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Forbes
a day ago
- Health
- Forbes
Why Autism Diagnoses Are Increasing: What Changed In 2013
Changes in diagnostic criteria drove an increase in autism diagnoses. Autism has been in the spotlight as more public figures react to rising diagnosis rates. Some frame it as an epidemic, prompting speculation about causes. But what many don't realize is that much of the increase can be traced to two major changes in how autism is diagnosed. Starting in 2013, people already diagnosed with ADHD could now also be diagnosed with autism, something that was not allowed previously. Further, doctors were now encouraged to consider a person's internal distress, not just observable externals, when determining whether their autistic experience qualified for diagnosis. These two changes account for a significant portion of the increase in autism diagnoses. To receive a mental health diagnosis, a person must show evidence of impairment. For autism, this means behaviors associated with a differently wired brain must cause real life challenges--not just exist. But how do we define impairment? During my medical training, that was a determination for the professionals to make. These standards were defined in the Diagnostic and Statistical Manual, Fourth Edition, the manual doctors used to determine mental health diagnoses. Originally published in 1994, the DSM-IV defined a mental disorder as causing 'clinically significant distress or impairment in social, occupational, or other important areas of functioning.' In the DSM-IV, impairment was assessed by external signs such as poor grades, job loss, or visible dysfunction. Internal distress, like working twice as hard as other just to keep up, was not considered. It was left to the doctor to determine what elements of a patient's story were 'clinically significant' and whether they were in 'important' areas of functioning. If someone had autistic features but excelled in school or work and had relationships, they might be told they weren't impaired and did not meet criteria for a diagnosis. Their internal experience--how hard things felt or the emotional toll it took--wasn't relevant. That changed in 2013 with the publication of the DSM-V, which heralded a critical shift in psychiatry: valuing a patient's internal experiences over mere appearances. While the fundamental definition of mental disorder remained the same, the DSM-V considered a person's internal suffering when evaluating them for clinically significant distress. For example, in the past a student would have to be failing classes to be considered impaired. But after DSM-V, a student getting As only through intense effort and personal cost--exhaustion, anxiety, and emotional burnout--could also be understood as experiencing impairment. This change meant that people who previously would have been dismissed now had their experiences validated. Jaimie Goralnick, MD, a child and adult psychiatrist in California recalls what it was like to consider autism prior to 2013. 'In my training, I was taught only to notice the people who fit a stereotypical image of what we think autism is, and that is only a small percentage of people who are autistic.' Today, fewer people are denied a diagnosis because they make eye contact or have friends. Clinicians are learning to ask deeper questions: Is that eye contact forced and exhausting? Have they faced lifelong bullying or exclusion, even though they also have friendships? This has been particularly important in recognizing women with autism, who often present more subtly. The second major change in DSM-V was the removal of the exclusion rule that prevented someone from being diagnosed with both ADHD and autism. Before 2013, meeting criteria for one ruled out the other. Since ADHD symptoms are often more visible, this led to many people's autism being missed. 'In my practice, there are many people who have been diagnosed with ADHD, and later realized they also are autistic,' says Dr. Goralnick. 'It's been life changing for them to be able to make sense of their experience in a clearer and more positive way." Currently, the scientific literature estimates that between 50 to 70% of people with autism also have ADHD. (Hours 2022) The reverse is harder to measure due to under-diagnosis, but studies have found that between 30 to 65% of children with ADHD also show clinically significant autistic traits. (Clark 1999, Ronald 2008, Sokolova 2017). This means that a significant number of people with ADHD are now also diagnosed with autism, leading to an apparent boost in autism numbers. With autism in the press so often lately, it is important to understand that while diagnosis rates have risen, autism itself has always been with us. The 2013 changes in the DSM allowed us to get better at recognizing it. And that's vital, because it gives people a chance to understand themselves, heal from rejections they've faced, connect with the autistic community and access therapies designed for autism. "Many of my patients are able to figure out ways to fit in and fly under the radar with some of their challenges,' Dr. Goralnick. 'They struggle a lot with depression and severe anxiety that just never quite responded to treatments, and there were a lot of things that just never made sense. But once we together realized they were autistic, the pieces came together and we began to understand their experience.' Autism wasn't invisible because it wasn't there. It was invisible because we weren't looking for it in the right way.
