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Counselling thread


Posts: 1331

This is your chance to get some advice from a real therapist. Ask me questions regarding your mental health issues etc. I will give honest advice or opinion. Keep it short and specific. If you dont take the chance you lose. I promise to answer without spite or bad intentions. 

Posts: 195
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How would you diagnose ASPD? Can you actually understand people's level of emotions? Or lack of emotions?

Posts: 195
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Explain nature vs. nurture with ASPD.

Posts: 1331
0 votes RE: Counselling thread
Omari said: 

How would you diagnose ASPD? Can you actually understand people's level of emotions? Or lack of emotions?

 Thats pretty easy. We screen with the SCID-II questionaire and if he or she ticks the right boxes we ask specific questions to explore further. It is diagnosed like any other mental illness. These days where I live it is still done based on the ICD-10. In the ICD-11 I have heard there won't be sperate PDs anymore. Just ageneral PD diagnose with specific perks. They keep postponing the release of the german version of the ICD-10 and it probably will take 5 more years until it is used. A common mistake with diagnosing PDs based on the ICD-10 is just checking for the specific diagnostic criteria. There are general diagnostic criteria for diagnosing any personality disorder. They also have to be fulfilled in order to justify a diagnosis. They are for example that it has to start very early, transcend through many areas of life, is not dependent on situative factors etc.. With ASPD they have to have done crime in childhood like killing animals, violence etc. Often they will have a F91.X already so then thats a very big clue. If they are really ASPD and they hit a therapist it is either in forensics or they are horribly depressed because they are low functioning. Same with narcisissts. There are many highly functional ASPD or narcisissts but they are usually not diagnosed because they would never go to a psychologist (which by the way if we are very conservative would mean that they don't qualify for getting diagnosed with ASPD or narcisism because they do not really suffer which is one of the necessary diagnostic criterias for diagnosing any disorder. this is a tricky point with ego syntonic PDs where i personally feel like sometimes the criteria have to be bend a bit) 

 

Omari said:
Explain nature vs. nurture with ASPD.

This is not really something where there is much to talk about. Nowadays there is not really a debate on whether mental illnesses, PDs etc are nature OR nurture, it is commonly accepted that it is both. Of course, you will find old psychoanalyst boomers telling you their shit but it is unscientific nonsense. The most upto date model on this issue is called the 'vulnerability-stress-model' and it describes the etiology of mental illnesses as a function of an interaction between (mostly biological) disposition and outside stressors. We know there are biological and genetic factors to any mental illness through identical twin adoption studies. Some factors are identified for specific mental disorders etc. Yet, not everyone who has it gets a mental illness which shows you that there are other (external) factors that influence as well. 

last edit on 9/21/2022 10:11:53 PM
Posts: 2763
0 votes RE: Counselling thread

why do i feel like shit 24/7? how could i maybe erase my own memories cus i wanna do that? why do i not feel attached to my body lol? are there aspects of my personality that stem from trauma? should i STFU?  should i put less sugar in my coffee? also aint no way you are a therapist lmfao

can you even tell my bitch ass is autistic or am i super good at hiding it?

am i being annoying on purpose? 

i will answer the last question and the answer is yes.

🌺🐀 🌺
last edit on 9/22/2022 6:00:30 PM
Posts: 2763
0 votes RE: Counselling thread

what is your therapist assessment of this: https://voca.ro/1m63QICC8tge

🌺🐀 🌺
Posts: 33428
0 votes RE: Counselling thread

"If they can't cure me, they must not really know what they're doing." 

Ę̵̚x̸͎̾i̴͚̽s̵̻͐t̷͐ͅe̷̯͠n̴̤̚t̵̻̅i̵͉̿a̴̮͊l̵͍̂ ̴̹̕D̵̤̀e̸͓͂t̵̢͂e̴͕̓c̸̗̄t̴̗̿ï̶̪v̷̲̍é̵͔
Posts: 195
0 votes RE: Counselling thread
Omari said: 

How would you diagnose ASPD? Can you actually understand people's level of emotions? Or lack of emotions?

