Tag: Psychological problems

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Dark Personality Psychology Psychiatric Disorders

5 Red Flags of Pathological Lying

In the current digital sphere, communication has diversified. No longer does one have to speak to each other directly. While this has greatly increased the convenience of communication, it has also increased the convenience for pathological lying.

Yes, this did just escalate quickly.

Pathological lying is a pattern of behavior of distorting or hiding information that is not really needed in the context. So, a pathological liar would be a person who lies ‘without much thought’, even in situations where he or she is not being harmed. One could connect pathological lying to psychopathy, Machiavellianism and/or narcissism.

However, compared to these large traits, pathological lying is one specific behavior. One study of 1,000 young offenders found excessive lying among 15% of males and 26% of females.

In this article, I will talk about 5 red flags that could give away someone who engages in pathological lying.

Let us begin!

1. Difficulty in Getting a Straightforward Answer

When one asks a simple question, a person who engages in pathological lying will respond with answers that are too vague. They might bring up some other topic or they might appear to connect the question to some other topic.

Not only that, you might feel as if you have to wrangle the answer out of them. This particle behavior is interesting because it directly relates to one aspect of a trait in the Five Factor Model of personality.

Straightforwardness is a major aspect of Agreeableness, a personality trait akin to being polite, honest and empathic.  Psychopaths, narcissists and Machiavellians, all generally score less on measures of straightforwardness.

2. The Behavior is Persistent across Age and Context

Scientists have also defined pathological lying as chronic lying behavior. A pathological liar would seem to lie almost indiscriminately, across multiple situations. So, one major identifier here is if you hang out with this person and he/she continues to fabricate information even when there is no real need to.

I would further argue here that a person who has had a habit of lying pathologically can also remain functional. It could be that they have learned how to lie differently in different contexts to escape being caught.

However, there is a high chance that if you are their friend, relative, family or any kind of long-term associate, you will detect small indications of missing and distorted information.

This relates to the next point.

3. Suspicious Friends, Family and Colleagues

Even if the point being lied about is not important, when we learn that something someone says is untrue and dishonest, we might not trust them. This then forms the basis of the turbulent relationships that a pathological liar would have.

In the case of people who engage in pathological lying, the social circle they have might be suspicious of them. They might say that the person is insincere. Because of that, their family members or friends and colleagues might find it difficult to confide in them.

Often this distrust could show up in behaviors like not leaving any valuables in the pathological liar’s custody. It could also show up in not including them in close-knit family gatherings.

A crucial point to remember here is that this exclusion from social gatherings further solidifies pathological lying.

So, it is not at all an attractive thing to any person, even if they pathologically lie about many things. In fact, excluding such people from these gatherings could lead to even more personal isolation, which could increase their levels of paranoia.

4. Very Frequent Contradictions in Narratives

We as humans are far from perfect. We make many of the same errors in judgment that many people around us make.

However, with respect to the majority of people, the contradictions in our speech or expressions are far lesser and in-between than in the case of a pathological liar. It could be that when recalling a memorable trip, the individual could distort multiple points of the story to make them look superior. Conversely, if they are narrating a story or some point, they might distort parts of the story to put down someone else that they might not found favorable.

Whichever route they take, pathological lying can be identified when the story that they tell seems to be fundamentally distorted, with various points excluded from it.

One could say here that this is because pathological liars lack insight.  

5. Confrontations Lead to Overreactions

No one really wants to be openly confronted about their lack of honesty. It makes us self-conscious about ourselves. However, we have enough wits about ourselves to realize genuine issues that we might have. When someone close to us tells us that we are being dishonest, we often make a goodwill attempt to understand what they mean.

Now, consider this in the context of an individual who does not realize that

  • they are being dishonest
  • being dishonest is a behavior that should be improved.

Such an individual would become defensive when they are confronted. Even in very private and personal settings. Since they do not consider you or anyone close to them trustworthy enough to tell the truth and be okay, they might see your or another friend’s advice as a challenge to their identity.

So, a pathological liar would view confrontations as open indication of antagonism.

And they would then reply according to this conception.

This could result in ‘fighting matches’ with their close associates. Further still, this could result in physical and violent confrontations.

Conclusion

While popular media portrays pathological liars as psychopaths with no distress, this is not the case. Pathological lying is one feature of many distressing psychological disorders. In fact, pathological lying is in itself considered to be a condition of its own, defined as pseudologia phantastica.

So, while pathological lying causes distress to others, it often originates from running from psychological distress in the individual. This makes it an uncomfortable condition for the person too.

If you feel as if you or someone around you has a behavior of lying pathologically, I would advise you to give this the proper time and care.

After all, wouldn’t it be great if we make our lives less distressing?

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Psychiatric Disorders

Major Depressive Disorder – Diagnostic Criteria, Features, and Prevalence

Written by Najwa Bashir

Major depression disorder (MDD) is a complicated and common mental illness. According to the sources, in 2008, the WHO ranked MDD as the third most common cause of disease in the world, and they predict that it will be the most common cause of disease by 2030. Mood problems that don’t go away, losing interest in enjoyable activities, feelings of shame or inadequacy, fatigue, trouble focusing, fluctuations in hunger, psychomotor retardation or unrest, sleep problems, or suicidal thoughts are all signs of this disorder.

Empirical evidence reveals that every year, more and more people encounter depression. About 300 million people around the world have MDD, which has become one of the main reasons people can’t work. MDD is more common in some groups, like pregnant women, older adults, kids, and others. This may be because of genetic, psychological, or social factors. Recurrent seizures can happen along with depression. They may happen even when the person is not depressed or may last longer than the condition itself.

Research has also found that a link exists between the growth of social skills and the frequency of MDD. According to a survey, MDD is starting to show up at younger ages because of changes in the economy and more stress in everyday life. Women are about twice as likely as men to have MDD. In particular, women are more likely to show signs of depression when they are dealing with social problems or high levels of stress. Furthermore, it has been found that fall and winter are times when seasonal sadness is more common.

The following article mentions the diagnostic criteria and features of MDD in light of DSM 5 TR.

Diagnostic Criteria

A. At least five of the following symptoms have been present for at least two weeks and are different from how they were before; at least one of these symptoms is either (1) depression or (2) reduced interest or pleasure.

  1. Feeling down most of the day, almost every day, as shown by their own words (like “feels sad, empty, or hopeless”) or by what other people say (like “appears tearful”) (Note: irritable mood in case of children and adolescents).
  2. A noticeable loss of interest or pleasure in all or almost all activities for most of the day, almost every day (as shown by an observation or a psychological report).
  3. Losing or gaining a lot of weight while not dieting (more than 5% of body weight in a month), or having less or more hunger almost every day. (Note: If a kid does not gain weight as expected, this is something to think about).
  4. Trouble sleeping or too much sleep almost every day.
  5. Psychomotor restlessness or slowing down almost every day (not just feeling antsy or being slowed down); this must be seen by others.
  6. Feeling tired or lacking energy almost every day.
  7. Nearly every day, having feelings of inadequacy or too much or the incorrect kind of guilt (which could be delusions)—not just self-blame or guilt about being sick.
  8. Making it harder to think or focus, or being unable to make up your mind, almost every day (either from your own story or what other people have seen). 9: Frequent thoughts of death (not just fear of dying), frequent suicidal ideas without a clear plan, or a suicide attempt or a clear plan to kill oneself.

B. The symptoms cause distress or harm in social, occupational, or other important performance areas that are clinically relevant.

C. The episode is not caused by the effects of a drug or another physical situation on the body. Keep in mind that criteria A–C show a major depressed state.
Note: After a big loss, like a death in the family, losing everything you owned, or getting sick or disabled, you may experience intense sadness, ruminating about the loss, insomnia, loss of appetite, and weight loss listed in Criterion A. This can look like a depressive episode. Even though these symptoms may make sense or seem suitable given the loss, it is important to carefully consider the presence of a major depressive episode in addition to the normal reaction to a big loss. It is necessary to use clinical opinion when making this choice, taking into account the person’s past and the community norms for showing sadness during a loss.

D. At least one major depressive episode cannot be explained by schizoaffective disorder and can’t be added to schizophrenia, schizophreniform disorder, delusional disorder, or other specific and unspecific schizophrenia spectrum disorders or other psychotic disorders.

E. No manic or hypomanic attack occurred ever.

Note: This exception does not apply if all of the manic or hypomanic events are caused by drugs or the effects of another medical condition on the body.

