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Social media is not disconnected from society as a whole. Influencers are called that because they have actual influence. You only need to look at and truly und

Social media is not disconnected from society as a whole. Influencers are called that because they have actual influence. You only need to look at and truly understand the MAHA movement to know this. It's not a movement by RFK; it's a movement of people (often moms) who are dissatisfied with their current situation and trying to do something to change it. They may be flat out wrong, but they have influence nonetheless. Did the diagnostic criteria in DSM 5 change as a result of social media, was it the other way around, or was it hidden variables affecting both? Regardless, the money and attention tend to follow what the common people are saying. See: https://pubmed.ncbi.nlm.nih.gov https://pubmed.ncbi.nlm.nih.gov

anonym29 1y ago
Topically relevant: the DSM 5 eliminated the distinction between what was formerly called an Asperger's Syndrome diagnosis from an Autism diagnosis, in part because the name "Asperger" came from a Nazi scientist, and therefore, per then-current political winds, the only morally correct action to take was to erase the name. Of course, this motive needed some kind of non-political justification to not come across as what it was (an example of non-medical political partisanship aimed at erasing history that was disfavored by the political partisans pushing the agenda), which is where the idea of re-categorizing what were and still are clearly at least two distinct clusters of diagnostic patterns as one grand, unified "autism spectrum" that functionally resulted in little more than muddying of waters in the field, which now need to be cleared up again - as pointed out by TFA. You're right that there are external variables, including non-medical variables, influencing the DSM-5's diagnostic shuffle, I just don't see them as particularly well "hidden".
- cogman10 1y ago
  No. Asperger's was eliminated as a diagnosis because differentiating it from autism was hard to do. Two different evaluations could land a kid as either autistic or asperger's depending on the day and the evaluator. And, importantly, Asperger's qualified for less therapies and treatment than autism did. That meant that even though your kid likely needed more treatment, they'd be denied it because they had a good day when being evaluated. The crossover for treatment was largely the same with autism qualifying for more. Even if it was the "Nazi link" they'd simply have changed the name to something more acceptable. TFA is suggesting that there are probably multiple conditions which cluster around similar symptoms which makes it hard to identify the exact cause of autism.
  - anonym29 1y ago
    The diagnostic reliability criteria even back then painted a picture of the details of the condition space being more nuanced than what were currently being captured, not less nuanced, so the idea of reducing nuance and distinction still seems questionable by an empirical and epistemological standpoint. However, that decision remains defensible and supported by the social justice / equity / de-hierarchicalization / eponym erasure motivational drives. These, besides the eponym erasure specifically, also explain many of the other changes in the DSM-5, like the elimination of many other more-detailed diagnoses, like PDD-NOS. This isn't to assert that the clinical reasoning offered didn't have merit, just that institutional consensus-forming behavior isn't immune to the macro backdrop of the sociopolitical winds of the day. Committee member A thinks: "These diagnostic categories aren't reliable" (true, clinical concern) Committee member B thinks: "Honoring Asperger is ethically uncomfortable" (true, historical concern) Committee member C thinks: "Hierarchical categories are problematic" (true, equity concern) Committee member D thinks: "Spectrum model reflects current research better" (true, scientific concern) No single person needs a "primary political motivation." No conspiracy needed. No explicit coordination required. Yet the outcome eliminating Asperger's and collapsing categories - emerges from a system where: - Progressive ideology shapes what problems become salient - Shared epistemic frameworks determine what solutions seem natural - Professional incentives reward what can be publicly justified - Social proof operates through "everyone reasonable agrees" "The clinical rationale was legitimate" doesn't contradict "political ideology shaped the outcome."
    - cogman10 1y ago
      > so the idea of reducing nuance and distinction still seems questionable by an empirical and epistemological standpoint. Again, it does not because the treatments as a result of diagnosis remain the same. The primary role of diagnosis is to inform treatment. If patients are seeing worse outcomes because of arbitrary "nuance", that indicates that the nuance carved out wasn't what needed to be carved out. > isn't immune to the macro backdrop of the sociopolitical winds of the day. This is conspiracy thinking. You don't have any evidence that it was "progressive ideology" that eliminated the diagnosis, you just surmise it based on some people not liking their diagnosis being named after a nazi. Slamming in reactionary politics in where it doesn't fit and a reasonable explanation does fit is just silly. Sure, nobody is immune from politics. But I'm going to need more than "feels, vibes, and makes sense to me" before I start second guessing why a well respected diagnostic committee (and others besides the DSM like the ICD) decided to merge the two diagnosis. Diagnoses for mental disorders, by their nature, are almost always going to have a level of arbitrary lines that could be drawn. That's why we have 5 versions of the DSM and will likely have a 6th in the future.
- in_cahoots 1y ago
  I'm not well-versed in the Asperger's debacle so I didn't feel like it was my place to speak up here. Thanks for adding your perspective.
- MangoToupe 1y ago
  How much does the DSM actually matter outside of clinical contexts? Labels have a life of their own, and people were linking aspergers and autism many years before the DSM did.
deleted 1y ago
[deleted]
MangoToupe 1y ago
I don't disagree with this at all; but I do question if there's been a lot of research for what kind of resources even help "high-performing or moderately-performing people", let alone directing these resources to this demographic over autistic people who struggle to meet society's expectations for individual productivity. "Advocacy" I could see more clearly, and I question how much of this "advocacy" is actually doing for "high-performing or moderately-performing" people. IMO, the only way to really "resolve" the anxiety over prioritizing one group over another in either discourse or in resources in the long term is finding a way to integrate non-productive people into the daily lives of productive people. This seems difficult to imagine in today's America, where community is largely based around interests and careers that will self-select these people away.

