The American Psychiatric Association periodically updates the DSM to reflect new understanding of mental health conditions and the best ways to identify them. The manual’s fifth edition – DSM-5 – took effect in May 2013. We anticipate that their profile of difficulties will be captured by ‘Social Communication Disorder’, a new category that will appear in DSM-5.The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM) to guide healthcare professionals diagnosing mental health conditions. Nevertheless, we identified a group of individuals who may miss an ASD diagnosis, due to insufficient repetitive and stereotyped behaviour. ![]() We attribute this to our ability to use detailed phenotyping to accurately implement the full range of ASD symptoms described in DSM-5. Neither IQ nor age was associated with the risk of not meeting criteria for ASD.Ĭonclusions: Our findings contradict studies that have suggested severely reduced sensitivity of DSM-5 ASD criteria in higher-functioning individuals. Of the 52 people with PDD-NOS who did not reach thresholds for ASD, 37 had insufficient repetitive behaviours for a DSM-5 diagnosis. Of the PDD-NOS cases 69% (115 of 167) met DSM-5 criteria for ASD. Most cases of DSM-IV-TR autism (175 of 185 95%) and Asperger’s disorder (137 of 143 96%) met DSM-5 criteria for ASD. ![]() Of the 231 children without a DSM-IV-TR PDD diagnosis, 61 (26%) met criteria for DSM-5 ASD. Results: Of the children with a DSM-IV-TR PDD diagnosis, 86% met criteria for DSM-5 ASD. 140 of these questions were combined to create a DSM-5 algorithm, which mapped the full range of symptoms described in DSM-5 ASD criteria. Symptoms were assessed by parent report using the Dimensional, Diagnostic and Developmental Interview (3Di).This interview contains over 200 questions capturing the full range of autistic phenomena, well beyond those described in DSM-IV-TR criteria. All either met DSM-IV-TR criteria for PDD, or had significant, sub-diagnostic autistic traits characteristic of the broad autism phenotype. Methods: Participants were 726 verbally able (mean verbal IQ=91) children and young people (mean age=9.5 years) who had been referred to a clinic for the assessment of social communication difficulties. ![]() Objectives: Using detailed and comprehensive phenotyping, we aimed to accurately implement DSM-5 ASD criteria to test whether they exclude from the autism spectrum individuals with a DSM-IV Asperger’s, autism or PDD-NOS diagnosis. Proponents of DSM-5 have countered these claims, arguing that such research is flawed, as it used data that were collected to capture DSM-IV and DSM-III defined symptoms, and so failed to properly implement DSM-5 diagnostic criteria. However, concerns have arisen that the threshold for receiving a diagnosis on the autism spectrum in DSM-5 is set too high several studies have suggesting that DSM-5 ASD criteria will exclude around 40% of those currently meeting DSM-IV-TR criteria and that sensitivity will be especially poor for high-functioning individuals. Empirical evidence already exists that these modifications will improve the reliability and validity of ASD. Changes include the creation of a single unitary category of autism spectrum disorder the replacement of the autism triad with an autism dyad the removal of the Asperger’s disorder and pervasive developmental disorder – not otherwise specified (PDD-NOS) diagnostic sub-categories the inclusion of sensory abnormalities as a core ASD symptom and the removal of language delay from diagnostic criteria. Background: Diagnostic criteria for autism will be radically revised in the fifth edition of the DSM, published in 2013.
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