Diagnostic Features

  • Symptoms of depression must continue at least two weeks and involve feeling low or losing interest in most or all activities virtually every day (Criterion A).
  • Four other symptoms must be present within the two-week timeframe. These might include changes in food, weight, sleep, or psychomotor activity; reduced energy; feelings of worthlessness or guilt; difficulties thinking, focusing, or making decisions; or thoughts of death, suicide, a suicide attempt, or a suicide plot.
  • The indicators must occur practically daily for at least two weeks, except for suicidal or death thoughts, which must occur several times, and attempted suicide or forming a plan, which only has to occur once.
  • The experience must be accompanied by clinically substantial anxiety or impairment in social, professional, or other crucial areas of functioning. For individuals with milder bouts, functioning may seem normal but requires more effort.
  • People typically complain of drowsiness or fatigue rather than depression or disinterest. You may miss depression if you do not seek for it.
  • Many with this disease feel exhausted and have problems sleeping. Psychomotor issues and delusional or near-delusional shame are rare but worsening.
  • Depressed, sad, helpless, disheartened, or “down in the dumps” are common symptoms of severe depression (Criterion A1). During the interview, sadness may be mentioned (e.g., the person looks like they’re crying).
  • Some people say they are “blah,” have no sensations, or are frightened, yet their facial expressions and conduct show they are sad.
  • Some people talk more about physiological aches and pains than melancholy. People who are more irritable may have persistent anger, a tendency to shout or blame others, or an overdone feeling of annoyance over trivial things.
  • Kids and teenagers usually feel restless or irritated, not sad. This should not be confused with feeling furious while disturbed.
  • Normal duties are usually less enjoyable. People may declare they’re “not caring anymore” about their activities or no longer appreciate them (Criterion A2).
  • Family members notice when someone quits having fun or socializing. A former golfer or sports fanatic youngster may quit playing. Some people lose a lot of sexual drive.
  • Changes might affect appetite. Sad individuals claim they must push themselves to eat. Some may eat more and seek sweets or carbohydrates. A person’s appetite may alter a lot, causing them to lose or gain weight or not acquire weight as predicted in youngsters (Criterion A3).
  • Sleep disorders include insomnia or oversleeping (Criterion A4). Insomnia sufferers commonly experience middle insomnia (waking up during the night and having problems getting back to sleep) or terminal insomnia. Initial insomnia may occur. Hypersleepers sleep longer at night or more during the day. Some people go to treatment for insomnia.
  • People who can’t sit still, pace, wring their hands, or tug or massage their skin, clothes, or other items are agitated. Retardation occurs when their speech, thoughts, and bodily movements slow down; they stop longer before replying; their speech is quiet, varied, or inexpressive; or they are mute (Criterion A5). Psychomotor agitation or delay must be visible to others, not only the person’s thoughts. Psychomotor agitation or delay is often accompanied by the other type. Fatigue and energy loss are common (Criterion A6).
  • A person may state they are always fatigued even while not moving. It feels like even minor tasks are laborious. Tasks may take longer or be done poorly. Someone may claim that getting dressed and washing their clothing in the morning is hard and takes twice as long. During acute bouts and partial remission, this symptom causes several serious depressive disorder issues.
  • A serious depressive episode can make a person feel worthless or guilty, including having an excessively low self-esteem or focusing on previous misdeeds (Criterion A7). Such people misinterpret neutral or minor circumstances in their everyday lives for personal defects and accept too much responsibility for unpleasant things. Someone who believes they create world poverty may have illusions due to worthlessness or shame. Depression makes people blame themselves for being unwell and unable to satisfy social or professional duties. Unless deluded, this does not fit this requirement.
  • Many people struggle with thinking, focusing, and making little decisions (Criterion A8). They may appear distracted or have problems remembering. Mentally demanding tasks often leave people helpless. Kids with unexpected grade drops may not be focused. Older people’s major complaint may be memory issues, which may be misinterpreted for dementia (sometimes termed “pseudodementia”).
  • Once the major depressed episode is over, memory issues usually disappear. In elderly persons, a major depressive episode may be the earliest indicator of irreversible dementia. Many individuals think about suicide or try to commit suicide (Criterion A9). They can range from a buried desire to not wake up in the morning to a fleeting thought that others would be better off if the individual were dead to a thorough suicide plot. Seriously suicidal people may have revised their wills, paid off their bills, obtained a rope or pistol, and chosen a location and time to commit suicide.
  • People may commit suicide because they want to give up because they cannot move over issues, stop an emotionally painful condition they fear will never end, cannot find joy in life, or don’t want to burden others. Eliminating these ideas may be a better predictor of decreased suicide risk than rejecting any further suicide intentions.
  • Even in milder situations, a severe depressive episode must induce clinically substantial sorrow or interfere with social, professional, or other crucial areas of functioning (Criterion B). If the handicap is severe, the person may not work socially or professionally. In the worst case, the individual may be unable to eat, dress, or clean oneself.
  • If they have difficulties focusing, forget things, or reject, minimize, or explain away their symptoms, they may not be honest. More information from others can assist determine the path of large depressive episodes and manic or hypomanic episodes.
  • Since major depressive episodes develop slowly, clinical facts regarding the worst phase of the current episode may be the greatest indicator.
  • Some severe depressive episode symptoms are similar to those of other medical conditions. Diabetes can cause weight loss, cancer can cause fatigue, and pregnancy or postpartum sleepiness can constitute hypersomnia. When obviously and totally caused by another medical condition, these indications do not indicate serious depression.
  • Check for non-vegetative indicators of sadness, a loss of enjoyment, guilt or worthlessness, difficulties focusing or making decisions, and suicidal thoughts. Restricting major depressive episodes to these non-vegetative symptoms seems to discover the same persons as the complete criteria.
Categories
Psychiatric Disorders

Diagnostic Features of Dyscalculia

Written by Najwa Bashir

Dyscalculia

Two of the most common learning disorders are dyslexia and dysgraphia. One is dyscalculia, characterized by having trouble with math (Ahuja et al., 2021). Dyscalculia is a learning disorder that makes it hard to understand and use numbers. This can affect students’ mathematics education and well-being (Asalisa & Meiliasari, 2023). According to the International Classification of Diseases (ICD-10), dyscalculia is a unique developmental disease that causes problems with speech, motor skills, and the ability to see and understand where things are in space (Aquil, 2020). Although dyscalculia is as prevalent as dyslexia and dysgraphia, it is less well-known and has received less research attention than the other two (Grigore, 2020). Consequently, many educators possess an inadequate understanding of dyscalculia (Kunwar & Sharma, 2020), and pupils afflicted with dyscalculia fail to receive the necessary assistance during their mathematical education (Salisa & Meiliasari, 2023).

Prevalence

Dyscalculia affects 3-7% of all children, adolescents, and adults. Severe, ongoing difficulties with math computations cause significant impairment in the workplace, in school, and daily life. It also increases the likelihood of co-occurring mental problems (Haberstroh & Schulte-Körne, 2019).

According to large-scale cohort research conducted in England, there are significant psychological and economic problems linked to low mathematical proficiency: Of those impacted, 70–90% dropped out of school before the age of 16, and just a small percentage had full-time jobs when they were 30. Compared to people without dyscalculia, their chances of being jobless and experiencing depressed symptoms were twice as high (Parsons & Bynner, 2005). An estimated £2.4 billion is spent annually in Great Britain on expenses related to severe mathematical impairment (Gross, 2006).

Diagnostic Criteria for Dyscalculia

Behavioral specialists can determine whether an individual has dyscalculia or a severe arithmetic problem by using the Dutch protocol “Dyscalculia: Diagnostics for Behavioural Professionals” (DDBP). The following criteria are addressed by the DDBP procedure in order to diagnose dyscalculia:

  • First criterion: To ascertain whether the math issue exists and how serious it is
  • Second criterion: To identify the math issue associated with the individual’s capabilities
  • Third criterion: Assessing the mathematical problem’s obstinacy

The protocol also notes that a fourth criterion—difficulties that predate the age of seven—is incorporated in many studies. For most kids, this is accurate; nevertheless, dyscalculia is typically identified later in life among (very) brilliant kids.

Diagnostic Features of Dyscalculia

The following are the typical features of dyscalculia (Salisa & Meiliasari, 2023):

Trouble understanding and using numbers and amounts starting in preschool

  • It’s hard to make the connection between a number (like 2) and the thing it stands for (like 2 apples).
  • People don’t fully understand the relationship between numbers and amounts (two apples and one apple = 2 + 1).
  • Because of this, it’s hard to count, compare two numbers or amounts, quickly evaluate and name small groups of dots, find a number’s position on the number line, understand the place-value system, and transcode.

Problems with simple math operations and other math-related tasks

  • Individuals don’t understand how to use computation rules because they don’t understand numbers and amounts well enough (17 + 14 = 1 + 1 and 7 + 4 = 13 or 211).
  • Questions with remembering math facts (like the multiplication table), which are facts that let you get the answers to simple math questions without having to do the math all over again.
  • No change from counting to non-counting methods (8 + 4 = 8 + 2 and 2 = 12) when doing math (8 + 4 = 9, 10, 11, 12 = 12).
  • These problems get worse as the math gets harder (bigger number range, written calculations, computations with multiple steps, word problems).

Important

  • Finger-counting is not a sign of dyscalculia; it is a normal way to help you remember math facts and learn how to do calculations quickly and correctly. Finger-counting over and over, especially for simple calculations that are done over and over, does show that there is a problem with the calculations.
  • What matters is not just that there are mistakes in the calculations; what matters is their range, how long they last, and how often they happen.

The main thing that is used to diagnose dyscalculia is a difference between a person’s brain and their supposed math skills. In a full test that can also be used to plan a therapy intervention, the cause of dyscalculia and problems understanding visual information should both be taken into account. This should be taken into account when choosing the right test methods. The new definition of dyscalculia takes into account not only IQ and math success in school, but also problems with basic skills that are common in people with dyscalculia. The IQ difference and the best IQ test for dyscalculia are still debated. One new thing about this work is that it uses a multidisciplinary method to give a full picture of dyscalculia and how to diagnose it. This could help scholars from other fields (Aquil, 2020).

Early diagnosis of dyscalculia will ensure early management of the problem. The aforementioned criteria and diagnostic features can help diagnose dyscalculia.

References

  • Ahuja, N. J., Thapliyal, M., Bisht, A., Stephan, T., Kannan, R., Al-Rakhami, M. S., & Mahmud, M. (2021). An investigative study on the effects of pedagogical agents on intrinsic, extraneous and germane cognitive load: experimental findings with dyscalculia and non-dyscalculia learners. IEEE Access, 10, 3904-3922. https://doi.org/10.1109/ACCESS.2021.3115409
  • Aquil, M. A. I. (2020). Diagnosis of dyscalculia: A comprehensive overview. South Asian Journal of Social Sciences and Humanities, 1(1), 43-59. Available at: https://acspublisher.com/journals/index.php/sajssh/article/view/1124
  • Grigore, M. (2020). Towards a standard diagnostic tool for dyscalculia in school children. CORE Proceedings, 1(1). https://doi.org/https://doi.org/10.21428/bfdb1df5.d4be3454
  • Gross, J. (2006). The long term costs of literacy difficulties. KPMG Foundation.
  • Haberstroh, S., & Schulte-Körne, G. (2019). The diagnosis and treatment of dyscalculia. Deutsches Ärzteblatt International, 116(7), 107. https://doi.org/10.3238/arztebl.2019.0107
  • Kunwar, R., & Sharma, L. (2020). Exploring Teachers’ Knowledge and Students’ Status about Dyscalculia at Basic Level Students in Nepal. Eurasia Journal of Mathematics, Science and Technology Education, 16(12). https://doi.org/10.29333/ejmste/8940
  • Parsons, S., & Bynner, J. (2005). National Research and Development Centre for adult literacy and numeracy. London: Institute of Education.
  • Salisa, R. D., & Meiliasari, M. (2023). A literature review on dyscalculia: What dyscalculia is, its characteristics, and difficulties students face in mathematics class. Alifmatika: Jurnal Pendidikan dan Pembelajaran Matematika, 5(1), 82-94. https://doi.org/10.35316/alifmatika.2023.v5i1.82-94
  • Van Luit, J. E. (2019). Diagnostics of dyscalculia. International handbook of mathematical learning difficulties: From the laboratory to the classroom, 653-668. https://doi.org/10.1007/978-3-319-97148-3_38
Categories
Psychiatric Disorders

Diagnostic Features of Dyslexia

Written by Najwa Bashir

Dyslexia

Individuals with dyslexia face trouble learning to read out loud and spell. According to the DSM5, dyslexia is a type of neurological disease. Neurodevelopmental diseases are genetic conditions that last a lifetime and show symptoms early in life. Research on dyslexia was based for a long time on the idea that it was a specific learning disability. By this, we meant that the disability could not be explained by clear causes like sensory issues or general learning challenges (low IQ). Then, because it wasn’t possible to tell the difference between how well kids with dyslexia and kids with more general learning problems read and use sounds, this way of defining “discrepancy” lost favor (Snowling et al., 2020).

