summarize my point, there's all sorts of genetic stuff that will end up completely unrelated with being autistic, but will end up correlated with getting diagnosed as autistic. This is because merely being neuro-atypical is not enough to get a mental health diagnosis, you need to combine it with enough life difficulties and social conflict to drive the bureaucratic machinery involved with producing a diagnosis.

psychphysic 4y ago
Excellent point well said. It's part of why I find the neurodivergency movement likely harmful. It's the functional impairment that defines disease. Traits which help classify the disease if one is present are present in those without disease. Shifting the definition from functional impairment to those traits is not a good thing.
- NoahKAndrews 4y ago
  Just because you're able to get through life doesn't mean there's not a lot of value in understanding yourself better.
  - psychphysic 4y ago
    If by understand yourself you mean pretend to have a diagnosable condition then there is something wrong. Claiming to have autism with no detectable impairment is like me claiming to be blind because despite having 6/6 vision (i.e. normal) because that's is actually worse than average vision for my age group (6/5 is average healthy young adult vision).
sdwr 4y ago
Great point, really well said. I don't want to go too far into the weeds on this, but mental illness in general is socially-defined and situation-dependent. Not to say it's not real, but it's affected by observation/treatment in a way that physical stuff isn't.
h0l0cube 4y ago
> To summarize my point, there's all sorts of genetic stuff that will end up completely unrelated with being autistic, but will end up correlated with getting diagnosed as autistic. It would be interesting to see, of the people that share these de-novo mutations, who have the genotypes, but not the phenotypes – or see if some people have been treading water as undiagnosed autistic their whole life and give them some insight as to why navigating a neurotypical world is so difficult for them.
cromulent 4y ago
Good point. The number of diagnoses is also bound by mental health service capacity, which suggests that whilst in the past only very severe cases would be diagnosed, now many more are (as funding increases [1]). The nature of health care also means that some of these conditions are "middle class" diseases, meaning that if you have the money to spend you can get diagnosed more quickly. There is some evidence of abuse of this, where wealthy parents get their children diagnosed in order to get school exams re-taken, etc. In general though, the diagnoses are spreading from the most severe to the middle of the range. For those neurodiverse who can manage reasonably well in society by presenting well behaviourally, knowing ones own neurotype can be incredibly helpful, even if you do not take any further action after the diagnosis. 1. https://www.statista.com/statistics/252393/total-us-expenditure-for-mental-health-services/ https://www.statista.com/statistics/252393/total-us-expendit...
- paraph1n 4y ago
  > knowing ones own neurotype How does one going about finding their neurotype?

psychphysic 4y ago

Excellent point well said. It's part of why I find the neurodivergency movement likely harmful. It's the functional impairment that defines disease. Traits which help classify the disease if one is present are present in those without disease. Shifting the definition from functional impairment to those traits is not a good thing.

NoahKAndrews 4y ago
Just because you're able to get through life doesn't mean there's not a lot of value in understanding yourself better.
- psychphysic 4y ago
  If by understand yourself you mean pretend to have a diagnosable condition then there is something wrong. Claiming to have autism with no detectable impairment is like me claiming to be blind because despite having 6/6 vision (i.e. normal) because that's is actually worse than average vision for my age group (6/5 is average healthy young adult vision).

sdwr 4y ago

Great point, really well said. I don't want to go too far into the weeds on this, but mental illness in general is socially-defined and situation-dependent. Not to say it's not real, but it's affected by observation/treatment in a way that physical stuff isn't.

h0l0cube 4y ago

> To summarize my point, there's all sorts of genetic stuff that will end up completely unrelated with being autistic, but will end up correlated with getting diagnosed as autistic. It would be interesting to see, of the people that share these de-novo mutations, who have the genotypes, but not the phenotypes – or see if some people have been treading water as undiagnosed autistic their whole life and give them some insight as to why navigating a neurotypical world is so difficult for them.

cromulent 4y ago

Good point. The number of diagnoses is also bound by mental health service capacity, which suggests that whilst in the past only very severe cases would be diagnosed, now many more are (as funding increases [1]). The nature of health care also means that some of these conditions are "middle class" diseases, meaning that if you have the money to spend you can get diagnosed more quickly. There is some evidence of abuse of this, where wealthy parents get their children diagnosed in order to get school exams re-taken, etc. In general though, the diagnoses are spreading from the most severe to the middle of the range. For those neurodiverse who can manage reasonably well in society by presenting well behaviourally, knowing ones own neurotype can be incredibly helpful, even if you do not take any further action after the diagnosis. 1. https://www.statista.com/statistics/252393/total-us-expenditure-for-mental-health-services/ https://www.statista.com/statistics/252393/total-us-expendit...

paraph1n 4y ago
> knowing ones own neurotype How does one going about finding their neurotype?