anonym29 1y ago

Topically relevant: the DSM 5 eliminated the distinction between what was formerly called an Asperger's Syndrome diagnosis from an Autism diagnosis, in part because the name "Asperger" came from a Nazi scientist, and therefore, per then-current political winds, the only morally correct action to take was to erase the name. Of course, this motive needed some kind of non-political justification to not come across as what it was (an example of non-medical political partisanship aimed at erasing history that was disfavored by the political partisans pushing the agenda), which is where the idea of re-categorizing what were and still are clearly at least two distinct clusters of diagnostic patterns as one grand, unified "autism spectrum" that functionally resulted in little more than muddying of waters in the field, which now need to be cleared up again - as pointed out by TFA. You're right that there are external variables, including non-medical variables, influencing the DSM-5's diagnostic shuffle, I just don't see them as particularly well "hidden".

cogman10 1y ago
No. Asperger's was eliminated as a diagnosis because differentiating it from autism was hard to do. Two different evaluations could land a kid as either autistic or asperger's depending on the day and the evaluator. And, importantly, Asperger's qualified for less therapies and treatment than autism did. That meant that even though your kid likely needed more treatment, they'd be denied it because they had a good day when being evaluated. The crossover for treatment was largely the same with autism qualifying for more. Even if it was the "Nazi link" they'd simply have changed the name to something more acceptable. TFA is suggesting that there are probably multiple conditions which cluster around similar symptoms which makes it hard to identify the exact cause of autism.
- anonym29 1y ago
  The diagnostic reliability criteria even back then painted a picture of the details of the condition space being more nuanced than what were currently being captured, not less nuanced, so the idea of reducing nuance and distinction still seems questionable by an empirical and epistemological standpoint. However, that decision remains defensible and supported by the social justice / equity / de-hierarchicalization / eponym erasure motivational drives. These, besides the eponym erasure specifically, also explain many of the other changes in the DSM-5, like the elimination of many other more-detailed diagnoses, like PDD-NOS. This isn't to assert that the clinical reasoning offered didn't have merit, just that institutional consensus-forming behavior isn't immune to the macro backdrop of the sociopolitical winds of the day. Committee member A thinks: "These diagnostic categories aren't reliable" (true, clinical concern) Committee member B thinks: "Honoring Asperger is ethically uncomfortable" (true, historical concern) Committee member C thinks: "Hierarchical categories are problematic" (true, equity concern) Committee member D thinks: "Spectrum model reflects current research better" (true, scientific concern) No single person needs a "primary political motivation." No conspiracy needed. No explicit coordination required. Yet the outcome eliminating Asperger's and collapsing categories - emerges from a system where: - Progressive ideology shapes what problems become salient - Shared epistemic frameworks determine what solutions seem natural - Professional incentives reward what can be publicly justified - Social proof operates through "everyone reasonable agrees" "The clinical rationale was legitimate" doesn't contradict "political ideology shaped the outcome."
  - cogman10 1y ago
    > so the idea of reducing nuance and distinction still seems questionable by an empirical and epistemological standpoint. Again, it does not because the treatments as a result of diagnosis remain the same. The primary role of diagnosis is to inform treatment. If patients are seeing worse outcomes because of arbitrary "nuance", that indicates that the nuance carved out wasn't what needed to be carved out. > isn't immune to the macro backdrop of the sociopolitical winds of the day. This is conspiracy thinking. You don't have any evidence that it was "progressive ideology" that eliminated the diagnosis, you just surmise it based on some people not liking their diagnosis being named after a nazi. Slamming in reactionary politics in where it doesn't fit and a reasonable explanation does fit is just silly. Sure, nobody is immune from politics. But I'm going to need more than "feels, vibes, and makes sense to me" before I start second guessing why a well respected diagnostic committee (and others besides the DSM like the ICD) decided to merge the two diagnosis. Diagnoses for mental disorders, by their nature, are almost always going to have a level of arbitrary lines that could be drawn. That's why we have 5 versions of the DSM and will likely have a 6th in the future.
in_cahoots 1y ago
I'm not well-versed in the Asperger's debacle so I didn't feel like it was my place to speak up here. Thanks for adding your perspective.
MangoToupe 1y ago
How much does the DSM actually matter outside of clinical contexts? Labels have a life of their own, and people were linking aspergers and autism many years before the DSM did.

deleted 1y ago

[deleted]

MangoToupe 1y ago

I don't disagree with this at all; but I do question if there's been a lot of research for what kind of resources even help "high-performing or moderately-performing people", let alone directing these resources to this demographic over autistic people who struggle to meet society's expectations for individual productivity. "Advocacy" I could see more clearly, and I question how much of this "advocacy" is actually doing for "high-performing or moderately-performing" people. IMO, the only way to really "resolve" the anxiety over prioritizing one group over another in either discourse or in resources in the long term is finding a way to integrate non-productive people into the daily lives of productive people. This seems difficult to imagine in today's America, where community is largely based around interests and careers that will self-select these people away.