Given that they have problems with the phonological part of language, people with dyslexia have trouble connecting spoken and written language. Decoding words correctly and quickly can make it harder to understand what you read and build your knowledge (Kim et al., 2012). Spelling problems can make it hard to compose written work properly. Dyslexia can make people do badly in school, feel bad about themselves, and lose drive. This doesn’t mean someone is stupid, lazy, or has bad eyesight; it happens to people of all brain levels (Berninger et al., 2013).

At first, the word dyslexia was called “word blindness” (Campbell, 2011). It comes from the Greek words for “days” (lexi, from lexicon) and “ia,” which means “impaired.” People with developmental dyslexia have trouble reading, decoding, and writing words at the word level; writing seems to be the most chronic problem (Berninger et al., 2008). The Working Definition of Dyslexia under the Individuals with Disabilities Education Act (IDEA) is a “specific learning disability” (Roitsch & Watson, 2019). Developmental dyslexia is one important example of a learning disability that has social and emotional effects that aren’t thought to be the main symptoms of the disorder. These problems can still be there or even get worse as an adult (Livingston et al., 2018). Therefore, early diagnosis and treatment of the disorder are essential to ensure the prevention of adverse consequences. Given next are the diagnostic features of dyslexia.

Diagnostic Features

The following are prominent features of dyslexia (Roitsch & Watson, 2019):

  1. Trouble developing sound awareness and thinking skills.
  2. Trouble correctly interpreting nonsense or things you need to know.
  3. Trouble reading single words on their own.
  4. Oral reading is wrong and hard to do.
  5. Not being able to read quickly.
  6. Different levels of learning the names of letters and the sounds they make.
  7. Trouble learning how to spell.
  8. Trouble finding words and naming things quickly.
  9. Having different levels of trouble with different parts of writing.
  10. Different levels of trouble understanding what they read.

Most of the time, kids in preschool and early elementary school who have dyslexia have trouble learning to talk, learn sounds and letters, colors and numbers, write, use their fine motor skills, and recognize sight words. The fact that these kids have trouble with pronunciation is often a sign that they might have trouble reading later on. Older kids with dyslexia may have bad handwriting, trouble learning foreign languages, issues with ordering language, trouble remembering things, spelling mistakes, and ongoing reading, writing, and math problems (IDA, 2019). Spelling and remembering words with more than one letter can be noticed in written language. Comprehension and understanding may be hard in reading skills, and reading skills that are slow and often wrong may be noticed. People who have dyslexia often have trouble phonologically coding words, which means they have trouble knowing how words sound and what they mean (Snowling, 2019, as quoted in Roitsch & Watson, 2019).

Cognitively, people with dyslexia have trouble recognizing hidden shapes (Martinelli & Schembri, 2014), shifting their attention, and having problems with parts of their working memory that deal with spoken and written language (the phonological loop) (Berninger et al., 2015). Working memory is one of the most common symptoms of dyslexia that people name. When someone with dyslexia has trouble with working memory, they have trouble temporarily storing knowledge while doing other cognitive tasks at the same time (Baddeley, 1992, as cited in Roitsch & Watson, 2019). Teenagers’ ability to read quickly is affected by their language knowledge, which is linked to their verbal working memory (Shaywitz et al., 2008). Language experts, interventionists, and diagnosticians face new problems with a group of people that consists of those who are talented and also have dyslexia. People who are “twice exceptional” often do better than their regular peers on tasks that test their speech, working memory, and language skills, but they take longer to learn phonological awareness and how to name things quickly. Additionally, these individuals show very high verbal reasoning skills. However, it can be hard for teachers and parents to diagnose dyslexia in these individuals because their abilities often hide the effects of dyslexia on spoken and written language tasks as well as standardized tests (van Viersen et al., 2016), while the core deficits associated with dyslexia remain (Nielson et al., 2016). The same is true for adults with dyslexia: their symptoms are often less obvious because they have learned how to deal with the condition and the problems that come with it. Mental problems like not understanding sounds and naming things quickly, as well as problems with working memory and written language, may still be present (Kilpatrick, 2015), along with other thinking and reading problems (Chung et al., 2011).

Conclusion

Dyslexia is a learning disorder that makes it hard to read, write, spell, and even talk. The International Dyslexia Association says that about 10% of people have dyslexia. Individuals with dyslexia cannot meet school standards because of their disabilities, which makes them feel overwhelmed and unimportant. With a world prevalence of at least 10%, a lot of students with dyslexia don’t get identified or get help for their symptoms. However, 90% of dyslexic children can be taught in normal classrooms with other kids their age if they get help early enough. It’s concerning that dyslexia was found in a large portion of the study sample. This highlights the need for more research and programs, such as campaigns to raise awareness among teachers, parents, and school officials. It’s also important to find children who haven’t been diagnosed with dyslexia yet and give them the right help as soon as possible (Sunil et al., 2023). The features mentioned above can help identify and diagnose dyslexia.

References

  • Berninger, V. W., Lee, Y. L., Abbott, R. D., & Breznitz, Z. (2013). Teaching children with dyslexia to spell in a reading-writers’ workshop. Annals of Dyslexia, 63, 1-24. https://doi.org/10.1007/s11881-011-0054-0
  • Berninger, V. W., Raskind, W., Richards, T., Abbott, R., & Stock, P. (2008). A multidisciplinary approach to understanding developmental dyslexia within working-memory architecture: Genotypes, phenotypes, brain, and instruction. Developmental neuropsychology, 33(6), 707-744. https://doi.org/10.1080/87565640802418662
  • Berninger, V. W., Richards, T. L., & Abbott, R. D. (2015). Differential diagnosis of dysgraphia, dyslexia, and OWL LD: Behavioral and neuroimaging evidence. Reading and Writing, 28, 1119-1153. https://doi.org/10.1007/s11145-015-9565-0
  • Campbell, T. (2011). From aphasia to dyslexia, a fragment of a genealogy: An analysis of the formation of a ‘medical diagnosis’. Health Sociology Review, 20(4), 450-461. https://doi.org/10.5172/hesr.2011.20.4.450
  • Chung, K. K., Ho, C. S. H., Chan, D. W., Tsang, S. M., & Lee, S. H. (2011). Cognitive skills and literacy performance of Chinese adolescents with and without dyslexia. Reading and Writing, 24, 835-859. https://doi.org/10.1007/s11145-010-9227-1
  • International Dyslexia Association (IDA, 2019). Dyslexia Basics. Retrieved from https://dyslexiaida.org/dyslexia-basics-2/
  • Kilpatrick, D. A. (2015). Essentials of assessing, preventing, and overcoming reading difficulties. John Wiley & Sons.
  • Kim, Y. S., Wagner, R. K., & Lopez, D. (2012). Developmental relations between reading fluency and reading comprehension: A longitudinal study from Grade 1 to Grade 2. Journal of experimental child psychology, 113(1), 93-111. https://doi.org/10.1016/j.jecp.2012.03.002
  • Livingston, E. M., Siegel, L. S., & Ribary, U. (2018). Developmental dyslexia: Emotional impact and consequences. Australian Journal of Learning Difficulties, 23(2), 107-135. https://doi.org/10.1080/19404158.2018.1479975
  • Martinelli, V., & Schembri, J. (2014). Dyslexia, spatial awareness and creativity in adolescent boys. The British Psychological Society. Available at: https://www.um.edu.mt/library/oar/handle/123456789/91865
  • Nielsen, K., Abbott, R., Griffin, W., Lott, J., Raskind, W., & Berninger, V. W. (2016). Evidence-based reading and writing assessment for dyslexia in adolescents and young adults. Learning disabilities (Pittsburgh, Pa.), 21(1), 38. https://doi.org/10.18666/LDMJ-2016-V21-I1-6971
  • Roitsch, J., & Watson, S. M. (2019). An overview of dyslexia: definition, characteristics, assessment, identification, and intervention. Science Journal of Education, 7(4). https://doi.org/10.11648/j.sjedu.20190704.11
  • Shaywitz, S. E., Morris, R., & Shaywitz, B. A. (2008). The education of dyslexic children from childhood to young adulthood. Annu. Rev. Psychol., 59(1), 451-475. https://doi.org/10.1146/annurev.psych.59.103006.093633
  • Snowling, M. J., Hulme, C., & Nation, K. (2020). Defining and understanding dyslexia: past, present and future. Oxford review of education, 46(4), 501-513. https://doi.org/10.1080/03054985.2020.1765756
  • Sunil, A. B., Banerjee, A., Divya, M., Rathod, H. K., Patel, J., & Gupta, M. (2023). Dyslexia: An invisible disability or different ability. Industrial psychiatry journal, 32(Suppl 1), S72-S75. https://doi.org/10.4103/ipj.ipj_196_23 van Viersen, S., Kroesbergen, E. H., Slot, E. M., & de Bree, E. H. (2016). High reading skills mask dyslexia in gifted children. Journal of learning disabilities, 49(2), 189-199. https://doi.org/10.1177/0022219414538517
Categories
Current Affairs Psychology in Pakistan

Tax Kum Karo: Analyzing the Relationship Between Income, Taxes and Mental Health in Pakistan

Written by Abdullah Qureshi

“If money is the bond binding me to human life, binding society to me, connecting me with nature and man, is not money the bond of all bonds? Can it not dissolve and bind all ties? Is it not, therefore, also the universal agent of separation?”

Karl Marx

Pakistan has entered its 5th unofficial year of economic turmoil. While the steep decline seems to have become lesser so, the decline still continues.

An Introduction to Pakistan’s Economic Woes

The National Accounts Committee (NAC) said that the average income per person went up a little from $1,551 in fiscal year 2023 to $1,680 in 2024. For reference, it was $1,766 in 2022 and $1,677 in fiscal year 2021.

On top of that, the Pakistani government is planning to raise direct taxes by 48% and secondary taxes by 35%.

This indicates an overall level of decline in the per capita income and a stark increase in taxes. To top it off, this decline is also in the midst of economic and political turmoil.

As a response to the proposed budget, many salaried people have resorted to protests. Banners are held high of #taxkumkaro (lower the taxes). These protests are still not as rage-filled as the table talk in Pakistani households.

What brews at the domestic and psychological level is far more debilitating than one can imagine.

These are the bare figures of the problem.

