Wednesday, October 04, 2017

Increasing Diagnoses of ADHD, ASD, BD…

“We Have Seen the Enemy and He is Us”

I’m sure someone has said this already, but I haven’t seen anything published that focuses on or emphasizes this.  It seems plainly obvious…

Along with the dramatic increase in knowledge/information about these disorders, and, this data’s rapid and wide spreading, we undoubtedly have “Cognitive Biases.”  How many times must it be said:  We are our own worst enemy! 

Three particular Cognitive Biases seem like the most-likely-suspects for much of the excessive, over-the-top, use of these words, terms, diagnoses…  
Availability Cascade” - self-reinforcing process in which a collective belief gains more and more plausibility through its increasing repetition in public discourse (or "repeat something long enough and it will become true").

Bandwagon Effect” - tendency to do (or believe) things because many other people do (or believe) the same. Related to groupthink and herd behavior.

Confirmation Bias” -  tendency to search for, interpret, focus on and remember information in a way that confirms one's preconceptions.

Now, this is NOT to say that any large or significant number of such “diagnoses” are invalid.  It’s simply that we humans fall prey, much more often and easily than we want to admit, to fallacies in our own thinking.

Most of us clinicians, including me, try very hard to do our “due diligence” with differential-diagnosis considerations and using multiple different assessment/diagnostic tools to arrive at s a “preponderance of evidence.”  I still take great offense and exception to the notion that the current, officially accepted method of diagnosing these disorders is “overly-subjective.”  Even some of the most so-called “medically objective” diagnostic methods can result in false positive and negative outcomes.  Plus, some individuals are so adept at hiding their symptoms that ONLY a “clinical interview” can ferret them out.

So, let’s stop trying to find the “bogey-man” everywhere else and look inside ourselves?    

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