# Introversion and Autism



## Kon (Oct 21, 2010)

Very interesting article:

INTROVERSION AND AUTISM: A CONCEPTUAL EXPLORATION OF THE PLACEMENT OF INTROVERSION ON THE AUTISM SPECTRUM

The conceptualization of the personality construct of introversion has been problematic since the term's inception due to the complexity and seemingly self-contradictory nature of the collection of attributes of which it is comprised. To advance the understanding of introversion, I propose that it is a continuous segment of the non-clinical part of the autism spectrum, and that it is not the same as the inverse of extraversion. When introversion and autism are placed on the same continuum, the nature of the relationship of the traits becomes more apparent, and new possibilities are available for exploration of both autism and introversion. This review of literature traces the origins and development of the concept of introversion and places it on the autism spectrum, demonstrating the apparent synonymous nature of the traits despite varying degrees of severity in expression. The current factorial structure of introversion demonstrates how autistic features interact to produce the personality dimension. Other factors, including genetic predisposition, relationships to the clinical and non-clinical symptoms of schizophrenia spectrum expression, and neurological findings that support the correlation will be considered. Finally, suggestions for future research and possible theoretical and empirical implications and applications are explored.

http://etd.fcla.edu/CF/CFE0003090/Grimes_Jennifer_O_201005_MA.pdf


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## odd_one_out (Aug 22, 2006)

I'm only on page 56.


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## Hangman (Dec 6, 2010)

definetly not reading 156 pages, but it does seem that introversion and autism correlate, seems there are many more autistics then we thought.


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## Under17 (May 4, 2010)

Cliff notes please.


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## King Moonracer (Oct 12, 2010)

autistic people cant percieve social norms and society. I didnt reaad whatever you linked, but they are introverted probably because they dont know what the **** is going on. They are so much different from everyone and see the world in a completely different perspective. Aspergers is kinda the same but not nearly as bad.


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## Kon (Oct 21, 2010)

What I kinda like about some stuff in this paper is the author does point out some of the potential commonalities between ASD, introversion, HSP and SAD. This may suggest some common etiologies as also suggested in this paper:

*Symptom overlap between autism spectrum disorder, generalized social anxiety disorder and obsessive-compulsive disorder in adults: a preliminary case-controlled study.*

"Patients with comorbid ASD differ from patients with pure OCD and SAD on autism-related problem behaviors, but there is also overlap between groups, possibly reflecting overlapping etiologies. Despite the relatively small sample size, these data strongly suggest that specific autism symptom domains should be assessed to pick up autism-related problems in OCD and SAD patients, and subsequently fine-tune treatment programs for these patients."

http://www.ncbi.nlm.nih.gov/pubmed


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## antonina (Oct 25, 2008)

*Extreme extroversion can also be a problem*

I would also like to point out that extreme extroversion can be a problem also. 
Extroverts tend to be impulsive and rarely think before acting:
Impulsivity, which Depue and Collins link to extraversion, can in its extreme case cause attention deficit/hyperactivity disorder, pathological gambling, intermittent explosive disorder, kleptomania, pyromania, trichotillomania, self-mutilation, and sexual impulsivity, as well as borderline personality disorder, and antisocial personality disorder (4). Jennifer Greenberg and Eric Hollander, M.D., in their article "Brain Function and Impulsive Disorders" characterize impulsivity as "the failure to resist an impulse, drive or temptation that is harmful to oneself or others" (4). One can see why Depue and Collins see impulsivity as being linked with positive emotionality: this definition of impulsivity is almost the same as their definition of positive emotionality (more sensitivity to reward than punishment). The only addition is the inability to determine when the punishment outweighs the reward. According to Depue, "the extreme extrovert, then, is someone who has high dopamine reactivity and, as a result, easily binds rewarding cues to incentive motivation. That person will appear full of positive emotion and highly active in approaching rewarding stimuli and goals. The low extrovert will find it difficult to be so motivated and will require very strong stimuli to engage in rewarding activities" (6). It is interesting to consider that the same quality that in moderation is looked at as ambition, in excess is considered a failure to resist an impulse, drive or temptation that is harmful to oneself or others. Clearly, this extroversion/impulsivity/incentive motivation is a very influential trait which must be kept in balance to maintain emotional well-being.


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## sparky10 (Dec 30, 2008)

"*Patients with comorbid ASD differ from patients with pure OCD and SAD on autism-related problem behaviors, but there is also overlap between groups, possibly reflecting overlapping etiologies*

Can anyone provide a synopsis of the key points on how they differ and
how you tell them apart?


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## Kon (Oct 21, 2010)

sparky10 said:


> "*Patients with comorbid ASD differ from patients with pure OCD and SAD on autism-related problem behaviors, but there is also overlap between groups, possibly reflecting overlapping etiologies*
> 
> Can anyone provide a synopsis of the key points on how they differ and
> how you tell them apart?


For SAD vs ASD, I found this diagram useful: I kinda feel that I have parts of both:


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## sparky10 (Dec 30, 2008)

Thanks Kon 

I still think i have aspects of both yet i have no problems understanding people, understanding social rules. How would sensory input be described and processing difficulties manifest themselves?


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## Kon (Oct 21, 2010)

sparky10 said:


> Thanks Kon
> 
> I still think i have aspects of both yet i have no problems understanding people, understanding social rules. How would sensory input be described and processing difficulties manifest themselves?


Asperger's tend to notice and pay attention to a lot of details in their surroundings and social stuff is very difficult when you think about it. I'm not sure if this an Aspie or a SAD thing but here's my problem with a dealing with a simple hug or kiss:

1. Am I supposed to hug this person?
2. When should I hug them or kiss them?
3. Am I supposed to use both hands or 1 hand?
4. Am I supposed to go on the left side or right side?
5. Do I kiss both sides or just one?
6. Should I actually touch them or just pretend to touch them with my lips?
7. They kinda smell. I don't feel like going near them. Will they get offended?
8. Why do we have to do these stupid things, it's so damn confusing?
9. I can tell I look clumsy, why do others look so natural at it?

etc.