In this essay, I will attempt to assess how income and taxes impact mental health. I will also discuss what this means in the context of Pakistan.

Income and Mental Health

‘Tax Kum Karo’ is not just about taxes.

It is also about the shockingly low income of the salaried class that has to now pay additional taxes.

Low-income populations usually live under stressful situations. These chronic stressors ratchet up the risk of worsening mental health problems. Economic turmoil has long been linked to dissatisfaction with life. Poverty is associated with greater risk of common mental disorders (Adler et al., 2016).

According to the World Bank, 40% of Pakistanis are already living below the poverty line, with another 10 million hovering just above it.

This is a colossal figure. I argue here that it is far more pernicious than just a matter of sustenance.

It is a matter of psychological and philosophical devastation of an entire nation.

First, let us do a bit of groundwork and understand how the economy interacts with psychology.

How does Income Affect Mental Health?

Shields-Zeeman (2021) conducted a study on the linkage between income and mental health. They found that income is associated with reduced psychological distress and improved health.

So, combing this research with the fact that poverty exacerbates psychological issues, this presents us with an ugly cocktail.

How does Mental Health Affect Income?

A decline in mental health has a significant cost in the productivity of a country.

A decline in physical health also has a substantial cost on the economy.

In fact, Poverty is thought to lower people’s ‘cognitive bandwidth,’ which can change how they make decisions and lead to dangerous health behaviors (Schilbach et al., 2016). Knapp and Wong (2020) wrote an entire essay detailing where economics and mental health meet. They cited productivity costs and the cost of illness (COI) as coming through both direct and indirect means.

Moreover, Marcotte & Wilcox-Gök (2001) conclude that 5–6 million workers in the US between the ages of 16 and 54 lose their jobs, don’t look for work, or can’t find work every year because of mental illness. Researchers think that people with mental illness make between $3,500 and $6,000 less a year compared to those who don’t have mental illness.

However, this relationship is even more complex when both directions are considered.

The Complexity

A review by Shields-Zeeman and Smit (2022) found that increases in income were associated with a small improvement in mental health. However, a drop in income had a larger negative influence on psychological well-being.

These findings suggest that the effect of income loss is more detrimental to mental health than an increase in income is for improving mental health.

This has important implications for those living just above or below the poverty line.

Why?

Because a very short drop in income can present these people a substantial risk to income security and mental health.

In Pakistan’s context, these findings have serious implications. This is because a significant amount of people were pushed to a lower socioeconomic class in the last 5 years (Ali, 2022). In fact, many of these crises featured political turmoil and polarization.

Link to Suicide

Another crucial bit of information is that domestic and financial problems are the two most significant reasons for suicide (Naveed et al., 2023). This, in some ways, solidifies a link between financial problems and severe psychological issues.

In fact, it is even more illuminating as the political polarization effects family leadership (Rashid & Rashid, 2024). This in turn could cause many domestic issues. Thus, the economic crisis and the political polarization have both a direct and indirect effect on mental health in Pakistan.

Taxation and Mental Health

Rawls’ (1971/1999) theory of justice says that countries with more progressive taxation had higher ratings of well-being. Meanwhile, countries with less progressive taxation had more negative daily experiences.

This was corroborated by a study conducted by Oishi et al. (2012).

However, in Pakistan, the current taxation is not progressive. This is because, according to the proposed budget, the people who fall inside the ‘middle class’ are also slapped with very similar tax bracket of the more affluent class.

Moreover, many of the taxes actually target the classes which are underprivileged.

The Pakistani Finance Bill was recently changed to raise taxes on business dairy farms and fuel. Builders and investors’ earnings are also taxed at a rate of 10% to 12%. Besides that, there is now a 10% sales tax on office supplies such as notebooks, pencils, pens, ink, staplers, and more.

MNAs’ trip allowances, on the other hand, has gone up from Rs10/km to Rs25/km.

There are also some seemingly ‘soft’ attempts to recover money from those who d o not pay their taxes.

These policies can be seen as pernicious for the people who they do not benefit.

The problem is that the people who do not benefit from this are also the people who no longer possess financial stability.

Another very important finding indicated by Oishi et al. (2012) was that in low income countries, even progressive taxation does not improve well-being.

Trust

It is no secret, however, that these tax demands are not the government’s own policy.

Most of the tax demands arise from the International Monetary Fund’s camp.

The IMF’s key demands include an increase in the tax revenue target, withdrawal of subsidies, taxes on the agriculture sector, increase in levy and taxes on power, gas and oil sectors, privatisation of sick government organisations and units and improving administration, a ministry official was quoted as saying.

The problem here is that this reduces the utility of government action. Once the utility is lowered, so is the level of trust in the population.

Nations are built on philosophical principles. A nation-state that cannot protect its citizens fails to justify its utility.

This can have an even more grievous impact on the national perception of the government. Rothstein and Uslaner (2005) argue that the social trust of a government is in itself a different dimension.

If social trust is lower, many people in the population reject even the better policies. Thus, if the current party in power has any interest in continuing its service in this fragile democracy, their way of handling the economic crisis is failing.

Conclusion

It appears as if the government of Pakistan has yet to understand basic principles of building trust. This trust is not built by documentation on social media about the work trips of chief ministers. Rather, trust is built based on policies which positively affect the people. One could argue that higher taxation is the way to go.

However, when allowances of government officials are increased at the same time, one can question:

Who is the state protecting?

So far, the tentative budget favors the people who are privileged. It allows room for tax evaders. But unfortunately, it strangles those who are already living below reasonable means.

 But the protests of ‘tax kum karo’ rage on. One can only hope that at some point, the middle class could find a way into the power corridors of Pakistan. Perhaps, the people who are suffering the most deserve a chance at ruling.

References

  • Adler, N. E., Glymour, M. M., & Fielding, J. (2016). Addressing social determinants of health and health inequalities. Jama, 316(16), 1641-1642.
  • Knapp, M., & Wong, G. (2020). Economics and mental health: the current scenario. World Psychiatry, 19(1), 3-14.
  • Marcotte, D. E., & Wilcox-Gök, V. (2001). Estimating the employment and earnings costs of mental illness: recent developments in the United States. Social Science & Medicine, 53(1), 21-27.
  • Naveed, S., Tahir, S. M., Imran, N., Rafiq, B., Ayub, M., Haider, I. I., & Khan, M. M. (2023). Sociodemographic characteristics and patterns of suicide in Pakistan: an analysis of current trends. Community mental health journal, 59(6), 1064-1070
  • Oishi, Shigehiro & Schimmack, Ulrich & Diener, Ed. (2011). Progressive Taxation and the Subjective Well-Being of Nations. Psychological science. 23. 86-92. 10.1177/0956797611420882.
  • Rashid, Z., & Rashid, S. (2024). Political Instability Causes & Affects. Pakistan Journal of Humanities and Social Sciences, 12(1), 294-303.
  • Rawls, J. (1999). A theory of justice (Rev. ed.). Cambridge, MA: Harvard University Press. (Original work published 1971)
  • Rothstein, B., & Uslaner, E. M. (2005). All for All: Equality, Corruption, and Social Trust. World Politics, 58(1), 41–72. doi:10.1353/wp.2006.0022
  • Schilbach, F., Schofield, H., & Mullainathan, S. (2016). The psychological lives of the poor. American Economic Review, 106(5), 435-440.
  • Shields-Zeeman, L., Collin, D. F., Batra, A., & Hamad, R. (2021). How does income affect mental health and health behaviours? A quasi-experimental study of the earned income tax credit. Journal of epidemiology and community health, 75(10), 929–935. https://doi.org/10.1136/jech-2020-214841
  • Shields-Zeeman, L., & Smit, F. (2022). The impact of income on mental health. The Lancet Public Health, 7(6), e486-e487.
Categories
Cognitive Psychology

Overview of The Cognitive Triad

Written by Abdullah Qureshi

Aaron Beck was one of the first people to say that the way people think about things can cause negative emotional experiences. In fact, the way people think about and process personal information can maintain this depressive state.

In particular, Beck’s (1979) cognitive theory says that the cognitive triad is a key process that makes depressed symptoms worse.

This concept is a three-part system made up of bad views of the self, the world, and the future.

In this article, I will attempt to describe the cognitive triad using both negative and positive views.

Structure of the Cognitive Triad

One of Beck’s most important ideas is that cognitive mental illness are caused by three bad views about regarding one’s circumstances.

These three categories are shown below:

The Cognitive Triad

People with negative views of the self think they are not good enough, worthy, or loveable. People with negative views of the world think that the world and other people are unfair and getting in the way of their goals. Lastly, having a bad view of the future means thinking that it will be hard and that the problems you are having now will last forever.  

On the other hand, some people may have a positive view of themselves, the world, and the future. This is called the positive cognitive triad, and it makes them happier, more satisfied with their life, and less likely to become depressed.

To put it another way, being strong helps people think positively. They have a positive view about themselves, the world, and the future. This in turn improves their health and makes them feel less stressed.

Views About Oneself

Negative

A bad view of the self is a trait of many illnesses and feelings. These conditions are obviously not healthy, such as depression or anxiety. People who are sad think they are flawed, inadequate, and unworthy. Tarlow and Haaga (1996) confirmed a link between having a bad view of oneself and having negative feelings in general. This backs up what the older and newer literature indicates.

People with more frequent negative states tend to have more negative views of themselves.

Positive

It is said that resilient people are self-efficacious, bold, and driven (Wagnild & Young, 1990). People with these traits are more likely to talk positively to themselves. So, this improves their self-image and makes them more independent. People who are strong have a good attitude about themselves. This attitude makes them look for and enjoy situations that make them feel good about themselves (Walsh & Banaji, 1997). In turn, they improve their mental health.

Views About the World

Negative

When someone is feeling down, they start to see the world in a bad light. For instance, people who are sad are unhappy with their current life and think that everyone is expecting too much from them. This indicates that they view the world having too many hardships. Moreover, they could perceive themselves as inferior to many people in their surroundings. This connects views about the self to the view of the world as well.

Positive

Conversely, a positive view of the world is common among people who are highly resilient (Parr et al., 1998). These people want to get back on their feet after problems and move on. People who have a positive view of the world are better able to see chances in tough situations and come up with ways to solve problems (Wang, 2009).

So, being able to think straight during tough circumstances makes them less prone to depression.

Views About The Future

Negative

People who have major mental problems might not be optimistic about the future. When someone is sad, they do not usually believe they can achieve their goals. According to a study by Leondari et al. (1998), these ideas about the future self might make it harder for students to do well in school.

However, having views of the future that are too positive could be a major issue as well.

