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Psychotic versus Asperger's Syndromes

by Darwin123
Tags: asperger, psychotic, syndromes, versus
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Darwin123
#1
Dec7-12, 01:20 PM
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Psychiatric terminology was changed recently. Some pschiatric terms have been dropped such as paranoia and schizophrenia. However, some technical terms are still considered valid. The definitions may have been changed, slightly. However, the words are still clinically formal. For example, Asperger's syndrome and psychotic personality are still valid terms.

1) What is the clinical difference, if any, between Asperger's syndrome and a psychotic personality?

Specific questions.

2) Suppose supervisors find out that an employee has been diagnosed with Asperger's syndrome. Are they justified in thinking that he is likely to be violent or pathologically aggressive?

3) Suppose supervisors find out that an employee has been diagnosed with psychotic personality. Are they justified in thinking that he is likely to be violent or pathologically aggressive?

Both Aspergers and psychosis is associated with "lack of empathy".

4) Is the "lack of empathy" clinically the same in both Aspergers and psychosis?



These questions are important. I know of a TV police program in which the serial killer was diagnosed with "Aspergers syndrome". The next day, employees with "Aspergers syndrome" were basically harassed "for the safety of others".

To be fair, this was a few months after one of those high school shootings. A student who was diagnosed as "psychotic" came to school and started to shoot everybody up. So everyone was tense as to "psychotics". However, it got associated with Aspergers syndrome.

Maybe this was justified and maybe not. Supervisors are supposed to keep watch over possible signs of trouble. If the two syndromes are different, there should be nearly objective ways to distinguish between them.
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Evo
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Dec7-12, 01:40 PM
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Quote Quote by Darwin123 View Post
Psychiatric terminology was changed recently. Some pschiatric terms have been dropped such as paranoia and schizophrenia. However, some technical terms are still considered valid. The definitions may have been changed, slightly. However, the words are still clinically formal. For example, Asperger's syndrome and psychotic personality are still valid terms.

1) What is the clinical difference, if any, between Asperger's syndrome and a psychotic personality?

Specific questions.

2) Suppose supervisors find out that an employee has been diagnosed with Asperger's syndrome. Are they justified in thinking that he is likely to be violent or pathologically aggressive?

3) Suppose supervisors find out that an employee has been diagnosed with psychotic personality. Are they justified in thinking that he is likely to be violent or pathologically aggressive?

Both Aspergers and psychosis is associated with "lack of empathy".

4) Is the "lack of empathy" clinically the same in both Aspergers and psychosis?



These questions are important. I know of a TV police program in which the serial killer was diagnosed with "Aspergers syndrome". The next day, employees with "Aspergers syndrome" were basically harassed "for the safety of others".

To be fair, this was a few months after one of those high school shootings. A student who was diagnosed as "psychotic" came to school and started to shoot everybody up. So everyone was tense as to "psychotics". However, it got associated with Aspergers syndrome.

Maybe this was justified and maybe not. Supervisors are supposed to keep watch over possible signs of trouble. If the two syndromes are different, there should be nearly objective ways to distinguish between them.
As far as I am aware, violence and aggression are not part of the symptoms of aspergers. What is "psychotic personality" as a diagnosis? Where do you find this referenced as a "valid term" in psychiatry?
NemoReally
#3
Dec7-12, 02:03 PM
P: 194
??

Look up the terms asperger and psychosis under the DSM-IV. They are quite distinct.

It is not justifiable to confuse being Aspergic with having disorder involving psychoses. Neither is it justifiable to use the actions, by themselves, of any given individual with a physical or psychiatric condition as an excuse to harass or conduct higher levels of supervision/surveillance on others with similar conditions. Individuals are just that, individual, and any risk assessment should be done on that basis not some over-reactive, knee-jerk reaction to whichever witches the media decide need hunting or Joe Public panics about.

Pythagorean
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Dec7-12, 02:10 PM
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Psychotic versus Asperger's Syndromes

Psychosis is a very broad term, there is no DSM IV entry for it. Psychosis is not automatically violent either.

I'm wondering if OP mean anti-social personality disorder... often refferred to as psychopathy. Again, hostility and aggression are not determining factors. Most sociopaths are not anything like how movies/media portray them (these are extreme cases that often results from the right combination of early childhood abuse and genetic propensity).

Some sociopaths may be productive members of society, doing jobs that other people are scared of (stuntman, soldier, policeman, fireman, jetfighter, war journalism, etc).