This stuff goes around in my mind all the time and makes me anxious when I have to go to weddings, funerals, baptisms, parties, etc. Also, I'm never sure what I'm supposed to say and then I have to watch that I don't say something that they might find offensive, etc. I hate formal socializations because the rules are very difficult to pick up. They seem to be a bit "fake" and/or artificial. I also hate not being able to swear or use "bad" words. I often get adults who are much younger than me tell me to watch my language, in front of kids, etc. I was always considered socially inept by my friends. I assumed that this was SAD but the distinction between SAD and Asperger's-related social anxiety seems like a very difficult one for me to differentiate. Maybe someone else can shed some light. I kinda go and forth from this forum and some Aspie forums and despite reading tons of stuff on it, it still seems very difficult to tell the difference. Maybe it's simple and I can't understand it. I'm not sure?


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## sparky10 (Dec 30, 2008)

Kon said:


> Asperger's tend to notice and pay attention to a lot of details in their surroundings and social stuff is very difficult when you think about it. I'm not sure if this an Aspie or a SAD thing but here's my problem with a dealing with a simple hug or kiss:
> 
> 1. Am I supposed to hug this person?
> 2. When should I hug them or kiss them?
> ...


Heres my take on it with the hug situation:-

If i was to hug someone the factors would be:-

Would this person want to be hugged?
The timing of the hug so as to not cause awkwardness?
If i was hugged and felt anxious then would i look anxious to others
and would they notice this, do i look awkward hugging this person?
In a formal situation this is hard because it varys as some people are touchy feely and others not tactile atall so it is tough to initiate wheras its easier to receive one.

In these situations i dont worry about saying something offensive as i would realise what might offend that person. They seem fake and artificial because they are so this makes socialising hard because its more of a judgemental atmosphere and everyone is trying to impress imo.
I dont have the swearing probs as i know it wouldnt be appropiate in that situation.
The problem is i like routine to a large extent and get anxiety if things change. In groups i find my listening skills go and feel kind of confused , dazed. If i get stressed my social skills become worse, and i hate feeling nervous as it overwhelms me. Im selfconcious a lot and analyse what i think and do all the time. 
Ive been looking into this a lot and find im erring to more social phobia but it does seem more than that as sa doesnt define how much it affects me to such a large extent.


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## odd_one_out (Aug 22, 2006)

The differences in AS-related social anxiety have not been studied, from what I've seen. Attwood (in his Complete Guide to ... book) summarises his clinical observations but doesn't go into depth and is unconvincing.



> How would sensory input be described and processing difficulties manifest themselves?


Off the top of my head: Differences in sensory perception in autism are found in all modalities. Perception can be more acute meaning the person is hypersensitive to stimuli. They might require earplugs, sunglasses, and loose clothing for instance. When overwhelmed by stimuli, i.e. overloaded, it can result in shutdown or meltdown. Shutdown can involve freezing in position, being unable to think your way out the situation, and being unable to process or use speech. Meltdown can involve complete loss of control. For instance, collapsing, screaming, self-harm, and sobbing. Overload without these can involve all processing and thought slowing down and being delayed, extreme fatigue, spacing out, nausea. All kinds of symptoms. Often you don't realise you're overloaded or do when it's too late and you're near/in shutdown or meltdown.

Processing difficulties can involve problems filtering out background noise and certain sound frequencies. Many have auditory processing deficits where they cannot distinguish speech sounds well in noisy environments. Much of this is also due to problems with attention and attention-switching.

Focus is very narrow and detail-oriented. That is, there is a local processing bias - a preference for detail over gestalt. This is an important basis for talent, along with systemising (see this study).


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## sparky10 (Dec 30, 2008)

Thanks odd one out

The therapist i see said i could have autistic traits and wouldnt rule out aspergers so i am unsure. She said my thinking is obsessive , ritualised but i have to think this way to be able to cope with life. Otherwise anxiety would become unbearable in certain situations.

Processing difficulties can involve problems filtering out background noise and certain sound frequencies. Many have auditory processing deficits where they cannot distinguish speech sounds well in noisy environments. Much of this is also due to problems with attention and attention-switching.( i experience this and find it v.hard to concentrate on more than one conversation in group setting and also b.ground noise can leave me unable to filter or concentrate on main focus). 

Focus is very narrow and detail-oriented. That is, there is a local processing bias - a preference for detail over gestalt. This is an important basis for talent, along with systemising ( This is hard to say as i dont know to what extent is narrow but i am definetely detail orientated)

I dont experience meltdown only rarely in my life and it is more cognitive/ breakdown psychologically but i do get overload characteristics but i am aware of them when i am having them.


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## Kon (Oct 21, 2010)

I found this interesting:

*Question by Fred M.: Shyness and Asperger's disorder: similarities and differences?*

A while back, an op-ed in the Wall Street Journal called Asperger's disorder "a pompous label for shyness". While perhaps going a bit far, I think it highlights a point: there are a number of similarities between people with (mild) Asperger's and people with shyness/social anxiety. While the standard issue answer to this question is, "Aspergers don't know how to interact, shy people do but are freaked out", one should consider that lack of social skills is widely reported in the literature on social anxiety and avoidant personality disorder. Many shy people withdraw for so many years that they lose the opportunity to develop social skills. Thus, they can't maintain a conversation, awkward silences, may be socially immature and underdeveloped, be withdrawn&#8230;just like people with Asperger's disorder.

Except in extreme cases, where the person in question is literally obsessed with some archaic topic, talks at people endlessly about said topic, has sensory issues, takes everything extremely literally and can not make generalizations, I would say social phobia/AvPD is almost always the more appropriate diagnosis. My feeling is a lot of people these days in the Social Phobia/Avoidant ballpark are misdiagnosed as Asperger's because it is a "trendy" diagnosis and the outward appearance can be so similar. I am especially skeptical about those online who claim to have Asperger's yet seldom ever mention any other symptom than the usual "I'm XX years old and never had a girlfriend." To me, that's classic Avoidant Personality, not Asperger's, except if there are fairly clear-cut autistic traits accompanying it.