Positive

Research shows that people who are strong are sure in their ability to see the future (Klohnen, 1996). For example, Zaleski et al. (1998) found that college students with a lot of hope are less affected by the bad effects of worry and have fewer health problems as a result. Moreover, they are likely to accept self-agentic talk, such as “I can do this” and “I am not going to be stopped” (Snyder et al., 1998).
According to past studies, people who have a lot of hope are better at fixing problems. Mak et al. (2011) say that they are more likely to take on tasks and use active coping techniques instead of passive-avoidant ones. Because of this, they are more likely to keep going when things get tough or stressful.

Having said this, there are issues with viewing the future too positively as well. For instance, Maden et al. (2016) found that employees who had higher positive evaluations of their future were less satisfied than those who had less positive views.

This could show how having unrealistic positive expectations of the world could negatively impact us.

Final Evaluation

Even though it is very important, it is still not clear what the theory and empirical state of the cognitive triad is. On the one hand, many theories say there is only one dimension. In other words, the triad’s three parts don’t really exist as three separate things; they combine. So, the cognitive triangle describes how people think about the self and two specific parts of the self: the future and the world (McIntosh & Fischer, 2000).

Beck (1979) acknowledged this quandary. However, he said that despite this correlation, the cognitive triad is still useful for clinical work.

Some studies found that negative views of the self and the future were most strongly linked to depressive symptoms in teens (Braet et al., 2015; Timbremont & Braet, 2006). Other studies also looked at the role of negative views of the world in kids and teens (Epkins, 2000; Jacobs & Joseph, 1997).

There is one broad consensus: our beliefs significantly affect our experience.

This is one of the core curative processes in psychotherapy.

References

Beck, A. T. (1979). Cognitive therapy and the emotional disorders. Penguin.

Braet, C., Wante, L., Van Beveren, M. L., & Theuwis, L. (2015). Is the cognitive triad a clear marker of depressive symptoms in youngsters?. European child & adolescent psychiatry, 24, 1261-1268.

Epkins, C. C. (2000). Cognitive specificity in internalizing and externalizing problems in community and clinic-referred children. Journal of Clinical Child Psychology, 29(2), 199-208.

Haaga, D. A., Dyck, M. J., & Ernst, D. (1991). Empirical status of cognitive theory of depression. Psychological bulletin, 110(2), 215.

Jacobs, L., & Joseph, S. (1997). Cognitive Triad Inventory and its association with symptoms of depression and anxiety in adolescents. Personality and Individual Differences, 22(5), 769-770.

Klohnen, E. C. (1996). Conceptual analysis and measurement of the construct of ego-resiliency. Journal of personality and social psychology, 70(5), 1067.

Leondari, A., Syngollitou, E., & Kiosseoglou, G. (1998). Academic achievement, motivation and future selves. Educational studies, 24(2), 153-163.

Maden, C., Ozcelik, H., & Karacay, G. (2016). Exploring employees’ responses to unmet job expectations: The moderating role of future job expectations and efficacy beliefs. Personnel Review, 45(1), 4-28.

McIntosh, C. N., & Fischer, D. G. (2000). Beck’s cognitive triad: One versus three factors. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 32(3), 153.

Parr, G. D., Montgomery, M., & DeBell, C. (1998). Flow theory as a model for enhancing student resilience. Professional School Counseling, 1(5), 26-31.

Snyder, C. R., LaPointe, A. B., Jeffrey Crowson, J., & Early, S. (1998). Preferences of high-and low-hope people for self-referential input. Cognition & Emotion, 12(6), 807-823.

Tarlow, E. M., & Haaga, D. A. (1996). Negative self-concept: Specificity to depressive symptoms and relation to positive and negative affectivity. Journal of Research in Personality, 30(1), 120-127.

Timbremont, B., & Braet, C. (2006). Brief report: A longitudinal investigation of the relation between a negative cognitive triad and depressive symptoms in youth. Journal of Adolescence, 29(3), 453-458.

Wagnild, G., & Young, H. M. (1990). Resilience among older women. Image: The Journal of Nursing Scholarship, 22(4), 252-255.

Walsh, W. A., & Banaji, M. R. (1997). The Collective Self a. Annals of the New York Academy of Sciences, 818(1), 193-214.

Wang, J. (2009). A study of resiliency characteristics in the adjustment of international graduate students at American universities. Journal of Studies in International Education, 13(1), 22-45.

Zaleski, E. H., Levey-Thors, C., & Schiaffino, K. M. (1998). Coping mechanisms, stress, social support, and health problems in college students. Applied Developmental Science, 2(3), 127-137.

Categories
Psychology in Pakistan

History of Psychology in Pakistan

Written by Najwa Bashir

The formal history of psychology in Pakistan dates back to the 1960’s. In Pakistan, psychology was recognized as a distinct academic discipline over 59 years ago (Zadeh, 2017). According to Michal J. Stevens, Wedding Danny, Dr. Nosheen Khan Rehman, and Taylor and Francis (2004), Pakistan had two universities in 1947. The psychology department was first set up in 1887 at the University of Punjab in Lahore (West Pakistan) and again in 1921 at Dhaka (East Pakistan; now Bangladesh). The University of Karachi, Sindh was founded in 1946, and the psychology school has been running since 1951.

Further psychology departments were set up in Peshawar in 1950 and in Rajshahi (East Pakistan) in 1953. Pakistan’s oldest psychology labs can be found at University of the Punjab, Government College University Lahore, and Dhaka University, which is now in Bangladesh but used to be in East Pakistan. In the 1960s, only the academic and theory parts of psychology were up and running. Experimentation was not a big focus.

In 1964, there were only 250 teachers working, no national psychological association, and no study magazine. However, later on, a psychological laboratory was set up at Punjab University in Lahore to study applied psychology. Universities were also encouraged to do experiments and research in psychology, and more journals for psychological research were published by Michal J. Stevens, Wedding Danny, Dr. Nosheen Khan Rehman, and Taylor and Francis (2004) (Firdous, 2010).

Up until 1960, one of the places where psychology was taught as part of the philosophy curriculum was the Government College in Lahore (Rafiq et al., 2022). GC Lahore used to teach psychology as part of the philosophy curriculum up until the 1960s. Psychology became its department at GC Lahore in 1962, thanks to the strong direction of Dr. Muhammad Ajmal. He became the department’s founder and head (Zadeh, 2017).

Forman Christian College, Lahore, was the second school that taught psychology. At Karachi University, the first separate school of psychology was set up. It was led by Qazi Muhammad Aslam, whose main area of study was philosophy. While Sindh University became its own thing in 1960. Syed Muhammad Hafeez Zaidi was seen in Frontiers of Psychological Research in Pakistan in 1975.

The main goal was for philosophy teachers to become involved in the field of psychology. Due to this, traditional indigenous people started studying psychology, which was mostly based on theory. There were early works in Pakistani psychology written by Hafeez Zaidi and a few others.

After 1960, many psychology schools sprung up. But at first, these departments couldn’t get many students, usually only three to seven. The reason was an opening in the job market. Before 1991, there were more than 10 universities in Pakistan that mostly offered M.A. and M.Sc. degrees in Psychology. Today, in 2018, about 12 universities have started to offer BS (Hons), MS, and Ph.D. studies in clinical psychology.

From the start until now, psychologists have needed a governing group, but the idea hasn’t fully grown yet. The University of Punjab and the University of Karachi both set up the Center for Clinical Psychology because President Zia Ul Haq was very interested in the field (Rafiq et al., 2022).

From 1960 to the present day, the field of psychology in Pakistan has been progressing slowly, but steadily. The growth can be seen in the fact that full-fledged psychology schools have been set up at the universities in Karachi, Sind, and Peshawar. Several associated schools began offering M.A. programs in psychology, and it became a separate subject to study at the Inter, B.A., and BSc levels. In 2007, HEC started a four-year BS Psychology program, which changed the way psychologists are trained at the college level in a big way.

In 1983, two schools of clinical psychology opened in Karachi and Lahore, two of Pakistan’s biggest metropolises. This was a big step forward for clinical psychology. At first, both schools gave people with a Master’s degree a one-year diploma in clinical psychology. After a while, both schools added graduate programs in clinical psychology. Dr. FarrukhZahor Ahmad started the Institute of Clinical Psychology in Karachi. He is a clinical psychologist who first learned his craft at the University of Stanford in Pakistan(Zadeh, 2017).

When the National Institute of Psychology, Islamabad opened in 1976, it added another important milestone to the history of psychology (Zaman, 1991). In 2000, Bahria University in Karachi opened the Institute of Professional Psychology. Several universities in Pakistan offer bachelor, graduate, and postgraduate programs in psychology and clinical psychology. These include the International Islamic University in Islamabad, NUST in Islamabad, and Beacon House in Lahore. The Pakistan Psychological Association (PPA) was founded in 1968, and the Pakistan Association of Clinical Psychologist (PACP) was founded in 1988. Both of these events were major turning points in the field. These are two national groups for psychologists, with the third one being just for professional psychologists(Zadeh, 2017).

Psychological journals can also be used to see how psychology has changed over time. The first psychology magazine came out in 1965, and there were five more until 1991 (Zaman, 1991). The Government College, Lahore’s Journal of Psychology, now called the Psychology Quarterly, has been out since 1962. In 1978, an Urdu journal called “Zehan” started coming out. From 1992 to 1995, the Institute of Clinical Psychology at the University of Karachi put out the Pakistan Journal of Clinical Psychology every other year. Journal printing stopped from 1995 to 2005, but it started up again in 2006 and has been going strong ever since (Zadeh, 2017).

The eleven years from 1995 to 2006 marks the time when the field of psychology grew incredibly in Pakistan and a huge number of people got PhDs in psychology. During this time, a culture of research grew, and as a result of rules set by the Higher Education Commission (HEC), research papers were required for academic job openings and raises (HEC, 2019). These requirements led to a rush of research papers being published in Pakistan, and many new research magazines were also set up. Back then, from 1995 to 2006, the internet wasn’t very common, and even where it was, there weren’t many places where you could get free papers. Many researchers in Pakistan relied on the research magazines that were available in their university libraries. Due to this, these studies were mentioned hundreds of times and were the easiest to find examples of published studies. Also, most of the people who wrote these studies were professors working at both public and private colleges. These professors also oversee MPhil and PhD studies, and most of the research done at that time was for MPhil or PhD theses (Kamrani et al., 2022).

