- How exactly does Structure relate to diagnoses in the Diagnostic and Statistical Manual of Mental Disorders? spencer-question
- If someone is diagnosed with Autism or manifests autistic traits, does that always mean they have Detached structure?
- Similarly for personality disorders like Narcissistic Personality Disorder, or mood disorders like Generalized Anxiety Disorder.
- On splitting and merging of disorders.
- There’s a tendency in psychology to collapse diagnoses. This is because diagnoses a formulated for the convenience of the therapist/psychologist. This is not because we find that there has been a shift in people’s psychology or a decrease in the amount of cases, but because doctors need to protect their reputation. The priority for doctors is for diagnoses to be kept severe enough to be taken seriously, but also have a diagnosis for everybody who feels like they have a problem so the patient doesn’t feel like they’re wasting their time going to the doctor. For example the introduction of SPCD (social pragmatic communication disorder) as a “less severe” diagnosis of autism.
- Similarly but in the opposite direction, there’s also a tendency to split diagnoses. When there is a decrease in the number of people coming in for diagnoses that are distinct but overlapping.
- When a decreasing number of people start coming for two diagnoses, and they often overlap, there’s a pressure to combine them into one because the more you have, and (thus?) creating new one, for when they need to split them, for their own interest, if it gets too many into one reality, then we probably start losing trust in them, like “oh you’re just making them up”.
- Less popular ones get merged, more popular ones get split.
- For example, take Derealization and depersonalization.
- They were originally developed as separate diagnoses.
- Derealization and depersonalization were merged because there were not a lot of people coming to get diagnosed for derealization or depersonalization specifically.
- Those experiencing depersonalization commonly experience symptoms of derealization, i.e. in the same way that early neurotics feel depression (the crisis phase of Psychotic.
- Psychotic depersonalization will often be accompanied by derealization. When you progress in structure, it takes on a different quality. For a Psychotic individual, derealization is accompanied by a strong contrast between what’s “normal” and what is “off”. They may “freak out” when the voices and dreams they experience are so different than normal. i.e. “Now I have a reality, but why do I keep hearing voices, seeing dreams that are ‘off’? Why doesn’t everything fit in reality?” Worried they may become detached again. This is why they start having psychotic breaks.