Am I wrong here? Am I off base? I think what I'm saying is fairly reasonable, and I wish people on the internet would stop calling themselves "Aspies" because they are introverts or experience a mild and very normal level of social awkwardness that would disappear if they stepped away from the computer for a few minutes. I'm actually glad Asperger's is being dropped from the DSM-V and being merged into Autism Spectrum Disorder. This way, the people really afflicted with it will still qualify for an ASD diagnosis, and the shy, introverted nerds will no longer have an excuse for being a social shut-in and will actually maybe grow a pair and start&#8230;gasp! talking to girls&#8230;

http://www.banishinganxiety.com/anx...pergers-disorder-similarities-and-differences


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## Kon (Oct 21, 2010)

Sometimes, I think if you're embarrassed of having SAD and prefer to have Asperger's then you probably have SAD. I can't see how someone with Asperger's would be embarassed about having SAD but I can see how someone with SAD being embarrassed/ashamed about having SAD. Is this a stupid argument/claim?


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## odd_one_out (Aug 22, 2006)

^ In general this might be so because autists are generally less aware of norms and more individual, but many with AS might be embarrassed of having SAD due to having rigid ideas about it, enough social awareness, and the SAD itself (i.e. fearing judgement by others). Do you think it's a common reason people with SAD self-diagnose AS? When people are embarrassed about having SAD it usually seems to be because they want to fit in and be normal, so I reckon they'd also be embarrassed about AS and probably more so.



sparky10 said:


> She said my thinking is obsessive , ritualised but i have to think this way to be able to cope with life. Otherwise anxiety would become unbearable in certain situations.


That's postulated to be one reason autists have obsessive, ritualised behaviour. The difference between such behaviours in the course of anxiety disorders such as SAD and autism may be mostly one of degree and history. For instance, in the DSM the degree required to meet the AS repetitive behaviour/interest criteria involves the routines and special interests being a source of considerable disability - they disrupt daily functioning and socialising - and they have a history in childhood. But also the interests in AS may differ in quality too, being more circumscribed. Checking out the expanded text in the DSM helps explain the list of criteria.



sparky10 said:


> i experience this and find it v.hard to concentrate on more than one conversation in group setting and also b.ground noise can leave me unable to filter or concentrate on main focus.


I do too. Auditory processing troubles have also been found in SAD. The trouble is there are areas of overlap like this (and in being detail-oriented) between the conditions and a high level of autistic traits in some with SAD is possible, which should be taken into account during treatment.

When considering criteria involving traits such as detail-orientation it's best to investigate the degree. For instance if there's persistent preoccupation with parts of objects (which could in high-functioning adults be described as preoccupation with aspects of systems), does it interfere with other functions and tasks? E.g. did it make schoolwork much harder because you didn't know how to answer in general terms? Do you lose sight of important tasks that need attention such as eating and bathing? Do you become absorbed/hyperfocused for hours at a time and can't switch tasks? Is there evidence for particular talents based on detail-orientation, especially higher than your general abilities - e.g. exceptional drawing skills, distinguishing pitch, collecting information, and understanding systems? Studying how such traits as detail-orientation manifest and the degree to which they're considered significant will help determine how much the criteria apply.



sparky10 said:


> I dont experience meltdown only rarely in my life and it is more cognitive/ breakdown psychologically but i do get overload characteristics but i am aware of them when i am having them.


This is all possible in ASD. Many with Asperger's don't get meltdowns.


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## sparky10 (Dec 30, 2008)

*In general this might be so because autists are generally less aware of norms and more individual, but many with AS might be embarrassed of having SAD due to having rigid ideas about it, enough social awareness, and the SAD itself (i.e. fearing judgement by others). Do you think it's a common reason people with SAD self-diagnose AS? When people are embarrassed about having SAD it usually seems to be because they want to fit in and be normal, so I think they'd also be embarrassed about AS and probably more so.
*

I agree with this i dont think you can say per se that someone with AS would not be embarrased to have sad as the point above underlines.
I do not think a diagnosis of AS would benefit someone with SAD and it would probably be more of a stigma for them in the way society looks at 
or judges the condition.

Thanks for the explanations odd one out it is becoming clearer in my
mind the differences between the conditions and how they affect you.


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## Kon (Oct 21, 2010)

odd_one_out said:


> Do you think it's a common reason people with SAD self-diagnose AS?


I don't know what to believe anymore but I did suspect it with myself. I didn't want to believe I had SAD. I self-diagnosed myself with it after 10 years or so of trying to fit in after my failure in university and then my psychiatrists gave me the diagnosis and prescribed clonazepam. But I ended up abusing it and narcotics.

But more recently no-one including my psychiatrist think I have SAD. My psychiatrist thinks I have GAD while my best friend who is active in the ASD community as his kid is affected by moderate autism is convinced I have ASD (Asperger's). He's known me for over 20 years. But either than driving my parents crazy with 1000s of question/day about everything, major sensory issues and narrow obsessive interests, I didn't have any other ASD traits when I was younger (e.g. communicating with peers, other minds, etc.), as far as I can remember.

For whatever reason if I think to myself, I have ASD instead of SAD, it feels like I'm just looking for an easy way out/explanation for my anxiety. I know it's stupid but it just feels that way


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## sparky10 (Dec 30, 2008)

I was diagnosed myself with GAD by a pdoc and secondary depression and
thats all the diagnoses i have had. Yet i know for a fact i have generalised social anxiety which has worsened in the last two years.
In the uk pdocs seem reluctant to give a diagnoses of SAD whether it is because it is one of the newer disorders or they do not know how to treat it aswell as something like GAD.
Kon do you find like me SAD doesnt adequately describe yourself, i am coming to the belief that i may have autistic traits yet not aspergers and
thats why nothing seems to fit.