 Thats pretty easy. We screen with the SCID-II questionaire and if he or she ticks the right boxes we ask specific questions to explore further. It is diagnosed like any other mental illness. These days where I live it is still done based on the ICD-10. In the ICD-11 I have heard there won't be sperate PDs anymore. Just ageneral PD diagnose with specific perks. They keep postponing the release of the german version of the ICD-10 and it probably will take 5 more years until it is used. A common mistake with diagnosing PDs based on the ICD-10 is just checking for the specific diagnostic criteria. There are general diagnostic criteria for diagnosing any personality disorder. They also have to be fulfilled in order to justify a diagnosis. They are for example that it has to start very early, transcend through many areas of life, is not dependent on situative factors etc.. With ASPD they have to have done crime in childhood like killing animals, violence etc. Often they will have a F91.X already so then thats a very big clue. If they are really ASPD and they hit a therapist it is either in forensics or they are horribly depressed because they are low functioning. Same with narcisissts. There are many highly functional ASPD or narcisissts but they are usually not diagnosed because they would never go to a psychologist (which by the way if we are very conservative would mean that they don't qualify for getting diagnosed with ASPD or narcisism because they do not really suffer which is one of the necessary diagnostic criterias for diagnosing any disorder. this is a tricky point with ego syntonic PDs where i personally feel like sometimes the criteria have to be bend a bit) 

 

Omari said:
Explain nature vs. nurture with ASPD.

This is not really something where there is much to talk about. Nowadays there is not really a debate on whether mental illnesses, PDs etc are nature OR nurture, it is commonly accepted that it is both. Of course, you will find old psychoanalyst boomers telling you their shit but it is unscientific nonsense. The most upto date model on this issue is called the 'vulnerability-stress-model' and it describes the etiology of mental illnesses as a function of an interaction between (mostly biological) disposition and outside stressors. We know there are biological and genetic factors to any mental illness through identical twin adoption studies. Some factors are identified for specific mental disorders etc. Yet, not everyone who has it gets a mental illness which shows you that there are other (external) factors that influence as well. 

Is this the one?

INSTRUCTIONS
Circle “YES” or “NO” if the question completely or mostly applies to you. If you do not understand a
question, leave it blank.
In the PAST YEAR:
1. Have you often become so preoccupied with fears of abandonment or separation from important
people in your life that it’s been hard to think about or do anything else?
NO YES
2. Have you often found with people you are getting to know, that they seem at first like the most
special and understanding person you have ever met, but then later they do something to disappoint
you?
NO YES
3. Have you often wondered who you really are as a person, or noticed that you seem like a different
person around different people?
NO YES
4. Have you often done the following activities? (circle all that apply)
1. Spent a lot of money on things that you later regretted? NO YES
2. Driven a vehicle well over the speed limit? NO YES
3. Had 5 or more drinks containing alcohol, or used drugs to get high? NO YES
4. Binged on food? NO YES
5. Had sex with someone you hardly knew? NO YES
5. On at least two occasions, have you tried to hurt yourself or kill yourself (e.g. choking, cutting,
burning, overdose, etc.) or threatened to do so?
NO YES
6. Have you often had mood swings or noticed that your mood can suddenly shift from happy or angry
to depressed, and then back again?
NO YES
7. Have you usually felt empty inside?
NO YES
8. Have you often had anger outbursts, during which you say things or do things that you later regret?
NO YES
9. At times when you have been stressed, did you ever develop any of the following reactions? (Circle
all that apply)
 Become very suspicious of people around you? NO YES
 Feel detached from what is going on around you, as if it isn’t real? NO YES
 Feel disconnected from your body or as if you are floating above it? NO YES

Posts: 1331
0 votes RE: Counselling thread
Omari said: 
Omari said: 

How would you diagnose ASPD? Can you actually understand people's level of emotions? Or lack of emotions?

