Autism Diagnosis: Too Much Looking and Too Little Listening?

"Internalising conditions are defined by what a person feels inside-thoughts, emotions, bodily sensations-that may not be visible to others. Take depression: although it can involve externally observable changes like altered sleep, appetite, or activity, its essence is often thought to draw heavily on internal, subjective experiences: lowered mood, emotional blunting, feelings of guilt, and rumination. The same is true for anxiety disorders, where excessive worry, dread, and tension are core criteria."

"Externalizing conditions are defined primarily by what is outwardly observable. Conduct disorder, for example, is diagnosed by repeated aggressive acts, destruction of property, or rule-breaking. Diagnosis of many, I would claim most, conditions included in our current diagnostic psychiatric manuals heavily rely on internal experience. What makes autism, and other neurodevelopmental conditions, unusual is that diagnosis remains, even today, primarily reliant on the "external", observable signs only."

Psychology distinguishes internalising conditions, defined by thoughts, emotions, and bodily sensations, from externalising conditions, defined by observable behaviors. Depression and anxiety hinge primarily on internal subjective experiences such as lowered mood, rumination, excessive worry, dread, and tension, even when accompanied by external changes. Externalising conditions like conduct disorder are diagnosed through repeated aggressive acts, destruction of property, or rule-breaking. Most conditions in current diagnostic psychiatric manuals rely heavily on reported internal experience. Autism and other neurodevelopmental conditions remain diagnosed chiefly through externally observable signs and behaviours. Diagnostic guidelines need ongoing evolution to capture diverse autistic experiences and internal perspectives.

Read at Psychology Today