References

  • Firdous, N. (2010). Historical Perspective of Psychology in Balochistan: Depiction, Dynamics and Development. Bi-Annual Research Journal “Balochistan Review”,23(2), 93-111. Available at: http://www.uob.edu.pk/Journals/Balochistan-Review/data/BR%2002%202010/93-111%20HISTORICAL%20PERSPECTIVE%20OF%20PSYCHOLOGY%20IN%20BALOCHISTAN%20DEPICTION,%20DYNAMICS%20AND%20DEVELOPMENT,%20Neelam%20Firdous.pdf
  • Higher Education Commission (2019). Quality Assurance. https://hec.gov.pk/english/services/universities/QA/Pages/faculty-appointment-criteria.aspx
  • Kamrani, F., Kamrani, N., &Kamrani, F. (2022). Eleven Years of Psychological Researches in Pakistan (1995-2006): What Titles Reveal About Pakistani Research. Journal of Professional & Applied Psychology, 3(2), 319-326. https://doi.org/10.52053/jpap.v3i2.117
  • Rafiq, M., Zareen, G., Khalid, A., Chahal, F. M., Maqbool, T., &Hadi, F. (2022). Clinical and neuropsychology in pakistan: challenges and wayforward. Pak-Euro Journal of Medical and Life Sciences, 5(1), 119-128. Available at:https://readersinsight.net/PJMLS/article/view/2442
  • Zadeh, Z. F. (2017). Clinical Psychology in Pakistan: Past, Present and Future. International Journal of Humanities and Social Science, 7(11), 26-28. Available at: https://www.ijhssnet.com/journals/Vol_7_No_11_November_2017/4.pdf Zaman,R.M. (1991). Clinical Psychology in Pakistan. Psychology and Developing Societies. Sage Publication. Available at: http://www.sagepublication.com?content/3/2/221.
Categories
Dark Personality Psychology

An Introduction to Sadism

Written by Abdullah Qureshi

Sadism is a psychological construct which has a relatively sparse amount of scientific literature. This is odd as sadism as a literary construct has been under study for centuries. According to Meloy (1997), sadism is basically getting pleasure from someone else’s physical or mental pain or from controlling and dominating them. Sadists are also known as violent narcissists or malignant narcissists because they get pleasure from hurting other people and don’t seem to care that they’re hurting others (Meloy, 1997).

So, there are two main components of sadism:

  • Deriving pleasure
  • ‘Hurting’ another human being

Having understood the components of sadism, I will now extend this investigation. In the next section, the subtypes of sadism will be identified.

Subtypes of Sadism

Psychopathic Sadism

Sadistic Personality Disorder was added as a diagnosis with eight criteria to the Diagnostic and Statistical Manual of Mental Disorders (DSM–III–R; American Psychiatric Association, 1987). To be diagnosed, a person had to meet at least four of these criteria. It’s interesting that none of the factors mentioned sexual sadism. Instead of that, they focused on dominance and power over other people.

This subtype of sadism pertains specifically to the assertion of dominance over other people and derivation of pleasure from that

Nevertheless, whether it is explored in literary pieces like 120 Days of Sodom, or in scientific manuals such as the DSM-V, sadism does have sexual connotations. In the DSM-V, it is considered as a paraphillic feature.

Hence, the next subtype of sadism I am going to explore is of sexual sadism.

Sexual Sadism

The term sadism was originally used to refer to the sexual arousal that some individuals experience in response to others’ suffering (Krafft-Ebing, 1907). This construct is still assessed today, under the more specific term sexual sadism.

Longpré et al. (2018) assessed the taxonicity of sexual sadism by conducting a taxometric analysis of the scores of 474 sex offenders from penitentiary settings on the MTC Sexual Sadism Scale. Their findings indicated that sexual sadism presents a clear underlying dimensional structure.

Thus, one can be sure that sexual sadism is a separate dimension.

However, there are some major issues with understanding sexual sadism. First, as Marshall and Kennedy (2003) have put it, there is a lack of consensus. Scientists are divided over whether the fundamental feature of sexual sadism is controlling the victim, humiliating them, and/or causing them physical pain.

Others have argued that it is none of these. For example, Proulx et al. (2006) have stated that sexual sadists are in fact primary rewarded by the power they exert over their victims, and not the victim’s distress per se.

To put it in a nutshell, there is confusion over whether

  • the infliction of pain gives this pleasure, or
  • the exertion of power over the other person is arousing.

Everyday Sadism

Sadism was thought to be a diagnostic condition until not too long ago. A lot of the study on sadism was done in investigative settings, mostly looking at sex crimes (Mokros et al., 2014). More recently, though, it has become clear that cruel traits can show up in other situations as well. This is called “everyday sadism” to differentiate it from sadism in sex or crime situations (Buckels et al., 2013). The idea of “everyday sadism” was helpful because it shows that these traits are present in community groups (O’Meara et al., 2011).

This further allows researchers to study sadism in various functional fields of life. These areas could be business, politics, work-life and relationships

Relation to Psychopathy

To understand the link between sadism and psychopathy, I will first explain the typology of psychopathy.

Millon and Davis (1998), through the psychodynamic approach came up with ten theory subtypes of psychopathy. These subtypes might be useful as a guide. However, they would be hard to study in the real world because psychodynamics are not easily defined.

Another problem is that it looks like a lot of the groups can be combined. There are times when these theoretical subtypes are too similar to help define accurate subtypes within psychopathy. However, factors that seem to be consistent with Cluster B personality disorders are taken into account. For instance, a “disengenuous psychopath” is someone who always needs attention, acts friendly on the outside, has a vague personality, and is never reliable. These traits are also found in psychopaths, but a psychopath who shows all of these traits to the fullest may indicate a stable form.
In 1998, Millon and Davis came up with three more subtypes: the evil psychopath, the covetous psychopath, and the unprincipled psychopath. These all seem to have a lot to do with different parts of antisocial personality disorder, narcissistic personality disorder, and sadism.

Here, we can see how psychopathic behavior can be a source of pleasure. This is especially in the case where the individual exerts their dominance over the other.

Difference between Sadism and Psychopathy

There is an overlap between sadism and psychopathy. Psychopathy is a part of the Dark Triad that has links to sexual sadism in both community and clinical samples (Baughman et al., 2014; Mokros et al., 2011).
In spite of these links, there are two types of data that show sadism is not very similar to the other negative personality traits.

Hence, it should be given its own name.

Let us look at these streams of evidence.

Low Correlation

First, the links to the Dark Triad aren’t very strong. For example, in one study, daily sadism was linked to psychopathy, Machiavellianism, and narcissism with r values of .31–37 (Chabrol et al., 2009). This indicates correlation. However, the correlation is not huge. Thus, it could be assumed that sadism is a separate construct.

Sadism Explains Antisocial Behavior Independent of the Dark Triad

In addition to the Dark Triad, sadism explains a different kind of antisocial behavior. This is true in the case of cyberbullying (Smoker & March, 2017). It is also exhibited in experiments involving blasting task opponents with white noise (Buckels et al., 2013), or trolling on Facebook (Craker & March, 2016).

So, sadism explains certain antisocial behaviors which are different from the ones observed in classical psychopathy.

Conclusion

Sadism is a unique personality construct. It appears to interact with environmental factors differently. Moreover, its combination with psychopathy or other dark personality traits produces unique outcomes. Hence, there is a need for sadism to be studied more individually. Studying sadism could indeed shed even further light on to deviant behaviors on social media.

Ultimately, by investigating sadism, we could end up discovering even more of the dark side of our personalit.

References

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.
  • Baughman, H. M., Jonason, P. K., Veselka, L., & Vernon, P. A. (2014). Four shades of sexual fantasies linked to the Dark Triad. Personality and Individual Differences, 67, 47-51.
  • Buckels, E. E., Jones, D. N., & Paulhus, D. L. (2013). Behavioral confirmation of everyday sadism. Psychological science, 24(11), 2201-2209.
  • Chabrol, H., Van Leeuwen, N., Rodgers, R., & Séjourné, N. (2009). Contributions of psychopathic, narcissistic, Machiavellian, and sadistic personality traits to juvenile delinquency. Personality and individual differences, 47(7), 734-739.
  • Craker, N., & March, E. (2016). The dark side of Facebook®: The Dark Tetrad, negative social potency, and trolling behaviours. Personality and Individual Differences, 102, 79-84.
  • Krafft-Ebing, R. (1907). Psychopathia sexualis. F. Enke.
  • Longpré, N., Guay, J. P., Knight, R. A., & Benbouriche, M. (2018). Sadistic offender or sexual sadism? Taxometric evidence for a dimensional structure of sexual sadism. Archives of Sexual Behavior, 47, 403-416.
  • Marshall, W. L., & Kennedy, P. (2003). Sexual sadism in sexual offenders: An elusive diagnosis. Aggression and Violent Behavior, 8(1), 1-22.
  • Meehl, P. E., & Yonce, L. J. (1994). Taxometric analysis: I. Detecting taxonicity with two quantitative indicators using means above and below a sliding cut (MAMBAC procedure). Psychological reports.
  • Meloy, J. R. (1997). The psychology of wickedness: Psychopathy and sadism. Psychiatric Annals, 27(9), 630-633.
  • Millon, T., Simonsen, E., & Birket-Smith, M. (1998). Historical conceptions of psychopathy in the United States and Europe.
  • Mokros, A., Osterheider, M., Hucker, S. J., & Nitschke, J. (2011). Psychopathy and sexual sadism. Law and human behavior, 35(3), 188.
  • Mokros, A., Schilling, F., Weiss, K., Nitschke, J., & Eher, R. (2014). Sadism in sexual offenders: Evidence for dimensionality. Psychological assessment, 26(1), 138.
  • Murphy, C., & Vess, J. (2003). Subtypes of psychopathy: Proposed differences between narcissistic, borderline, sadistic, and antisocial psychopaths. Psychiatric quarterly, 74, 11-29.
  • O’Meara, A., Davies, J., & Hammond, S. (2011). The psychometric properties and utility of the Short Sadistic Impulse Scale (SSIS). Psychological assessment, 23(2), 523.
  • Smoker, M., & March, E. (2017). Predicting perpetration of intimate partner cyberstalking: Gender and the Dark Tetrad. Computers in Human Behavior, 72, 390-396.
  • Waller, N. G., & Meehl, P. E. (1998). Multivariate taxometric procedures: Distinguishing types from continua. Sage Publications, Inc.
Categories
Psychiatric Disorders

Diagnostic Features of Attention-Deficit/Hyperactivity Disorder

Written by Najwa Bashir

ADHD is a brain condition characterized by problems with not paying attention, getting things done, or being too active and impulsive. People with inattention and disorganization can’t stay on task, don’t seem to listen and lose things they need for jobs at levels that aren’t appropriate for their age or level of development. Overactivity, pacing, not being able to stay sat, interrupting other people’s activities, and not being able to wait are all signs of hyperactivity-impulsivity that are too much for the person’s age or level of development. During youth, ADHD often happens at the same time as “externalizing disorders” like oppositional defiant disorder and conduct disorder of some people. ADHD often lasts into adulthood, which can make it hard to function in social, school, and work settings (American Psychiatric Association, 2022, p. 36).