Washington Post
13-06-2025
- Entertainment
- Washington Post
Diddy trial live updates: Federal agent, ex-assistant to testify in Sean Combs's case
Sean Combs's trial, estimated to last eight weeks at the Daniel Patrick Moynihan U.S. Courthouse in New York City, will not be publicly broadcast. During jury selection, prosecutors provided a list of 190 names — including celebrities and public figures — that could surface during testimony. With the trial underway, here are the major players expected at court — including attorneys, potential witnesses and family members.
CNET
12-06-2025
- CNET
The Rise of Police Swatting: I Asked Cops for Details to Protect Your Home
Swatting is a disturbing (and very illegal) prank where a fake threat is called in to police at an innocent target's address. You may have seen it in a growing number of headlines over recent years. Swatting can be especially dangerous for unwary people at home, who have no idea police are surrounding their residence or what to do in response. Swatting began in the gaming world as a particularly malicious joke after a bad game, related to doxxing people and making online threats. But it's grown since then, with swatting becoming a consequence of political disagreements, neighborhood feuds and teenage dares. It's also grown more sophisticated, with websites and apps springing up that let you spoof your phone number (or use a VoIP service) and also disguise your voice. Some swatters even hack into vulnerable security cameras when they do it. Obviously, this is a huge source of distress for everyone, from gamers to public figures. I spoke with law enforcement and emergency response specialists to find out everything you should know about swatting, including tips if you're worried. First, the good news about swatting Many police departments are now ready for swatting has been around long enough that law enforcement agencies and emergency communication centers are generally aware of it. The FBI continues to issue guidance alerts, including the latest public service announcement, from April 2025. That means swatting is a bit less likely to work, since responders are increasingly aware of the hallmarks of swatting, like spoofed or blocked numbers, a lack of background noises, a lack of nearby confirming calls and a caller who can't confirm key details. I reached out to the Portland Police Bureau to learn more. Public information officer Sgt. Kevin Allen had encouraging information. "Every time I have heard about it happening," he said, "the initially responding patrol officers have done a phenomenal job of vetting the call and determining that it is not legitimate." That's helping to avoid the fear, money and time that's wasted when people are swatted. The FBI has worked to raise awareness of swatting, too. And despite the dangers, the number of deaths resulting from swatting is very, very low, confined to a handful of tragic cases, such as one in Kansas in 2017 and another in Tennessee in 2020. And now that a number of swatters have been sentenced to serious prison time, internet trolls know they can face real consequences. However, the problem is that the allegation of swatting is so serious, as it is with crimes like murder, kidnapping or a bomb threat, that emergency services generally have to investigate. And police don't always know if it's a swatting case until they arrive at an address and check it out, which is why it can be so dangerous. But there are safety measures you and your friends and family can take. What to do if you think you've been swatted You can prepare for swatting if you believe you've been threatened. kali9/Getty Images If you've gotten threatening messages or other signs that make you think you've just been swatted or will be soon, there are a few important things you can do right away to stay safe. Contact law enforcement Reach out to your local police and explain the problem. "If someone thinks they might be targeted, it's a good idea to file an informational police report about it," Allen said. "Responding officers would have access to that, typically, and that would help." Law enforcement responses can vary, but sometimes it helps to report that you're worried you've been swatted. "Here in Portland, officers may set up a perimeter around a residence and try to make phone contact," Allen said, "So having an accurate and current name and phone number in the system is really helpful." Also contact your local emergency communications center and explain the issue to them. Often, they'll also be able to put in a note for your address that says you're worried you've been swatted. Get loved ones to a safe place If possible, relocate pets and family until the swatting danger appears to have passed. You may not have a lot of time, but do what you can to make sure arriving police officers won't be running into your pets or scaring any children. Stay aware and alert If you get threatening messages in a game or online forum, take them seriously and start paying attention for signs of swatting. "It's smart to maintain some awareness about what's happening in your home," Allen said. "Sometimes we find people are home alone, playing video games with their sound-blocking headphones and can't hear us calling, knocking or 'loud hailing' -- that's when we use a loudspeaker to call into a home." Prep your home for a visit Remember, law enforcement officers