 Thats pretty easy. We screen with the SCID-II questionaire and if he or she ticks the right boxes we ask specific questions to explore further. It is diagnosed like any other mental illness. These days where I live it is still done based on the ICD-10. In the ICD-11 I have heard there won't be sperate PDs anymore. Just ageneral PD diagnose with specific perks. They keep postponing the release of the german version of the ICD-10 and it probably will take 5 more years until it is used. A common mistake with diagnosing PDs based on the ICD-10 is just checking for the specific diagnostic criteria. There are general diagnostic criteria for diagnosing any personality disorder. They also have to be fulfilled in order to justify a diagnosis. They are for example that it has to start very early, transcend through many areas of life, is not dependent on situative factors etc.. With ASPD they have to have done crime in childhood like killing animals, violence etc. Often they will have a F91.X already so then thats a very big clue. If they are really ASPD and they hit a therapist it is either in forensics or they are horribly depressed because they are low functioning. Same with narcisissts. There are many highly functional ASPD or narcisissts but they are usually not diagnosed because they would never go to a psychologist (which by the way if we are very conservative would mean that they don't qualify for getting diagnosed with ASPD or narcisism because they do not really suffer which is one of the necessary diagnostic criterias for diagnosing any disorder. this is a tricky point with ego syntonic PDs where i personally feel like sometimes the criteria have to be bend a bit) 

 

Omari said:
Explain nature vs. nurture with ASPD.

This is not really something where there is much to talk about. Nowadays there is not really a debate on whether mental illnesses, PDs etc are nature OR nurture, it is commonly accepted that it is both. Of course, you will find old psychoanalyst boomers telling you their shit but it is unscientific nonsense. The most upto date model on this issue is called the 'vulnerability-stress-model' and it describes the etiology of mental illnesses as a function of an interaction between (mostly biological) disposition and outside stressors. We know there are biological and genetic factors to any mental illness through identical twin adoption studies. Some factors are identified for specific mental disorders etc. Yet, not everyone who has it gets a mental illness which shows you that there are other (external) factors that influence as well. 

Is this the one?

INSTRUCTIONS
Circle “YES” or “NO” if the question completely or mostly applies to you. If you do not understand a
question, leave it blank.
In the PAST YEAR:
1. Have you often become so preoccupied with fears of abandonment or separation from important
people in your life that it’s been hard to think about or do anything else?
NO YES
2. Have you often found with people you are getting to know, that they seem at first like the most
special and understanding person you have ever met, but then later they do something to disappoint
you?
NO YES
3. Have you often wondered who you really are as a person, or noticed that you seem like a different
person around different people?
NO YES
4. Have you often done the following activities? (circle all that apply)
1. Spent a lot of money on things that you later regretted? NO YES
2. Driven a vehicle well over the speed limit? NO YES
3. Had 5 or more drinks containing alcohol, or used drugs to get high? NO YES
4. Binged on food? NO YES
5. Had sex with someone you hardly knew? NO YES
5. On at least two occasions, have you tried to hurt yourself or kill yourself (e.g. choking, cutting,
burning, overdose, etc.) or threatened to do so?
NO YES
6. Have you often had mood swings or noticed that your mood can suddenly shift from happy or angry
to depressed, and then back again?
NO YES
7. Have you usually felt empty inside?
NO YES
8. Have you often had anger outbursts, during which you say things or do things that you later regret?
NO YES
9. At times when you have been stressed, did you ever develop any of the following reactions? (Circle
all that apply)
 Become very suspicious of people around you? NO YES
 Feel detached from what is going on around you, as if it isn’t real? NO YES
 Feel disconnected from your body or as if you are floating above it? NO YES

 No, the one we use has 117 items. And it is just for screening. You have to also do the interview afterwards. You don't really diagnose based on a questionaire. It is best to use as many different sources of information you can get. 

 

The newest one in english is called SCID-5-pd.

last edit on 9/23/2022 4:43:36 PM
10 / 16 posts
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