2 Questions:
1) Is it common practice for you diagnose someone with a Neurological condition having never met them, asked them any questions, run any tests on them, etc. - just based on a 10 minute video of them getting arrested after they had been drinking?
2) if the answer to #1 is Yes, then your posts make more sense to me, but do you at least see how someone might feel that's a bit problematic?
I'm trying to stay in the middle here - but you make it difficult when you say things like "You haven't given me any alternate explanations to explain his behavior". I clearly asked you before.....
All of these seem like plausible reasons for Walton's behavior:
Depression/Mental/Emotional Health issues
Immaturity/Anger Issues
Just being a bad drunk & an *******
I mean - I've been around tons of dudes who behave irrationally, aggressively, unpredictably when they're drunk. **** - I've been that dude some nights.
To which you responded - "You make a good point about mental health issues being another likely factor".
So I've given you a laundry list of other possible explanations - but all you see is the mental health angle. So while you say you're open to other explanations - I don't really think you are. Which is fine - just don't keep saying you are if you're not.
Let's keep things in perspective. I offered an opinion of a diagnosis in a free forum. This was not a formal evaluation and I didn't sign off on an assessment that could, for example, determine Mark's treatment. If this were a formal diagnosis, I would have sought out collateral documentation to corroborate my clinical impressions.
That said, I can and frequently do form a clinical impression after observing an individual for a brief period, even just 10 minutes. Furthermore, absent corroborating evidence, I have made formal diagnoses based solely on clinical impressions. In this case, my clinical impression remains that Mark is exhibiting signs and symptoms consistent with an underlying neurological condition (by the way, this is not the only video I have watched; there are several videos online that show Mark's bizarre, erratic, and violent behavior).
I'm having trouble keeping up with all the posts I'm responding to so you're right that I had forgotten you had actually suggested other possible explanations, although it's hardly a "laundry list." Whatever, let's examine them:
Depression/Mental/Emotional Health issues - these all fall under the category of psychiatric illness, which I've already stated could be contributing factors, if not primary causes.
Immaturity/Anger Issues - this is where things get nebulous. What do you mean by immaturity? How do you define it? How do you measure it? How would you determine if a person is mature vs. immature? As for anger - aggression, irritability, violent outbursts etc. are clinical symptoms or features of multiple neurological and psychiatric illnesses, e.g. PTSD, Alzheimer's diseases etc. Again, they are symptoms and not the cause of these conditions. So, I view Mark's anger and violence as a behavioral outcome of an underlying condition, not the cause itself.
Just being a bad drunk & an ******* - first, I would never refer to someone as a "bad drunk." What I would say is that that person has a severe alcohol-use disorder. As stated earlier, AUDs and other substance-use disorders are mental health issues, which I've already said may be possible explanations/diagnoses. As for him being an *******, how do you define being an *******? How do you measure it? How do you distinguish an ******* vs. a nice guy?
Behavioral health is an inexact science. The brain is an organ that is vastly different and significantly more complex than any other organ in our bodies. It affects behavior but also emotion, thought, speech, and perception. Making it even more complex is the fact that we don't have biomarkers to help determine diagnoses. The best we can do at this time (without opening up our skulls) is to examine clinical features. In an earlier post, I provided you with the clinical features as to how I arrived at CTE. I'm not sure what more I can do to support my position. I am also comfortable stating that I'm open to alternate explanations, but am still waiting for additional plausible explanations over and above those that are considered psychiatric illnesses/brain conditions, which I have already agreed are plausible.
How about this? My position is that in Mark's case what we're witnessing are symptoms of CTE. How about you rule-out CTE i.e. dispute the clinical criteria I provided and make a case for something else that would better explain his clinical presentation. If you are going to include your suggestions of immaturity and/or being an ******* then you need to explain those constructs. How are they defined? How would you measure them? How would they account for his overall clinical presentation? What are the criteria that will help a clinician to determine a mature person vs. immature person, or ******* vs. good guy?
Doesnt make them right or wrong...
