Reading the Research: Psychology Has A Long Way To Go

Welcome back to Reading the Research, where I trawl the Internet to find noteworthy research on autism and related subjects, then discuss it in brief with bits from my own life, research, and observations.

Today's article underlines how far psychology has yet to go in terms of making scientifically valid diagnostic categories for mental illness and neurological differences.  This study focused on obsessive-compulsive disorder (OCD), which sometimes has a crossover with autism.  But it's also relevant because quite frankly, autism is a trashbin diagnosis.  

When a diagnostic label can be equally applied to myself (an independent, speaking adult with a house and a car) and to a 9 year old who cannot be toilet trained, has not progressed emotionally past age 4, and does not speak... something has gone very wrong, scientifically speaking.  That diagnostic label is all but useless.

I'd known this was the case with autism for years, but it surprised me that apparently the same is somewhat true of OCD and other mental disorders.  There are many kinds of obsessive-compulsive behaviors.  The stereotypical one is repetitive handwashing, but the article also calls out binge-eating, excessive shopping, and various types of addiction.  

Let me particularly call your attention to this paragraph:

"In the current study, patients met an average of 3.7 concurrent diagnoses.  Disorders are also highly heterogeneous -- which means that two patients might have the same diagnosis, but have little to no overlapping symptoms and might respond in entirely different ways to the same treatment."  

To me, there were two bombshells in this paragraph.  First, 3.7 diagnoses on average?  That's a lot of metaphorical alphabet soup.  Perhaps I shouldn't be surprised, given that I think they gave me 5 diagnoses at the end of my testing.  I reject one, but that still puts me at 4, which is right around that average.  In other types of science, you don't need 3.7 labels to describe a phenomenon.  You have a classification: meteor, and three types: iron, stone, and stony-iron.  We've been studying the human mind and brain for over a century, and apparently the best we can manage is 3.7 diagnostic labels...

...and secondly, those diagnostic labels aren't even self-consistent!  I'd always kind of assumed autism and ADHD were relatively new and not well understood, but that other labels weren't so absurdly different in terms of the mixture of people that fall into them.  Apparently I was very wrong, and much of this is definitely still theory, not practical application.  

I probably should have known better given how many different therapies there are for depression.  There's pharmaceuticals (many and varied!), neurofeedback, supplementation/vitamins, exercise, talk therapy (like CBT), ketamine, and deep brain stimulation, to name a few.  Here's a link to a similar "wow, this diagnostic label sure has a lot of different symptoms!" study for major depression.  

Apparently the human brain, being a self-reprogramming computer that generates consciousness somehow, is possibly the most complex thing we've ever tried to study.  I just hope, for all of our sakes, that it doesn't take too much longer to get a handle on what we need to understand to help people.  

(Pst! If you like seeing the latest autism-relevant research, visit my Twitter, which has links and brief comments on studies that were interesting, but didn't get a whole Reading the Research article about them.)