DSM-5: Asperger's Scrapped

[PC LOAD LETTER]

along with a few other diagnoses such as paranoid personality disorder and schizoid personality disorder.

http://www.scientificamerican.com/article.cfm?id=redefining-mental-illness

Asperger's related section is on page 5 - 6


Good-bye to Asperger’s?
Certain behavioral quirks have long been thought to distinguish Asperger’s syndrome from other autistic disorders. “Aspies,” as people with this affliction sometimes call themselves, tend to develop intense fascination with very specific objects or facts—the wheels of toy cars or the names of constellations—in the absence of a general interest in, say, automotive mechanics or astronomy. Now the diagnosis will disappear, and Aspies may find an important part of their identity stripped away.

Currently Asperger’s is one of five so-called pervasive developmental disorders, along with autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and the lesser-known Rett syndrome and childhood disintegrative disorder (CDD). All these problems are characterized by deficits in communication and social skills as well as by repetitive behaviors. Indeed, the APA has decided that four of the five disorders—autistic disorder, Asperger’s, CDD and PDD-NOS—are so similar that they should all be placed into a new category called autism spectrum disorder (ASD). Psychiatrists using the new DSM will give anyone on the spectrum a diagnosis of ASD, along with a rating of illness severity.

Children whom psychiatrists would previously have diagnosed with CDD fall at the more severe end of the spectrum. They typically experience an almost complete deterioration of social and communication skills starting sometime between the ages of two and 10. Asperger’s patients will land on the milder end. They generally do not show language delays and, in fact, often display excellent verbal skills. Rett syndrome, in which known genetic mutations stunt physical growth, along with language and social skills, is gone from the manual entirely. Ironically, the APA is eliminating it because a genetic test for the condition makes diagnosis so precise and straightforward. For now the DSM prefers to limit itself to a blunter diagnostic measure: behavior.

Statistical studies published in 2011 and 2012 confirm that the DSM-5 criteria for autism are more accurate than those penned in the DSM-IV. The revised guidelines practically guarantee that anyone told they have the disorder really has it. To qualify as autistic by the new manual, a patient must meet five of seven symptoms—a higher bar than the six-of-12-symptom cutoff in the DSM-IV.

Some psychiatrists say the new rules are too strict: they worry some high-functioning autistic people, such those now diagnosed with Asperger’s, may not meet the criteria and may miss out on educational and medical services as a result. On the other hand, if people with milder autismlike symptoms do make it onto the spectrum, the lack of an Asperger’s label could benefit them. States such as California and Texas now provide educational and social services to people with autism that they deny to those with Asperger’s. Some parents argue, though, that limited resources should go to kids with more severe symptoms before anyone else. —F.J.

[Kenco Smooth]

This is one of the bigger changes which seems to have caused the least consternation and controversy. Even critics like Simon Baron Cohen have been pretty light handed in the debates over it.

Much more worrying are the just released results of field trials with new diagnostic criteria which have particularly shown terrible inter-rater reliability of major depressive disorder and generalised anxiety disorder. There really is a lot in the current plans for the DSM-V which is very worrying especially with how keen the APA seems to be to bulldoze through to the planned 2013 publishing date.

[Revolution starts with U]

My cousin's little sister has RETT and I'm glad to see it is fully regarded as a genetic disorder now... as it was pretty clear she wasn't suffering from simply a mental disease.

[Sperm-Doll Setsuna]

I've been in favour of integrating Asperger's into a general and wider autism spectrum for a long time, so I don't think it's so bad. Especially with how the disagreeable pop-culture publicity seems to have watered down support schools and other institutions have been willing to offer in some areas. The DSM-IV defintion of Asperger was, in addition, an awful and vague claptrap, even compared to alternative psychiatric diagnosis manuals.

Every time I see rubbish like:


“Aspies,” as people with this affliction sometimes call themselves, tend to develop intense fascination with very specific objects or facts—the wheels of toy cars or the names of constellations—in the absence of a general interest in, say, automotive mechanics or astronomy.

I die inside. Quite a crock of shit, I'd say.

[Kronsteen]

There's a definition here (http://askville.amazon.com/diagnose-Asperger%27s-syndrome/AnswerViewer.do?requestId=2389572).

If you don't feel like wading through a formal definition, try this survey:

1) Are you more affectionate than other people think you should be?
2) Are you less affectionate than other people think you should be?
3) Do you get very interested in things that other people think are boring?
4) Are you socially awkward?
5) Do you get depressed?
6) Do you sometimes behave in ways that anyone thinks is inappropriate?
7) Do you not care about their opinion?
8) Do you sometimes misunderstand another person's speech?
9) Do other people sometimes misunderstand you?

If the answer to any of these is yes, you may have aspergers. Or you may just be like everyone else on the planet...in that you fit the criterion for being possibly aspergic.

Or possibly someone needs to find a decent definition for autistic spectrum disorder.

[blake 3:17]

From the OP:
Some psychiatrists say the new rules are too strict: they worry some high-functioning autistic people, such those now diagnosed with Asperger’s, may not meet the criteria and may miss out on educational and medical services as a result. On the other hand, if people with milder autismlike symptoms do make it onto the spectrum, the lack of an Asperger’s label could benefit them. States such as California and Texas now provide educational and social services to people with autism that they deny to those with Asperger’s. Some parents argue, though, that limited resources should go to kids with more severe symptoms before anyone else. 

I hate capitalism.