3 ms·

The criteria for diagnosing ASD today are vastly different from those that would’ve resulted in an autism diagnosis shortly after the abolishment of lobotomy, i

The criteria for diagnosing ASD today are vastly different from those that would’ve resulted in an autism diagnosis shortly after the abolishment of lobotomy, it is hardly surprising the rate keeps going up as you widen the net.

NomDePlum 2y ago
What's the link between ASD and lobotomies?
- cma 2y ago
  I think he's just trying to choose a point in time when mental healthcare was more primitive to go along with saying the diagnosis is more sophisticated now. A main thing is that people with autism would just be classified as generally mentally disabled and the rise in autism is highly tied a drop in that general diagnosis. I don't think that covers 100% of the rise but does seem to make up the big majority. U.S. special-education autism classification was created in 1994 and tied to a big rise in diagnosis. https://news.wisc.edu/data-provides-misleading-picture-of-autism/ https://news.wisc.edu/data-provides-misleading-picture-of-au...
  - NomDePlum 2y ago
    Thanks. That helps.
- viraptor 2y ago
  Progress of understanding.
  - NomDePlum 2y ago
    Sorry, still not that clear to me. Are you saying that there is no direct link but rather understanding of various areas increased due to the stopping of this practice?
    - deleted 2y ago
      [deleted]
    - viraptor 2y ago
      We understood more about various conditions and treatments, so we stopped doing harmful things like lobotomies and refined the definitions on some conditions as needed. Those are not directly related though.
    - ang_cire 2y ago
      > understanding of various areas increased due to the stopping of this practice Yes, this absolutely. You can't study something after altering it. The "treatments" for people with any kind of neurodivergence (real, or imagined) in the past were often interventions that destroyed enough of their brain or body to prevent them from exhibiting any neurodivergent symptoms (e.g. lobotomy, EST/ECT, teeth-pulling[1], etc). [1]: https://www.amusingplanet.com/2019/01/henry-cotton-psychiatrist-who-tried-to.html https://www.amusingplanet.com/2019/01/henry-cotton-psychiatr...
    - tsimionescu 2y ago
      There is no direct link, but the point is that an increasing trend in diagnosis of ASD is not surprising when the baseline is coming from a time when doctors thought cutting out parts of your brain to make you more calm was a good idea. Basically, we shouldn't look at numbers reported by doctors willing to perform lobotomies for depression as a reliable indicator of the incidence of ASD in the population at the time.
jampekka 2y ago
This is a huge factor, in ASD and in mental/behavioral issues in general. Not saying it's a bad thing but it makes comparison over time to be apples to oranges.
chiefalchemist 2y ago
Yes, but is that a feature or a bug? Certainly those who define these things understand the need and value of historic tracking. And yet the target keeps moving. If expanding the definition is the feature required action should be taken to mitigate the bug. True?
mschuster91 2y ago
> The criteria for diagnosing ASD today are vastly different Not that much. The difference between now and 50 years ago is that a) we don't just throw them into asylums, b) we actually have accessibility of getting diagnosed, c) employment opportunities suitable for many people with mental disabilities (such as factory line assembly) have gone down the drain.
- AlecSchueler 2y ago
  None of those points are related to diagnostic criteria.
  - crote 2y ago
    No, they are related to the pool of people being diagnosed. You're only getting a diagnosis if a) you have access to a psychiatrist and b) you are running into enough issues in your daily life to warrant having it looked into. Life has gotten a lot more complex over the past few decades, so people run into issues more often - and earlier in life. Someone who would've just been "a bit of a weird guy" 50 years ago is getting an autism diagnosis today, simply because these days they run into issues as a child and are being put in front of a psychiatrist.
    - dns_snek 2y ago
      Even 50 years ago they weren't just slightly odd people who were otherwise happy to exist in a simpler society. Those people ran into the same issues and turned to alcohol, drugs, and suicide. The only difference is that nobody understood why they were suffering.
- dns_snek 2y ago
  > Not that much. Very much so. What we now call Autism Spectrum Disorder was referred to as "childhood schizophrenia" in the DSM-2 [1], things only started moving in the right direction with the DSM-3 [2] when it was finally sort-of recognized as an independent disorder of "infantile autism", but some core elements of ASD like sensory processing differences were only recognized in the DSM-5. There's a good overview at [3]. It's good that criteria are different today, the criteria from decades ago failed to include majority of ways that autism expresses itself, many of which benefit from support and accommodations even though they're not obviously debilitating. [1] https://www.madinamerica.com/wp-content/uploads/2015/08/DSM-II.pdf https://www.madinamerica.com/wp-content/uploads/2015/08/DSM-... [2] https://aditpsiquiatriaypsicologia.es/images/CLASIFICACION%20DE%20ENFERMEDADES/DSM-III.pdf https://aditpsiquiatriaypsicologia.es/images/CLASIFICACION%2... [3] https://pmc.ncbi.nlm.nih.gov/articles/PMC8531066/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8531066/
jsheard 2y ago
> shortly after the abolishment of lobotomy That's an important bit of context whenever RFK Jr. talks about how conditions like Autism and ADHD weren't a thing when he was growing up - his own aunt, who may well have had one of those conditions, was dealt with by giving her a lobotomy and then hiding her away. Those are the supposedly better times he's harkening back to. https://en.wikipedia.org/wiki/Rosemary_Kennedy https://en.wikipedia.org/wiki/Rosemary_Kennedy
- ekianjo 2y ago
  Lobotomy was not given to young children even when it was a thing...
  - RacingTheClock 2y ago
    In this case lobotomy was put on a non consenting 23 year old. So much better?
  - shepherdjerred 2y ago
    > who was one of the youngest survivors of the transorbital lobotomy, a procedure performed on him when he was 12 years old. https://en.wikipedia.org/wiki/Howard_Dully https://en.wikipedia.org/wiki/Howard_Dully
    - ekianjo 2y ago
      You can detect autism in kids before they are 5... So my point still stands
StefanBatory 2y ago
Also... the picture of left-handed people would fit in here. https://slowrevealgraphs.com/2021/11/08/rate-of-left-handedness-in-the-us-stigma-society/ https://slowrevealgraphs.com/2021/11/08/rate-of-left-handedn... The very much same applies here I think.
- MisdiagnosedMan 1y ago
  [dead]