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## chinatownbus (Nov 15, 2010)

I have been wrestling with whether I have Asperger;s (my Doc and therapist seem to think I do) or social anxiety. I have basically always been shy/ avoidant but I think this because I am very self conscious, have fear of embarrassing myself. I think I have SA and not AS. I want to prove to my doc and therapist that I don't have AS. There seems to be a fair amount of overlap but I believe that AS is something your are born with whereas SA is a learned trait that comes with experience. To tease one from another appears to be difficult so I am curious to learn what traits are distinctly AS and distinctly SA.


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## Kon (Oct 21, 2010)

sparky10 said:


> Kon do you find like me SAD doesnt adequately describe yourself, i am coming to the belief that i may have autistic traits yet not aspergers and thats why nothing seems to fit.


Yes, SAD doesn't adequately describe me either. For instance:

1. I don't have a low self-esteem like many on this board. 
2. I don't care that much for socialization or being popular. I kinda feel sorry for people that are overly-social because they miss out on a lot stuff that I like. It's kinda hard to do both. Maybe it's a lot easier to be introverted and have SAD than be a wannabe extrovert and have SAD?
3. I don't have problems making friends or girls even though I'm shy.

My major problems are work-related anxiety. I've always been school-smart but real-world dumb. Work has been a total nightmare. I ended up abusing both my prescription and non-presecription meds. I also hate my sensory issues (misophonia). I don't know what I have but if I could pick characters from t.v., I'm like a cross between Spock, Kramer (from Seinfeld) and Joey (from Friends).

How about yourself? Tell me some stuff, like why you don't think SAD describes you? Do you any obsessions/interests that interefere with normal activities and/or spend a disproportionate amount of time doing/thinking about?


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## odd_one_out (Aug 22, 2006)

Kon said:


> I don't know what to believe anymore but I did suspect it with myself. I didn't want to believe I had SAD.


Do you mean you found the idea of having SAD more embarrassing than AS?



Kon said:


> But more recently no-one including my psychiatrist think I have SAD.


You mention great performance anxiety, and since SAD's broad, it's quite likely you have some version of it.

As for GAD, psychiatrists seem to plonk that on everyone. The ICD-10 has a good list of GAD criteria. I have it in my photo album here, showing what the diagnosticians thought applied to me.



Kon said:


> I didn't have any other ASD traits when I was younger (e.g. communicating with peers, other minds, etc.), as far as I can remember.


I take it you mean you fit the repetitive behaviours/interests criteria as a child but not the social communication deficits. What causes you to think these didn't fit?



Kon said:


> For whatever reason if I think to myself, I have ASD instead of SAD, it feels like I'm just looking for an easy way out/explanation for my anxiety. I know it's stupid but it just feels that way


Maybe you've absorbed some of the external messages. There are many around, sometimes even from professionals, making various accusations and generalisations about those who suspect autism. Some of the messages to self-diagnosed are vicious. Also, having an analytical mind that notices intricacies can result in never-ending questions. This means firm conclusions are never reached or there's concern something might be true just because there's a possibility, always meaning there's room for doubt.



chinatownbus said:


> I have been wrestling with whether I have Asperger;s (my Doc and therapist seem to think I do) or social anxiety. I have basically always been shy/ avoidant but I think this because I am very self conscious, have fear of embarrassing myself. I think I have SA and not AS. I want to prove to my doc and therapist that I don't have AS. There seems to be a fair amount of overlap but I believe that AS is something your are born with whereas SA is a learned trait that comes with experience. To tease one from another appears to be difficult so I am curious to learn what traits are distinctly AS and distinctly SA.


SAD can have neurodevelopmental aspects too. It's a broad category. If you want to convince your doc and therapist you don't have Asperger's, then examine (and/or post here) the exact reasons they provide for suspecting it. Breaking it down like that into individual criteria makes it easier to challenge.


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## fredbloggs02 (Dec 14, 2009)

This is just throwing words at something we think of as a finality. This never ends. Of course the words don't reflect a truth for everyone because they were only misplaced to begin with atan attempt to relate to everyone. I'm taking a psychology course at the moment and the language is just. "undesirable behaviour exhibited" it's just... Well it's good for a laugh. This is really a fruitless endeavour to me to try and encapslate all of which is and which isn't something in words, like this. Kinda like a Portugese translator translating a Spanish tablet, he'd get the gist of it but not the meaning.


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## Kon (Oct 21, 2010)

odd_one_out said:


> Do you mean you found the idea of having SAD more embarrassing than AS? .


Yes.



odd_one_out said:


> I take it you mean you fit the repetitive behaviours/interests criteria as a child but not the social communication deficits. What causes you to think these didn't fit?.


Yes, I had and have repetitive behaviours/interests. Whether they are normal hobbies/interests, I'm not sure. They are narrow and they did interfere with my work/school/life. The 2 that come to mind:

1. Bohmian mechanics/metaphysics and the relationship to the mind-body problem. 
2. Strength training and the optimal volume of exercise necessary to optimize muscle size.

This stuff was totally outside my field (s) and I spent more time in the library, internet, buying books and writing on it then I ever did in school.



odd_one_out said:


> Also, having an analytical mind that notices intricacies can result in never-ending questions. This means firm conclusions are never reached or there's concern something might be true just because there's a possibility, always meaning there's room for doubt.


Yes, that's one my major problems at work.



odd_one_out said:


> SAD can have neurodevelopmental aspects too. It's a broad category. If you want to convince your doc and therapist you don't have AS, then examine (and/or post here) the exact reasons they provide for suspecting it. Breaking it down like that into individual criteria makes it easier to challenge.


His reasons for not suspecting AS is his belief that I talk with him not at him and he feels I can connect with him. He told me if I had AS, he wouldn't feel this interpersonal connection like I'm both listening and talking?