Attention deficit/hyperactivity disorder (ADHD) is one of the most common mental and behavioral illnesses that kids and teens come to see for help. People with ADHD often have signs and problems that last a long time, even into adulthood. A lot of the time, ADHD is linked to other problems, like mood, worry, or drug abuse issues. Untreated ADHD has a lot of social and community costs over a person’s lifetime, such as poor academic and job performance, crime, car accident safety, and relationship problems (Wilens & Spencer, 2010). ADHD is one of the most common neurological diseases in the world. About 5–7% of children and teens (Polanczyk et al., 2007; Thomas et al., 2015) and about 2.5% of adults (Fayyad et al., 2017; Song et al., 2021) have it. A careful clinical review of symptoms and functional problems is needed to make a diagnosis of ADHD. Important standard factors help doctors make accurate diagnoses, such as the Diagnostic and Statistical Manual of Mental Disorders – 5th version (DSM 5) (Da Silva et al., 2023). According to DSM 5 TR, the following are the diagnostic criteria and features of attention-deficit/hyperactivity disorder.

Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder

A. A pattern of persistent lack of attention and/or hyperactivity-impulsivity that gets in the way of working or growth, as shown by (1) and/or (2):

  1. Not paying attention: at least six of the following symptoms have been present for at least six months in a way that is not consistent with the child’s developmental level and has a direct negative effect on social, academic, or work activities:
    Note: The symptoms are not just a sign of oppositional behavior, resistance, anger, or not being able to understand what to do or how to do it. There must be at least five signs for older teens and adults (17 years and up).
    a. Doesn’t pay close attention to details or makes careless mistakes in school, work, or other activities (for example, forgets or skips details, produces incorrect work).
    b. Often has trouble staying focused on tasks or games (for example, has trouble staying on task during classes, talks, or long reading).
    c. During direct communication, often doesn’t seem to listen (e.g., mind seems elsewhere, even when there aren’t any obvious distractions).
    d. In general, doesn’t do what they’re told and doesn’t finish schoolwork, jobs, or work duties (for example, they might start a task but get distracted quickly).
    e. Has a lot of trouble planning activities and tasks (for example, can’t keep things in order; work is often messy and disorganized; suffers from poor time management and misses deadlines).
    f. Usually avoids, dislikes, or doesn’t want to do things that take long-term mental effort, like schoolwork or chores; for older teens and adults, this could include writing reports, filling out forms, or going over long papers.
    g. Frequently drops things they need to do things (like school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, cell phones, etc.).
    h. Is quickly distracted by outside stimuli, which for later teens and adults may include thoughts that aren’t connected.
    i. Forgets to do things like do jobs and run errands, or for older teens and adults, remember to return calls, pay bills, and keep meetings.
  2. Hyperactivity and impulsivity: At least six of the following symptoms have been present for at least six months in a way that is not consistent with the child’s age or level of development and has a bad effect on social, academic, or work activities:
    Note: The symptoms are not just a sign of oppositional behavior, resistance, anger, or not being able to understand what to do or how to do it. There must be at least five signs for older teens and adults (17 years and up).
    a. Moves their hands or feet around a lot or squirms in their seat.
    b. Often gets up from their seat when they are supposed to stay put, like when they are in class, the office, or another place of work, or when they need to stay put in other situations.
    c. Runs around or climbs up often when it’s not proper to do so. Note: In teens and adults, it may just mean feeling restless.
    d. Not able to play or do other fun things alone very often.
    “Is often on the go,” acting like they are “driven by a motor” (e.g., can’t or doesn’t like being still for long periods of time, like in restaurants or meetings; others may see them as restless or hard to keep up with).
    f. Talks too much a lot of the time.
    g. Often blurts out an answer before the question is finished (for example, finishing other people’s words; can’t wait their turn in a talk).
    h. Often has trouble waiting for his or her turn (for example, in line).
    Often stops or gets in the way of other people’s conversations, games, or activities (for example, butts into conversations, games, or activities; may start using other people’s things without asking or getting permission; for teens and adults, may get in the way of or take over what others are doing).

B. Several signs of not paying attention or being restless and reckless were present before the age of 12.
C. In two or more places (like at home, school, or job; with friends or family; doing other things), the person shows several signs of not paying attention or being hyperactive-impulsive.
D. There is strong proof that the symptoms impair or lower the quality of social, academic, or professional performance.
E. The symptoms aren’t just a part of schizophrenia or another psychotic disorder, and they can’t be explained by another mental disorder, like a mood disorder, an anxiety disorder, a dissociative disorder, a personality disorder, or heavy or light drug use.

Specify if:
F90.2 If both Criteria A1 (not paying attention) and A2 (being hyperactive or impulsive) have been met for the past 6 months, the person will be given a combined presentation.
F90.0 Presentation that is mostly not paying attention: If Criteria A1 (not paying attention) is met but Criteria A2 (hyperactivity or recklessness) has not been met in the last 6 months.
F90.1 If Criteria A2 (hyperactivity-impulsivity) is met and Criterion A1 (inattention) has not been met in the last 6 months, the person is likely to be hyperactive or impulsive.
Specify if:
In partial remission: Less than the full set of standards have been met for the past 6 months, but the symptoms still make it hard to function in social, school, or occupational settings.
Specify the current severity:
Mild: There are few or no symptoms that go beyond those needed to make the diagnosis, and the symptoms don’t make it hard to do things at work or in social situations.
Moderate: There are symptoms or problems with functioning that are between “mild” and “severe.”
Severe: There are a lot of symptoms, more than what is needed to make a diagnosis, or several very bad symptoms. The symptoms make it very hard to function in social or work settings.

Diagnostic Features for Attention-Deficit/Hyperactivity Disorder

  • Attention-deficit/hyperactivity disorder (ADHD) is characterized by a pattern of chronic inattention and/or hyperactivity-impulsivity that gets in the way of working or growth. ADHD kids with inattention act out by getting sidetracked, not following through on directions, not finishing work or jobs, having trouble staying focused, and being disorganized. This isn’t because they are defiant or don’t understand.
  • Hyperactivity is when a person does too much of something, like running around when it’s not proper, or when they fidget, tap, or talk too much. Adults with hyperactivity may be very antsy or wear other people out with all their activity. If someone acts impulsively, they do things quickly and without thinking, which could hurt themselves (for example, running into the street without looking).
  • Impulsivity could mean that a person wants benefits right away or can’t wait to get them. People who act on impulse may be socially offensive (for example, talking over other people too much) or make big decisions without thinking about the long-term effects (for example, applying for a job without enough information).
  • ADHD starts in childhood.
  • The fact that several symptoms must be present before age 12 shows how important a significant clinical picture during childhood is. At the same time, a younger age at onset is not given because it is hard to say for sure when the symptoms started in youth.
  • It is not always accurate for adults to remember symptoms from their youth, so it is helpful to get extra information. ADHD can’t be confirmed if there aren’t any signs before age 12.
  • If signs of what seems to be ADHD show up for the first time after age 13, they are more likely to be caused by another mental problem or the brain effects of drugs.
  • The problem must show up in more than one place, like at home, at school, and at work. It’s usually not possible to get a good picture of a person’s major symptoms in different settings without talking to people who have seen them in those situations.
  • Most of the time, signs change based on the situation and place.
  • Signs of the disorder might not be present if the person is rewarded often for good behavior, is closely watched, is in a new place, is doing very interesting things, is constantly stimulated from the outside (for example, by electronic screens), or is interacting with one person at a time (for example, in the clinician’s office).

The aforementioned criteria and features by DSM 5 TR can be kept into consideration to diagnose individuals with attention-deficit/hyperactivity disorder. Early diagnosis can ensure the treatment is started in the early phase of the individual’s life to help him deal with the issues and avoid farsighted adverse consequences.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
  • American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (2022). Washington, DC, American Psychiatric Association.
  • Da Silva, B. S., Grevet, E. H., Silva, L. C. F., Ramos, J. K. N., Rovaris, D. L., & Bau, C. H. D. (2023). An overview on neurobiology and therapeutics of attention-deficit/hyperactivity disorder. Discover Mental Health, 3(1), 2. https://doi.org/10.1007/s44192-022-00030-1
  • Fayyad, J., Sampson, N. A., Hwang, I., Adamowski, T., Aguilar-Gaxiola, S., Al-Hamzawi, A., … & Kessler, R. C. (2017). The descriptive epidemiology of DSM-IV adult ADHD in the world health organization world mental health surveys. ADHD Attention Deficit and Hyperactivity Disorders, 9, 47-65. https://doi.org/10.1007/s12402-016-0208-3
  • Polanczyk, G., De Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis. American journal of psychiatry, 164(6), 942-948. https://doi.org/10.1176/ajp.2007.164.6.942
  • Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X., & Rudan, I. (2021). The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis. Journal of global health, 11. https://doi.org/10.7189/jogh.11.04009
  • Thomas, R., Sanders, S., Doust, J., Beller, E., & Glasziou, P. (2015). Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics, 135(4), e994-e1001. https://doi.org/10.1542/peds.2014-3482
  • Wilens, T. E., & Spencer, T. J. (2010). Understanding attention-deficit/hyperactivity disorder from childhood to adulthood. Postgraduate medicine, 122(5), 97-109. https:/doi.org/10.3810/pgm.2010.09.2206
Categories
Psychiatric Disorders

Diagnostic Features of Autism Spectrum Disorder

Written by Najwa Bashir

Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by problems communicating with others, limited hobbies, and doing the same things over and over again (American Psychiatric Association, 2013). Autism spectrum disorder, or ASD, is a group of brain disorders. Patterns of behavior, hobbies, activities, and social problems that happen over and over again are what define this range. Some kids with ASD have behavior and mental health issues. This is because ASD is a difficult neurodevelopmental disease. Unfortunately, these kids get upset when things change around them because they aren’t very good at adapting. The signs start in early childhood and make it hard to do normal things. Language problems, brain challenges, and epilepsy happen more often in children with ASD than in the general population (Mughal et al., 2022).