NomDePlum 2y ago

What's the link between ASD and lobotomies?

cma 2y ago
I think he's just trying to choose a point in time when mental healthcare was more primitive to go along with saying the diagnosis is more sophisticated now. A main thing is that people with autism would just be classified as generally mentally disabled and the rise in autism is highly tied a drop in that general diagnosis. I don't think that covers 100% of the rise but does seem to make up the big majority. U.S. special-education autism classification was created in 1994 and tied to a big rise in diagnosis. https://news.wisc.edu/data-provides-misleading-picture-of-autism/ https://news.wisc.edu/data-provides-misleading-picture-of-au...
- NomDePlum 2y ago
  Thanks. That helps.
viraptor 2y ago
Progress of understanding.
- NomDePlum 2y ago
  Sorry, still not that clear to me. Are you saying that there is no direct link but rather understanding of various areas increased due to the stopping of this practice?
  - deleted 2y ago
    [deleted]
  - viraptor 2y ago
    We understood more about various conditions and treatments, so we stopped doing harmful things like lobotomies and refined the definitions on some conditions as needed. Those are not directly related though.
  - ang_cire 2y ago
    > understanding of various areas increased due to the stopping of this practice Yes, this absolutely. You can't study something after altering it. The "treatments" for people with any kind of neurodivergence (real, or imagined) in the past were often interventions that destroyed enough of their brain or body to prevent them from exhibiting any neurodivergent symptoms (e.g. lobotomy, EST/ECT, teeth-pulling[1], etc). [1]: https://www.amusingplanet.com/2019/01/henry-cotton-psychiatrist-who-tried-to.html https://www.amusingplanet.com/2019/01/henry-cotton-psychiatr...
  - tsimionescu 2y ago
    There is no direct link, but the point is that an increasing trend in diagnosis of ASD is not surprising when the baseline is coming from a time when doctors thought cutting out parts of your brain to make you more calm was a good idea. Basically, we shouldn't look at numbers reported by doctors willing to perform lobotomies for depression as a reliable indicator of the incidence of ASD in the population at the time.