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## sparky10 (Dec 30, 2008)

How about yourself? Tell me some stuff, like why you don't think SAD describes you? Do you any obsessions/interests that interefere with normal activities and/or spend a disproportionate amount of time doing/thinking about?

Thats the crux i dont have any obsessions/ interests that consume me although i do *Live* by routine and get overly stressed if anything changes. Any stress stimulus overwhelms me and sends me ito a tailspin. The feelings i get in people situations can one of intense confusion and analysing every little thing i think and do and this can carry over to when i am alone. I would say highly self concious but not at perceived flaws inadequacies but more like just watching myself as a state of mind.


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## Kon (Oct 21, 2010)

sparky10 said:


> Thats the crux i dont have any obsessions/ interests that consume me although i do *Live* by routine and get overly stressed if anything changes. Any stress stimulus overwhelms me and sends me ito a tailspin. The feelings i get in people situations can one of intense confusion and analysing every little thing i think and do and this can carry over to when i am alone. I would say highly self concious but not at perceived flaws inadequacies but more like just watching myself as a state of mind.


I'm self conscious in that I feel there's way too much for me too handle and I feel overwhelmed like I'm going to short-circuit my brain. Or if I don't know everything, I feel like I might as well not know anything. Many times at work, I feel like I'm being bombarded with way too much input for me to handle (problems with multi-tasking/information over-load). I felt like that even in school when I was in labs especially since there was a time constraint. Labs (Physics, Chemistry, Biology, geology) were a torture for me. Work is much, much worse.

Other people think I'm lazy or slow/dumb, but I think it's more than that. I just find it overwhelming especially when you add the social stuff to the mix. My psychiatrist still thinks this is all GAD and I think he would argue that the stuff you mentioned would fall under the umbrella of GAD, I think?
Some more questions:

1. Do you have immense difficulty making decisions?
2. Did you or do you ask a lot of questions about stuff to people that you feel comfortable with to the point of getting them angry (because some of the questions are very repetitive and a bit childish)?
3. Do you have immense difficulties expressing yourself especially verbally?
4. Do you get very anxious when you feel you don't know something?

These are things that really bother me. I'm no sure if these are GAD or AS symptoms or both?


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## Kon (Oct 21, 2010)

I thought I would post this here also:

*The intense world theory - a unifying theory of the neurobiology of autism.*

A physicist famously wanted to find the grand unifying equation behind the laws of nature, in a form that you could put on a t-shirt. Neuroscientists Kamilla and Henry Markram have proposed a grand unifying theory of autism, and the key to it is in this picture. I wouldn't want to be seen wearing it quite yet, but if the theory pans out, I'm sure we could come up with a more torso-friendly diagram.

So what does this mean? The Markrams call their idea the Intense World Theory. Essentially, they propose that all of the diverse symptoms of autism are direct or indirect consequences of the autistic brain's being hyper-responsive to stimuli. (They published an earlier version of this theory in 2007). Not the brain as a whole, and not each individual cell, either. Rather, they say that the abnormality lies in local microcircuits. The best known of these are the cortical columns and minicolumns. Neurons in any given microcircuit are connected both with their neighbors, and with more distant cells. A bit like a large company with offices in different cities: people within each office talk to each other, but they also phone and email the other branches.

The theory goes that the autistic brain has too many connections within any given microcircuit. So, when the circuit is activated, it reactivates itself too strongly, and shows a stronger, and longer, excitation. A bit like if the offices were open-plan, so everyone can overhear everyone else, and it all gets very noisy. So what's the evidence for this? There's circumstantial support. It "makes sense", if you're willing to accept an analogy between hyperactive local neural circuits and hyper-intense psychological phenomena.

We know that a given cortical minicolumn responds to a particular type of stimulus, or aspect of a stimulus; there are minicolumns for horizontal lines, for lines at 10 degrees to the horizontal, and so on. People with autism are often fixated on little details. It's a leap, but not an impossible one, to see these as related. But the only really direct biological evidence is from rats. The story starts with valproate (VPA), an effective anticonvulsant also widely used in bipolar disorder. VPA has to be used with extreme caution in women because of the risk of birth defects.

Children whose mothers take VPA (and to various degrees other similar drugs) during pregnancy often suffer various physical and behavioural problems, the fetal anticonvulsant syndrome. Sadly, this happened quite a lot in the past, before the risks were appreciated. The key point is that autistic symptoms extremely common in children exposed to high-dose VPA. Markram (and other people) have studied rats exposed to valproate in the womb. They found that, well, they're weird. Proponents would say that they behave a lot like how an "autistic" rat would: they are less sociable, prone to repetitive behaviours, highly anxious, etc.

Can a rat "have autism"? That's one to ponder. On the one hand, rats are surprisingly smart, sociable animals. For every human brain region, there's a rat equivalent in roughly the same place, which does roughly the same thing. They have cortical columns and minicolumns like ours (we just have more of them). They even "laugh" when you tickle them. On the other hand... they're rats. They run around gutters eating trash.

The t-shirt image at the top of this post is based on Markram and colleagues work on the cortical network properties of VPA-exposed rats (e.g. this and several other studies). These studies revealed hyper-connectivity within local microcircuits, and have also shown that circuits from VPA-exposed rats "learn" faster: they form new synaptic connections via the process of LTP at an accelerated rate, likely due to over-expression of NMDA glutamate receptors. They admit that it's a big leap from that to human autism. But it's not an impossible leap. As they say:

This provided the potential cellular and circuit explanation for how an autistic brain could be easily trapped in a painfully intense world, potentially explaining a broad range of common autistic symptoms such as sensory sensitivity, withdrawal, repetitive behavior, idiosyncrasies, and even exceptional talents.

The major attraction of the theory is that it is a unified one: it seems to explain everything about autism, although maybe it's just vague enough to be stretched to cover anything. For example, Markram attributes the social awkwardness of autistic people to an overactive amygdala, which makes them extremely anxious in social situations, especially when meeting people's gaze; this, he says, means that they quickly learn to avoid other people in an attempt to cope with this Intense World.