The World Health Organization (WHO) reports that 0.76 percent of children around the world have ASD. However, this only includes about 16 percent of all children in the world (Baxter et al., 2015). The Centers for Disease Control and Prevention (CDC) says that about 1.68% of 8-year-old children in the US (or 1 in 59 children) are identified with ASD (Biao, 2018; Palinkas et al., 2019). Parent-reported ASD findings in the US in 2016 were 2.5% on average (Kogan et al., 2018). Autism and Developmental Disabilities Monitoring Network (ADDM) data shows that the number of people with ASD in the US more than doubled between 2000–2002 and 2010–2012 (Biao, 2018). It might be too early to say anything about trends, but in the US, the number of people with ASD seems to have leveled off, with no statistically significant rise from 2014 to 2016 (Xu et al., 2018). No changes have been made to the DSM-5 diagnostic standards yet, so it’s too early to say what effect they will have on frequency (Palinkas et al., 2019).

ASD can happen to people of any race, ethnicity, or income level, but not everyone with ASD is diagnosed the same way. It has been shown that ASD is more common in white children than in black or Hispanic children (Baio, 2018). Even though the differences seem to be going down, they may still be there because of shame, limited access to healthcare services, or the fact that a patient’s first language is not English (Hodges et al., 2020).

People all over the world who have ASD have a lot of health problems. Finding ASD early can lower the number of children who have developmental problems and help them communicate better (Salari et al., 2022). The following text mentions the diagnostic criteria and features of autism spectrum disorder according to DSM 5 TR (American Psychiatric Association, 2022).

Diagnostic Criteria for Autism Spectrum Disorder

A. Consistent problems with social contact and interaction in a variety of settings, shown by any or all of the following, either now or in the past (examples are meant to show, not list all of them; see text):

  1. Problems with social and emotional exchange, such as an odd social approach and an inability to have a normal back-and-forth talk; less sharing of interests, feelings, or affect; or failing to start or respond to social interactions.
  2. Lack of skills in nonverbal communication behaviors used for social interaction, such as not combining verbal and nonverbal communication well, having problems with eye contact and body language, not understanding and using gestures properly, or not using any facial expressions or nonverbal communication at all.
  3. Problems with making, keeping, and understanding relationships, such as having trouble changing how they act in different social situations, having trouble making friends or sharing pretend play, or not being interested in their peers.

B. Limited, recurring patterns of behavior, hobbies, or activities, as shown by at least two of the following, either now or in the past (examples are provided for reference only; see text):

  1. Movements, objects, or words that are patterned or repeated, such as simple motor stereotypies like lining up toys or spinning objects, echolalia, or using unique phrases.
  2. Insisting on things staying the same, not changing, or speaking or acting in a certain way over and over again (for example, being very upset by small changes, having trouble with transitions, having rigid thought patterns, welcome practices, or having to take the same route or eat the same food every day).
  3. Very limited, fixed interests that are intense or focused in a way that isn’t normal (for example, a strong connection to or preoccupation with strange items, interests that are too limited or that last too long).
  4. Being overly or underly sensitive to sensory input or showing an odd interest in sensory parts of the environment (for example, not caring about pain or temperature, being sensitive to certain sounds or textures, smelling or touching things too much, or being visually interested in lights or movement).

C. Symptoms must be present in the early stages of development, but they may not show up fully until social demands are too much for the person’s limited abilities, or they may be hidden by tactics learned later in life.
D. The symptoms make it hard to act normally in social, professional, or other important areas of life.
E. Intellectual developmental disorder (also called intellectual disability) or global developmental delay are not better ways to explain these problems. A lot of the time, intellectual developmental disorder and autism spectrum disorder happen together. To identify both of them at the same time, a person’s social speech skills must be below what is normal for their age.

Note: People who have a sure-fire DSM-IV diagnosis of autism spectrum disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise defined should be given that label. If someone has major problems with social communication but doesn’t otherwise meet the standards for autism spectrum disorder, they should be checked for social (pragmatic) communication disorder.
Specify the current level based on problems with social contact and limited, repeated patterns of behavior:
Requiring very strong strength
Requiring a lot of help
Needing help:
Specify if:
Whether there is intellectual disability along with it
Together with or without language problems
Specify if:
linked to a known genetic or other health problem or external cause (Note on the code: add more code to find the genetic or other medical problem that goes with it.)
linked to a mental, behavioral, or neurological issue
Specify if:
With catatonia

Diagnostic Features of Autism Spectrum Disorder

  • As per criteria A and B, people with autism spectrum disorder have limited, repetitive patterns of behavior, hobbies, or activities and chronic problems with reciprocal social contact and social interaction. These signs show up early in life and make it hard to do normal things (Criteria C and D).
  • Core diagnostic features are clear during the developmental stage, but problems may not be seen in some situations because of assistance, compensation, and present supports.
  • The disorder also shows up in very different ways based on how severe the autism is, the person’s level of development, their chronological age, and maybe even their gender. This is where the word “spectrum” comes from.
  • People who don’t have intellectual or language impairments may have more minor signs of deficits (e.g., Criterion A, Criterion B) than people who do have intellectual or language impairments and may be working hard to hide these deficits.
  • Lack of social communication problems will be less obvious if a person has better communication skills in general (for example, speaks clearly and doesn’t have any brain disabilities). In the same way, Criterion B weaknesses (limited patterns of behavior and interests) might not be as clear if the interests are more in line with what kids their age normally like (like trains or Ancient Egypt instead of moving a string).
  • The problems with social contact and conversation that are listed in Criterion A are widespread and last a long time.
  • Verbal and unconscious communication problems in social situations show up in different ways based on the person’s age, level of intelligence, language skills, and other things like past and present care and support.
  • Lack of speech, language delays, trouble understanding speech, repeated speech, or speech that is too precise or stilted are just a few of the language problems that many people have. Autism spectrum disease makes it hard to use language for social contact, even when formal language skills like vocabulary and grammar are fine.
  • Lack of social-emotional exchange, or the ability to interact with others and share thoughts and feelings, can be seen in young children who don’t initiate social interactions or share emotions, and who also don’t copy other people’s behavior closely or at all.
  • Languages that do exist are often one-sided and don’t involve social reciprocity. They are used to ask for things or name things instead of to talk, share thoughts, or make comments. When it comes to older kids and people who don’t have intellectual disabilities or language delays, problems with social-emotional reciprocity may show up as issues with understanding and responding to complicated social cues like learning when and how to join a chat and what not to say.
  • Individuals who have come up with ways to deal with some social challenges still have trouble in new or uncontrolled situations and find it hard and stressful to consciously figure out what is socially natural for most people. Researchers think that this behavior may make it harder to diagnose autism spectrum disorder in these people, maybe especially in older women.
  • People who have problems with nonverbal communication skills for social interactions may not make eye contact, make eye contact less often, or use movements, facial expressions, body language, or speech intonation in ways that are not normal for their culture.
  • Impaired joint attention is an early sign of autism spectrum disorder. This can show up as not pointing, showing, or bringing things to share an interest with others, or as not following someone’s eye look or pointing.
  • People may learn a few useful gestures, but their collection is smaller than other people’s, and they don’t always use expressive motions when they’re talking to others. Teenagers and adults who speak more than one language may have trouble matching their body language with their speech, which can make their relationships seem strange, awkward, or over the top.
  • In some situations, impairment may be pretty subtle (for example, someone may make good eye contact when talking), but it will be clear if they can’t combine eye contact, gesture, body posture, prosody, and facial expression when they’re talking to other people, or if they have trouble keeping these things up for long periods of time or when they’re stressed. People who have trouble making, keeping, and understanding relationships should be rated by how well they meet age, gender, and cultural norms.
  • It’s possible that there isn’t any, very little, or normal social interest, which can show up as rejecting others, being passive, or approaching them in a way that seems hostile or annoying. These issues are especially clear with young kids, who don’t get enough shared social play and imaginative play (like age-appropriate, open pretend play). Later, they become very set in their ways when they play.
  • Older people may find it hard to understand what behavior is acceptable in some settings but not others (for example, being relaxed during a job interview) or the various ways that language can be used to communicate (for example, comedy, white lies). There may be a clear desire for doing things by yourself or with people who are much younger or older than you.
  • Many times, people want to make friends without having a full or accurate picture of what friendship really means (for example, bonds that only involve shared hobbies). It’s also important to think about your relationships with peers, coworkers, and providers (in terms of reciprocity).
  • As stated in Criterion B, someone with autism spectrum disorder also has limited, repetitive patterns of behavior, hobbies, or activities. These patterns can look different depending on the person’s age, ability, intervention, and present supports.
  • Some examples of stereotyped or repetitive behaviors are flapping the hands or flicking the fingers, using the same objects over and over (like spinning coins or lining up toys), and talking in the same way over and over (echolalia, which is the delayed or immediate repetition of heard words; using “you” when talking about oneself; using stereotyped words, phrases, or prosodic patterns).
  • Too much adherence to routines and limited patterns of behavior can show up as resistance to change (e.g., distress at what seem like small changes, like taking a different route to school or work; insisting on following rules; rigidity of thought) or ritualized patterns of speaking or acting (e.g., asking the same questions over and over, pacing a perimeter).
  • People with autism spectrum disorder often have very narrow, fixed interests that aren’t focused or intense enough. For example, a baby who is very attached to a pan or piece of string; a child who is obsessed with vacuum cleaners; an adult who spends hours making schedules.
  • Some interests and habits may be caused by an apparent over- or under-reactivity to sensory input. This can show up as strong reactions to certain sounds or textures, touching or smelling things too much, being fascinated by lights or spinning objects, or sometimes not caring about pain, heat, or cold.
  • Extreme reactions or routines about the way food tastes, smells, feels, or looks, or limiting food too much, are common and may be a sign of autism spectrum disorder.
  • A lot of people with autism spectrum disorder who don’t have problems with their intelligence or speaking learn to control their repeated behaviors in public. For these people, doing the same thing over and over, like rocking or moving their fingers, may help them relax or calm down. Special hobbies can be fun and inspiring, and they can also help you get an education and a job later on.
  • Limited, repeated patterns of behavior, hobbies, or activities may have been present as a kid or in the past, even if the symptoms are not present now. This means that the diagnostic criteria were met.
  • Criterion D says that the traits must make it clinically significant harder to do important things in social, occupational, or other areas of present performance.
  • Criterion E says that the person’s social communication problems, which may be joined by an intellectual developmental disorder (ID), are not in line with their developmental level; the problems are worse than what would be expected based on their level of development.

Conclusion

Individuals all over the world who have ASD have a lot of health problems. Diagnosing ASD early can lower the number of children who have developmental problems and help people communicate better. So, health officials need to know how common ASD is and how it’s getting worse so they can plan and carry out the right steps to lessen its effects.

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