I think one of the main differences is people on the autism spectrum don't have theory of mind, so it's out of ignorance that they may hurt people's feelings or be disruptive, wereas sociopaths have theory of mind and often utilize it for personal gain, exploiting people's current frame of mind.
Darwin123
#5
Dec7-12, 06:29 PM
P: 741
Quote Quote by Evo View Post
As far as I am aware, violence and aggression are not part of the symptoms of aspergers. What is "psychotic personality" as a diagnosis? Where do you find this referenced as a "valid term" in psychiatry?
I think what I really meant by psychotic was psychopathy.

What is the difference between asperger's and psychopathy?

Pythagorean pointed out that what I described really sounds like "anti-social personality disorder... often refferred to as psychopathy." He offered the solution that the psychopathic person has a theory of mind, while the anyone on the autistic spectrum (e.g., Asperger's syndrome) does not.

Is that it? Or is there something else?
Pythagorean
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Dec7-12, 06:44 PM
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Well, asperger's is part of a more broad category now: pervasive developmental disorder.

here's the DSM for sociopathy
http://en.wikipedia.org/wiki/Antisoc...rder#DSM-IV-TR

here's the DSM for pervasive developmental disorder (have to scroll down to 'diagnostic criteria')
http://www.sacramentopsychology.com/...tr-#Diagnostic criteria for Autistic Disorder

There's quite a difference. To generalize, personality orders aren't about performance, but more character, while developmental disorders can affect performance.

There's actually a lot of controversy about personality disorders... the general criteria for a mental disease requires that the disease cause distress. Classically, that meant to the person suffering the disease, but often with personality disorders it's others who suffer. So is it right for psychiatrists to require sociopaths get treatment or should the just be treated like adults responsible for their actions?

High functioning asperger's may look similar to (the more typical) mild cases of sociopathy on the outside, but I'd speculate that subjectively, it's experienced very differently.
Evo
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Dec7-12, 07:59 PM
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Quote Quote by Darwin123 View Post
I think what I really meant by psychotic was psychopathy.

What is the difference between asperger's and psychopathy?

Pythagorean pointed out that what I described really sounds like "anti-social personality disorder... often refferred to as psychopathy." He offered the solution that the psychopathic person has a theory of mind, while the anyone on the autistic spectrum (e.g., Asperger's syndrome) does not.

Is that it? Or is there something else?
This kind of repeats what pyth and I have both pointed out earlier. Sorry this is such a long post, long posts tend to discourage people from reading, but this is mainly to answer your question.

Psychopathy sends you to antisocial personality disorder.


Psychopathy and the DSM-IV criteria for antisocial personality disorder

http://www.ncbi.nlm.nih.gov/pubmed/1918618


Antisocial personality disorder

The causes of antisocial personality disorder are unknown. Genetic factors and child abuse are believed to contribute to the development of this condition. People with an antisocial or alcoholic parent are at increased risk. Far more men than women are affected. The condition is common in people who are in prison.

Fire-setting and cruelty to animals during childhood are linked to the development of antisocial personality.

Some people believe that psychopathic personality (psychopathy) is the same disorder. Others believe that psychopathic personality is a similar but more severe disorder.

Antisocial personality disorder is a mental health condition in which a person has a long-term pattern of manipulating, exploiting, or violating the rights of others. This behavior is often criminal.

A person with antisocial personality disorder may:

Be able to act witty and charming

Be good at flattery and manipulating other people's emotions

Break the law repeatedly

Disregard the safety of self and others

Have problems with substance abuse

Lie, steal, and fight often

Not show guilt or remorse

Often be angry or arrogant
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001919/

This couldn't be more different than aspergers disorder.

Diagnostic criteria for Asperger’s syndrome according to DSM-IV (shortened)

Qualitative impairment in social interaction, as manifested by at least two of the following:

1. Marked impairment in the use of multiple nonverbal behaviors such as eye-to eye gaze, facial expression, body postures, and gestures to regulate social interaction

2.Failure to develop peer relationships appropriate to developmental level

3.Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people

4.Lack of social or emotional reciprocity

B Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

2,Apparently inflexible adherence to specific, nonfunctional routines or rituals

3.Stereotyped and repetitive motor mannerisms
Persistent preoccupation with parts of objects

C The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.

D There is no clinically significant general delay in language e.g., single words used by age two years, communicative phrases used by age three years).

E There is no clinically significant delay in cognitive development.