Henry Markram is best known as the leader of the Blue Brain Project, which aims to simulate a brain using supercomputers. So he's no stranger to big ideas. Whether this idea is as solid as it is big remains to be seen, but I think he's to be applauded for at least having a crack at a unified account of autism, something which, as far as I know, no-one else has had the guts to try yet (Edit: But see the comments for a debate on that question)...

http://neuroskeptic.blogspot.com/2011/01/grand-unified-theory-of-autism.html 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010743/pdf/fnhum-04-00224.pdf


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## iuseings (Nov 11, 2009)

Kon said:


> Sometimes, I think if you're embarrassed of having SAD and prefer to have Asperger's then you probably have SAD. I can't see how someone with Asperger's would be embarassed about having SAD but I can see how someone with SAD being embarrassed/ashamed about having SAD. Is this a stupid argument/claim?


I can see what's attractive about having the AS instead of SA in a general way. I think people don't take people with social anxiety disorder as serious as an disorder as AS. AS has become more commonly known in society to be a genetic/biological disorder, while SA isn't as well known or accepted as serious as an disorder because it's origins aren't purely genetic/biological based. People also make AS synonymous with intelligent/savant abilities as they do with most ASD. 
On the other hand some people like to masquerade under a different identity sometimes because it's more comfortable to not be known for your actual problems. Intense embarressment and feelings of shame are apart of SAD and, without a doubt, as time elapses from point of diagnosis embarrassment over having SA can develop.
That's just my perspective on it.

I really think the key to knowing if you have Autism or Aspergers is to remember and re-analyze your development to see if it similar to those with ASD. I don't really buy that you have it from what I've read in this thread so far.


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## Kon (Oct 21, 2010)

iuseings said:


> On the other hand some people like to masquerade under a different identity sometimes because it's more comfortable to not be known for your actual problems. Intense embarressment and feelings of shame are apart of SAD and, without a doubt, as time elapses from point of diagnosis embarrassment over having SA can develop.


That is exactly how I feel except I couldn't put in words. Thanks for that. That really helps me. I honestly think I have a bit of both, primarily because I do have sensory issues that are a bigger problem in my non-work world than my SAD. And I am immensely obsessive about certain topics. It really helped me in university because of it. But you are right it might just be the combo of SAD and GAD.

Edit: I read the full autism pdf article. It's amazing and I feel like it describes me. Here's an interesting quote on the theory of SAD in AS which further confuses the boundary between the two:

"However, contrary to the deficit-oriented or disconnected Amygdala Theory and Theory of Mind of autism, we propose that the amygdala may be overtly active in autism, and hence autistic individuals may in principle be very well able to attend to social cues, feel emotions and even empathize with others or read their minds, but they avoid doing so, because it is emotionally too overwhelming, anxiety-inducing, and stressful."

"The lack of social interaction in autism may therefore not be because of deficits in the ability to process social and emotional cues, but because a sub-set of cues are overly intense, compulsively attended to, excessively processed and remembered with frightening clarity and intensity. Typical autistic symptoms, such as averted eye gaze, social withdrawal, and lack of communication, may be explained by an initial over-awareness of sensory and social fragments of the environment, which may be so intense, that avoidance is the only refuge."

"The Intense World Theory proposes that amygdaloid hyperreactivity and hyper-plasticity may in particular provoke a disproportional level of negative emotions and affect in autism, such as elevated stress responses and anxiety as well as enhanced fear memory formation. Enhanced phobias and anxiety levels were first noted by Kanner himself in his original case studies (Kanner, 1943) and later confirmed by population studies on children with autism (Muris et al., 1998; Gillott et al., 2001; Evans et al., 2005) and their relatives (Micali et al., 2004). A peek into the autistic world of increased anxiety, stress, and fear formation is delivered in the fascinating introspection of autistics Temple Grandin and Sean Barron, who vividly describe how anxiety and fear lead to social withdrawal and avoidance (Grandin and Barron, 2005)."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010743/pdf/fnhum-04-00224.pdf


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## odd_one_out (Aug 22, 2006)

^ I remember strongly relating to the intense world paper and the hyper-perception, hyper-attention, hyper-memory and hyper-emotionality.

More on special interests

In the DSM, the special interest criterion is

*encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus*.

It can be abnormal in either. You also don't have to have special interests for diagnosis if other repetitive behaviour criteria apply.

In the ICD-10, the special interest criterion gives more options:

*encompassing preoccupation with one or more stereotyped and restricted patterns of interest that are abnormal either in content or focus; or one or more interests that are abnormal in their intensity and circumscribed nature though not in their content or focus.*

Examples of abnormal content would be a child with a fascination for shower faucets or (one I've read) blocked toilets (and pretending to be one).

The Gillberg special interest criterion requires one of the following:

*exclusion of other activities
repetitive adherence
more rote than meaning *

The more rote than meaning one could involve something like studying a catalogue of air conditioners and comparing their properties purely for interest.

Studies of special interests in AS show that about 5% to 15% don't have one. Common ones include fascination with animals and dinosaurs, like typical children, but the intensity or focus differs. Also: branches of science, public transport systems, drawing, music and collecting.

After one of my assessments they described why they thought I met the special interest criterion. They wrote I developed an interest in Star Trek in my teens and bought technical manuals and blueprints, watched the episodes every day on TV, including the repeat later in the day, wrote a synopsis of each episode, and spent much of my time in a fantasy world every day instead of joining in with others. They mentioned how I developed an interest in space and taught myself to use constellation charts and a telescope, and later on spending large amounts of time studying psychology. This was to the exclusion of socialising with others who were around. I'd spend hours alone in my room or in the dark because I was so absorbed. It would also stop me eating, bathing and sleeping.