jampekka 2y ago

This is a huge factor, in ASD and in mental/behavioral issues in general. Not saying it's a bad thing but it makes comparison over time to be apples to oranges.

chiefalchemist 2y ago

Yes, but is that a feature or a bug? Certainly those who define these things understand the need and value of historic tracking. And yet the target keeps moving. If expanding the definition is the feature required action should be taken to mitigate the bug. True?

mschuster91 2y ago

> The criteria for diagnosing ASD today are vastly different Not that much. The difference between now and 50 years ago is that a) we don't just throw them into asylums, b) we actually have accessibility of getting diagnosed, c) employment opportunities suitable for many people with mental disabilities (such as factory line assembly) have gone down the drain.

AlecSchueler 2y ago
None of those points are related to diagnostic criteria.
- crote 2y ago
  No, they are related to the pool of people being diagnosed. You're only getting a diagnosis if a) you have access to a psychiatrist and b) you are running into enough issues in your daily life to warrant having it looked into. Life has gotten a lot more complex over the past few decades, so people run into issues more often - and earlier in life. Someone who would've just been "a bit of a weird guy" 50 years ago is getting an autism diagnosis today, simply because these days they run into issues as a child and are being put in front of a psychiatrist.
  - dns_snek 2y ago
    Even 50 years ago they weren't just slightly odd people who were otherwise happy to exist in a simpler society. Those people ran into the same issues and turned to alcohol, drugs, and suicide. The only difference is that nobody understood why they were suffering.
dns_snek 2y ago
> Not that much. Very much so. What we now call Autism Spectrum Disorder was referred to as "childhood schizophrenia" in the DSM-2 [1], things only started moving in the right direction with the DSM-3 [2] when it was finally sort-of recognized as an independent disorder of "infantile autism", but some core elements of ASD like sensory processing differences were only recognized in the DSM-5. There's a good overview at [3]. It's good that criteria are different today, the criteria from decades ago failed to include majority of ways that autism expresses itself, many of which benefit from support and accommodations even though they're not obviously debilitating. [1] https://www.madinamerica.com/wp-content/uploads/2015/08/DSM-II.pdf https://www.madinamerica.com/wp-content/uploads/2015/08/DSM-... [2] https://aditpsiquiatriaypsicologia.es/images/CLASIFICACION%20DE%20ENFERMEDADES/DSM-III.pdf https://aditpsiquiatriaypsicologia.es/images/CLASIFICACION%2... [3] https://pmc.ncbi.nlm.nih.gov/articles/PMC8531066/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8531066/

jsheard 2y ago

> shortly after the abolishment of lobotomy That's an important bit of context whenever RFK Jr. talks about how conditions like Autism and ADHD weren't a thing when he was growing up - his own aunt, who may well have had one of those conditions, was dealt with by giving her a lobotomy and then hiding her away. Those are the supposedly better times he's harkening back to. https://en.wikipedia.org/wiki/Rosemary_Kennedy https://en.wikipedia.org/wiki/Rosemary_Kennedy

ekianjo 2y ago
Lobotomy was not given to young children even when it was a thing...
- RacingTheClock 2y ago
  In this case lobotomy was put on a non consenting 23 year old. So much better?
- shepherdjerred 2y ago
  > who was one of the youngest survivors of the transorbital lobotomy, a procedure performed on him when he was 12 years old. https://en.wikipedia.org/wiki/Howard_Dully https://en.wikipedia.org/wiki/Howard_Dully
  - ekianjo 2y ago
    You can detect autism in kids before they are 5... So my point still stands

StefanBatory 2y ago

Also... the picture of left-handed people would fit in here. https://slowrevealgraphs.com/2021/11/08/rate-of-left-handedness-in-the-us-stigma-society/ https://slowrevealgraphs.com/2021/11/08/rate-of-left-handedn... The very much same applies here I think.

MisdiagnosedMan 1y ago
[dead]