F Criteria are not met for another specific pervasive developmental disorder or schizophrenia.
Initial symptoms of the disorder can be observed
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695286/

As Pyth and I both pointed out, there is nothing similar between the two disorders.
zoobyshoe
#8
Dec9-12, 10:41 PM
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Quote Quote by Darwin123 View Post
These questions are important. I know of a TV police program in which the serial killer was diagnosed with "Aspergers syndrome". The next day, employees with "Aspergers syndrome" were basically harassed "for the safety of others".
As people have pointed out, there's no similarity between Asperger's and psychopathy (or sociopathy, or anti-social personality disorder). They're extremely different.

There is, however, quite an overlap between some manic episodes and sociopathy. Manic people can be very manipulative and extremely deceptive and exhibit very compelling charm. Thwarted or crossed they can, in some cases, become angry and violent. It's not uncommon for Bipolar people to get themselves into serious trouble during manic episodes, such that the police are called.

I mention that about manic people because it's certainly possible for an individual to have both Aspergers and Bipolar Disorder. That is the only circumstance in which I can think of someone with Asperger's being violent. In that case it would be the Bipolar part of the dx causing the problem and not the Asperger's part.

I would suspect the person in the Police program must have had just such a dual diagnosis and the wrong one was emphasized.
Jean-Victor C
#9
Dec19-12, 08:25 PM
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What is thoroughly disquieting about the recent mass shooting, apart from it, is the reaction of the public toward people suffering from mental illness. It is as if, for want of another scapegoat such as people of other races or people of other religions, one turned against mentally ill people as a group, as if it did not take years of study with good teachers for a person with a good brain to make the fine distinctions necessary for a proper diagnosis. And there is the moral question that is totally evacuated, as if mentally healthy people were all paragons of virtue and mentally ill people totally bereft of any morality. People who suffer from Asperger syndrome tend to be law abiding citizens to a fault. It seems that Adam Lanza suffered from Asperger syndrome. He was also trained as a survivalist and had ready access to military grade weapons. What gives?
Evo
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Dec20-12, 01:49 PM
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Quote Quote by Jean-Victor C View Post
What is thoroughly disquieting about the recent mass shooting, apart from it, is the reaction of the public toward people suffering from mental illness. It is as if, for want of another scapegoat such as people of other races or people of other religions, one turned against mentally ill people as a group, as if it did not take years of study with good teachers for a person with a good brain to make the fine distinctions necessary for a proper diagnosis. And there is the moral question that is totally evacuated, as if mentally healthy people were all paragons of virtue and mentally ill people totally bereft of any morality. People who suffer from Asperger syndrome tend to be law abiding citizens to a fault. It seems that Adam Lanza suffered from Asperger syndrome. He was also trained as a survivalist and had ready access to military grade weapons. What gives?
Let's not forget that we don't know if he was ever diagnosed with anything, although discriptions from people that knew him tend to indicate something. He might have had aspergers, but it would be a different mental illness that made him capable of committing mass murder. People aren't limited to one disorder, which is something most people appear not to understand.
Jean-Victor C
#11
Dec20-12, 03:04 PM
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Who will ever know? It is possible that he killed his mother in a fit of rage and that everything went downhill from this moment when he singlehandedly destroyed his whole life. One does not even have to have a mental illness to act like a monster and then implode.
Evo
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Dec20-12, 03:19 PM
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Quote Quote by Jean-Victor C View Post
Who will ever know? It is possible that he killed his mother in a fit of rage and that everything went downhill from this moment when he singlehandedly destroyed his whole life. One does not even have to have a mental illness to act like a monster and then implode.
So true. What he did really didn't need much planning ahead of time, his mother had more guns and ammo than he'd ever need right in the house. Seems she may have suffered from paranoia. We may never know what went on in that house between them. Too bad the father wasn't involved in his son's life. The brother said he hadn't seen Adam (the shooter) in at least 2 years.

But, we're taking this thread off topic. There is a thread to discuss the shooter and his family here http://www.physicsforums.com/showthread.php?t=658903
Jean-Victor C
#13
Dec20-12, 07:14 PM
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Thank you for the reminder and the link.
dimensionless
#14
Dec30-12, 01:56 PM
P: 464
People with Asperger's have difficulty with socialization and non-verbal communication. People with a psychotic personality, or psychopathy, are capable of socialization and non-verbal communication, but don't care about it. Based on my knowledge and observations, Asperger's is not associated with violent or pathologically aggressive behavior.


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