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## sparky10 (Dec 30, 2008)

Kon said:


> I'm self conscious in that I feel there's way too much for me too handle and I feel overwhelmed like I'm going to short-circuit my brain. Or if I don't know everything, I feel like I might as well not know anything. Many times at work, I feel like I'm being bombarded with way too much input for me to handle (problems with multi-tasking/information over-load). I felt like that even in school when I was in labs especially since there was a time constraint. Labs (Physics, Chemistry, Biology, geology) were a torture for me. Work is much, much worse.
> 
> Other people think I'm lazy or slow/dumb, but I think it's more than that. I just find it overwhelming especially when you add the social stuff to the mix. My psychiatrist still thinks this is all GAD and I think he would argue that the stuff you mentioned would fall under the umbrella of GAD, I think?
> Some more questions:
> ...


1. Do you have immense difficulty making decisions? no not really but yes when i am anxious. 
2. Did you or do you ask a lot of questions about stuff to people that you feel comfortable with to the point of getting them angry (because some of the questions are very repetitive and a bit childish)?no there has been occasions in the past but i would not do this normally.
3. Do you have immense difficulties expressing yourself especially verbally?
4. Do you get very anxious when you feel you don't know something?

The last 2 could you give examples of how immense difficulties expressing yourself verbally is for you and what sort of things make you anxious when you dont know them?

This will help me answer the last two in regards to how they would be in
severity.


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## Anasthasiya (Jan 30, 2011)

Okay, the difference between the two in a large part is that AS has many other symptoms that are not recognized to be in SAD. Like sensory issues, different language, motor skills, literal thinking, intense interests, need for routine, repetitiveness, weird behavior, communication problems and low social skills.. 

About social contact, an AS person would wonder: 
Am I supposed to say something now or later? Do I have to say something?
Can I hug the person? When should I hug the person? When should I look people in the eyes? Why do I need to? Am I saying something wrong? How should I behave when I first meet with someone?
Some kind of that thoughts but can also be ones like: shaking hands is uncomfortable. Do I have to? How can I avoid it? If that behavior is not good, what should I do? How should I ask someone? or something. Or doesn't even know what is doing wrong and can be well unaware of that until someone says it to him. And then starts to worry about what the hell could be wrong and how to do it right. 

That is because a person with AS doesn't have a clue about behavior, simply put. It means there are no or really lacking social skill, called social skills deficiency or social skills problems. When you have AS, you don't know anything about nonverbal communication, it is like a foreign language, unrecognizable, not understood. Then you have trouble knowing how you say a thing because you do not differentiate the tone of voice or have trouble with speaking or voice regulation. We often speak awkwardly, in a monotone, or simply different to other people. Talking can be different in both semantics and pragmatics what is typical for SPLD (semantic pragmatic language disorder) which does overlap with the language area of Asperger's. Also, you do not recognize subtle social cues, are unaware of your behavior, do not recognize behavior of others, have trouble picking up what some behavior means and what is that... stuff like that. 
And so the problems are often that you are simply unaware of behavior. 
Sometimes trouble in communication is also caused by sensory issues. Like avoidance of physical contact, eye contact, sounds, bright lights, etc... And so you can become anxious because of that later in life, but the cause is different like in SAD. If you have ASD and then have developed SAD also it is developed because you started to fear situations by not knowing the behavior and got judged for not behaving the right way. So you are having fear of ridicule, of wrong communication or behavior, of appearing different, of doing something wrong or appearing stupid, but the reason lies in your AS and low social skills because of it. If you get judged for having low social skills, you'll try to avoid social situation because you fear you'll again be judged and do not wanna hear and feel it again. That is how it is in my case. 

In SAD you will often have thoughts like: Will I say it right? Should I say it? Will people accept me if I do that? Will they tease me? What should I do?
I am afraid of being judged, etc. 
Actually I don't think that people with SAD lack social skills. If they would not have the anxiety, their social skills are normal. They do not experience general lack of social skills, but more anxiety of how they may appear to someone. So thoughts can really be similar or even overlap if you have both conditions. 
In SAD the thoughts are caused by anxiety, but they, if they only have SAD and not some other autism-similar disorder (there are many like Nonverbal Learning Disorder, Hyperlexia, SPLD, Dyspraxia, ADHD-spectrum, some other disorders, etc.), they know how to communicate, know to read body language, don't have language differences like not knowing tone of voice or talking strangely, in monotone or with different pragmatics, etc., the know what effect will their behavior have on others, they are aware of their behavior and have an idea of what they are doing wrong, I could say they are a bit too conscious about the behavior. But in general social skills are developed normally, no lack of them. There is more lack of self-esteem, insecurity about appearance of the behavior, what other would think of it, etc., and it can be caused by bullying, ridicule, trauma, it can also develop if you are naturally shy, introverted, or some other bad experiences, or you just are too conscious about what people would think of you and it is so important to you. Then it can develop and anxiety comes. 
I know some people who only have SAD and they are normal, but they are anxious about how they appear etc., but they know about the behavior, recognize subtle communication, they just fear how they will be perceived and can't open up because of the fear so it causes them trouble in social functioning. But they are otherwise normal. 

Hope I told the difference well. It is just how I see it. Now you can decide to which one here you belong


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## antonina (Oct 25, 2008)

Kon said:


> I'm self conscious in that I feel there's way too much for me too handle and I feel overwhelmed like I'm going to short-circuit my brain. Or if I don't know everything, I feel like I might as well not know anything. Many times at work, I feel like I'm being bombarded with way too much input for me to handle (problems with multi-tasking/information over-load). I felt like that even in school when I was in labs especially since there was a time constraint. Labs (Physics, Chemistry, Biology, geology) were a torture for me. Work is much, much worse.
> 
> Other people think I'm lazy or slow/dumb, but I think it's more than that. I just find it overwhelming especially when you add the social stuff to the mix. My psychiatrist still thinks this is all GAD and I think he would argue that the stuff you mentioned would fall under the umbrella of GAD, I think?
> Some more questions:
> ...