are often required to investigate swatting claims. That means you may still get a visit even if you do everything right. Store any weapons you have and prepare to greet police. When I talked with John Chiaramonte, president of consulting services at 911 facilitator Mission Critical Partners, he said, "Stay calm, follow police commands and avoid sudden movements. ... Comply with commands and clarify when it's safe. Afterward, file a report and preserve any threatening messages." Chiaramonte said he thinks additional federal legislation should address swatting, but for now, he said, remember that police officers often believe it's a real emergency. "Awareness, preparation and communication can help ensure a safe outcome," he said. How to avoid being swatted You can help lower the risk of swatting if you think you may be a target."It's difficult to 'prevent' swatting," Allen told me. Swatting is frightening because it's uncontrollable, and you usually don't know when or even why it's happening. But there are several practical steps that can reduce your risk, especially when it comes to the internet hordes. Turn off location services. If your gaming platform or communication hub uses location-based services, turn them off when possible. They make it much easier to find your real address online. You can usually find these settings in your profile or the data-sharing sections of the apps you use. If your gaming platform or communication hub uses location-based services, turn them off when possible. They make it much easier to find your real address online. You can usually find these settings in your profile or the data-sharing sections of the apps you use. Wipe your address from the internet. "Review your online presence for sensitive personal information that could enable malicious actors to conduct a swatting attack," the FBI suggests. I have a full guide on how to do this here. You can't usually scrub your address everywhere, but you can make it a lot harder to find. Steps like using a P.O. Box and sending requests to take down personal contact info can make a big difference. Plus, you may get less junk mail. "Review your online presence for sensitive personal information that could enable malicious actors to conduct a swatting attack," the FBI suggests. I have a full guide on how to do this here. You can't usually scrub your address everywhere, but you can make it a lot harder to find. Steps like using a P.O. Box and sending requests to take down personal contact info can make a big difference. Plus, you may get less junk mail. Don't share your address on social media or other sites. From your profile info to other ID data, don't include information on your address or the city you live in on any social media you use. If you use a payment service, create a separate one for your online activities that doesn't have your real name attached. "Exercise care when posting content (including photos and videos) or sharing it with individuals online," the FBI says. That includes platforms like Reddit, Discord and Twitch. From your profile info to other ID data, don't include information on your address or the city you live in on any social media you use. If you use a payment service, create a separate one for your online activities that doesn't have your real name attached. "Exercise care when posting content (including photos and videos) or sharing it with individuals online," the FBI says. That includes platforms like Reddit, Discord and Twitch. Use a VPN if worried. A VPN can make it much harder to track your IP address and similar info that could be used by a more determined swatter to identify your location. If you're concerned and you aren't already using a VPN, this is an excellent opportunity to get one. A VPN can make it much harder to track your IP address and similar info that could be used by a more determined swatter to identify your location. If you're concerned and you aren't already using a VPN, this is an excellent opportunity to get one. Remember, swatting thrives on conflict. Unless you're a celebrity, swatting usually has some purpose or some triggering event behind it. The more you avoid open conflict online and, well, generally avoid being a jerk, the less likely it is someone will swat you. Do you need to worry about accidentally swatting someone? Not really. If you're dialing 911 in an emergency and you're as honest as possible with emergency services, they should be able to help you out, even if you accidentally get an address wrong or lose your train of thought. But it's a good idea to take a deep breath and try not to flub any details. For more helpful info from our experts, check out the best home security systems, how to update your smart home passwords and whether you need to worry about any kinds of smart home hacking.
Washington Post
09-06-2025
- Entertainment
- Washington Post
Diddy trial live updates: Ex-girlfriend ‘Jane' continues testimony in Sean Combs's sex-trafficking case
Sean Combs's trial, estimated to last eight weeks at the Daniel Patrick Moynihan U.S. Courthouse in New York City, will not be publicly broadcast. During jury selection, prosecutors provided a list of 190 names — including celebrities and public figures — that could surface during testimony. With the trial underway, here are the major players expected at court — including attorneys, potential witnesses and family members.