I have number 1, 2-sometimes people say I ask too many questions but this is not all the time, but when I learn something new, 3. I feel inarticulate at times, and 4 is true.

My doctor has me down as GAD, SA, and major depression. Although my dad fits the autism spectrum criteria. Odd one out says there is such a thing as Broad Autism Phenotype where you are on the spectrum but not at a clinical threshold. People with autism have more relatives with depression than those with Down's syndrome so there is some genetic relationship.


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## kev (Jan 28, 2005)

I only read your blurb but I thought some people with asperger syndrome are actually pretty outgoing (even if oblivious to what people think about them).


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## antonina (Oct 25, 2008)

I just attended my first Adult Asperger's group as I have been curious about it. I noticed that many people there were quite outgoing even though it was a large group of over 20 people. It seems they need things done a certain way and this causes them to have lots of conflicts with people. Many of them didn't seem afraid to speak their mind on issues. They also were not afraid of speaking in a large group. From seeing this I definitely think introversion and autism are not the same thing. Of course I'm sure people can be introverted and autistic also. The main thing really seemed to be not being able to read social cues and having conflicts because of this. The other thing that stood out to me was that they like to do things efficiently at work and don't like office politics interfering with this. It's hard for them to play social games when they often have a mechanical mind and can see the solution to a problem but it isn't accepted by their coworkers. They can come off as arrogant. It was interesting going to this meeting. I don't think I have the full thing because I know you have to play games with people and kiss up to them even though I don't like it. One man said his mind is driven to make him do something a certain way because he knows it's right even if it makes his coworkers mad. He says he's often been proven right later on also. He is an engineer. Anyway, I think we are dealing with separate but at times related issues when talking about HSP, introversion, SA, and Autism spectrum.


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## softshock11 (Jan 9, 2011)

so now i may be autistic............ as if dealing with SA wasn't enough


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## odd_one_out (Aug 22, 2006)

antonina said:


> I just attended my first Adult Asperger's group as I have been curious about it. I noticed that many people there were quite outgoing even though it was a large group of over 20 people. It seems they need things done a certain way and this causes them to have lots of conflicts with people. Many of them didn't seem afraid to speak their mind on issues. They also were not afraid of speaking in a large group.


When I attended a group about 1/2 the size, there were 3 or 4 loud, seemingly quite outgoing ones and the rest only contributed sometimes or not at all. One guy really hurt my ears. Although such groups aren't adequate representations of such a diverse diagnostic group, they can illustrate some of the variation within it. I suspect those in the more withdrawn category often drop out (like me) or don't attend in the first place (and are maybe often not diagnosed in the first place because their symptoms aren't overt). Although there seems to have been a lot of emphasis on the active but odd category of Asperger's (which is likely represented by the individuals you mention) since Asperger's was introduced, high functioning ASD is associated with higher scores than controls on measures of introversion (example: see this study), and they happen to have overlaps with several items in the Autism Spectrum Quotient (AQ).

I can provide some info. I know on personality from the literature and how it relates to ASD. Numerous studies have found connections between personality traits and psych disorders. Personality traits run a spectrum, and spectrum/dimensional models characterise disorders as amplified versions of such traits. (Note, there are other models besides these spectrum ones.)

Considering personality traits and ASD, it's complex and underinvestigated. Personality has a large genetic influence, so investigating its relationship to the core autism symptom domains could help the search for causal factors in ASD.

Instead of the present autism symptom triad, two core ASD areas are proposed for the next DSM edition: 1. communication/language deficits and 2. restricted interests/repetitive behaviours. Researchers are beginning to investigate the underlying structure of these 2 core areas in terms of maladaptive personality traits. Decomposing the core areas like this might explain some of the wide variation in patients and improve treatment.

Evidence is emerging for relationships between certain maladaptive personality traits and the 2 core autism areas mentioned above in children. A study by De Clercq et al. (2010) was conducted using personality questionnaires for children. The main finding was that the introversion facet of withdrawn traits and the facet of lack of empathy predicted the communication/language deficit area of ASD. Also, the restricted interest/repetitive behaviour area of ASD was predicted by the risk behaviour and inflexibility trait facets. This supported a relationship between aspects of personality dysfunction and ASD*.

But they found such trait facets could not account for all the variance, and that this may mean that the entire autism spectrum cannot be incorporated into a model involving traits and pathology being on a single spectrum.

*[This also supported various studies showing that the 2 core ASD areas likely have independent causes (at the genetic, neural and cognitive level).]


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## Kon (Oct 21, 2010)

antonina said:


> Anyway, I think we are dealing with separate but at times related issues when talking about HSP, introversion, SA, and Autism spectrum.


On this overlap between these conditions/disorders, there are even a few studies suggesting motor skills and language delays may also be more common in children with SAD:

---------------------
Eur Child Adolesc Psychiatry. 2008 Mar;17(2):99-107. Epub 2007 Sep 11.

Is social anxiety disorder in childhood associated with developmental deficit/delay?

Children with social anxiety disorder (SAD) have been reported to display reduced social skills. Less attention has been paid to whether neurodevelopmental deficits/delays (NDD's) in language and motor function may contribute to their impaired social skills. The present study aimed to assess the extent of language and motor impairment in children with SAD. A population-based screened sample consisting of 150 children (11-12 years) was assessed with a diagnostic interview (Kiddie-SADS), the Wechsler Abbreviated Scale of Intelligence (WASI) and the Motor Assessment Battery for Children (MABC). Test results were compared across five diagnostic groups: SAD (n=29); ADHD (n=23); SAD and ADHD (n=6); "other disorder" (n=44) and "no disorder" (n=40. Delays in language and motor development as reported by mother were also investigated. Verbal IQ and motor skills were reduced and maternally reported delay was more frequent in the SAD group compared to the "other disorder" and "no disorder" group.

http://www.ncbi.nlm.nih.gov/pubmed/17849080


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