Forbes
29-05-2025
- Entertainment
- Forbes
The 4 Phases Of Fame, Broken Down By A Psychologist
Everyone has wondered what it would be like to be famous at one point or another in life. Even if it's not something you actively crave, the lifestyle of a famous person can be fascinating. Unless you are famous, you can never truly know the experience of having your name on everyone's lips, your face plastered across billboards and having every move of yours scrutinized by millions. Like most things in life, the reality of fame is not what most people fantasize about. There is more to living a celebrity lifestyle than red carpets and adoring fans. It's a complex psychological journey that can take a person on a wild ride through their inner emotional world. Famous people often experience different phenomenologies throughout their highly publicized careers. As explained by a 2003 article by Brown University, the word 'phenomenology' describes 'a philosophy of experience.' This means that throughout their time in the spotlight, many singers, actors and public figures relate to the lived experience of fame in different ways at different points in time. Here are the four different phases of fame. Chappell Roan is this generation's 'it' girl, and her recent rise to fame is a textbook case of fame's love-hate phase. While she is arguably one of the most relevant stars at the moment, Roan herself has admitted that when it comes to fame, it's not all glamorous. In a recent interview with The Guardian, she compared fame with the sensation of 'going through puberty,' noting that there are emotions she has never felt before and now has to deal with. It's easy to see why a star whose fame saw a meteoric rise like Chappell Roan would struggle with the consequences of fame. On one hand, she deeply appreciates the platform it has given her art. She is free to express herself and gets paid to do it — a dream she has harbored, by her own admission, since she was a child. On the other hand, fame can also be abusive. The pressure, scrutiny and invasiveness can be overwhelming and violating. Many young celebrities often liken their early careers to being touted around like 'show ponies.' This is an experience unlike any other and one that requires firm boundaries if the celebrity wishes to survive in a cutthroat environment. In a 2009 study published in the Journal of Phenomenological Psychology on the experience of fame, a celebrity interviewee stated, 'I have been addicted to almost every substance known to man at one point or another, and the most addicting of them all is fame.' Fame opens doors to a lifestyle most average people can only imagine. The society we live in treats celebrities like royalty, and the non-stop inflow of adulation and appreciation can be difficult to detach from. Pop culture news is rife with stories where celebrities indulge in degrading and potentially dangerous things to cling to relevance and status – celebrities who will do anything for the next 'hit' of fame. A 2013 study from Personality and Individual Differences correlated the 'need' to be famous with feelings of vulnerability and narcissism. People often want the power associated with fame, and many will do anything to achieve it. Fame can be a psychological drug that, if not handled with care, can wreck individuals the same way any drug addiction can. Like anything in life, fame can be adapted to as well. Celebrities like Keanu Reeves seem to have cornered the market on how to be a household name while keeping some semblance of normalcy about them. Of course, none of us can ever know their true nature, but there is a small and rarified group that has navigated long, illustrious careers with little to no scandals. This is the phase of adaptation. Celebrities who enjoy this experience are the rare beings who have conquered the beast and come out relatively unscathed. Considering the nature of the fame 'monster' and the ever-growing world of cancel culture, this is no easy feat. The study mentioned above in the Journal of Phenomenological Psychology shows that celebrities who achieve this phase have a fame protocol that helps them overcome the pitfalls of being well-known. One celebrity stated, 'You don't make eye contact, or you keep walking . . . and you just don't hear (people calling your name).' While these patterns can contribute to reclusive behaviors, many of them help celebrities keep their sense of sanity in a world of chaos. Remember when J.K. Rowling, the author of the beloved Harry Potter series, could do no wrong? Fame, however, can be fickle, and public opinion can turn on a dime, especially when your values are strongly in contrast to the fan base that once adored you. As one 2006 article in The New York Times eloquently puts it, 'Fame eats its own.' This is what most celebrities eventually come to accept. The reward of being a household name comes with the pitfall that, eventually, the media will turn on you, and that will be a wave you have to ride. As an antidote to this, many celebrities choose to focus on the job rather than fame itself. The New York Times' article also states that many celebrities choose to take solace in the work they produce and how that affects people. For these celebrities, this is the trade-off for being famous. While most of us feel like we own our favorite celebrity, we must remember there is a person behind the glitz and glamor; not a God, but also, not an object. Fame might look enticing from the outside, but it comes with a hefty price tag — one that's most often paid in the currency of mental and emotional well-being, and frequently without consent. Do you empathize with the celebrity experience or do you need to dial back your parasocial connections? Take this science-backed test to find out: Celebrity Attitude Scale.
