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http://pro.psychcentral.com/2013/dsm-5-changes-depression-depressivedisorders/004259.html#
http://pro.psychcentral.com/2013/dsm-5-changes-personality-disorders-axisii/005008.html
http://www.dsm5.org/Pages/Default.aspx
DSM 4 DSM 5
Differences
Where's Aspergers?
What are the DSM 4 DSM 5 Differences?
Let's take a look.
The American Psychiatric Association has
eliminated Aspergers from the proposed
DSM 5 along with the "Pervasive
Developmental Disorders" (PDD) category,
of which Autism and Aspergers were
subsets (see the outline on the DSM
4 page).
They have replaced PDD with the category
"Autism Spectrum Disorder" and listed
"Autism Spectrum Disorder" as the only
diagnosis in this category (see DSM 5
Outline of Neurodevelopmental
Disorders).
In the Association's own words, they have
eliminated the diagnoses of Childhood
Disintegrative Disorder, PDD-NOS, and
Aspergers, saying that they are now part
of Autism Spectrum Disorder. (You may
want to read more about PDDNOS andHigh Functioning Autism.)
I was initially not happy with this, and I'm
still not sure about it, but let's examine
the proposed DSM 5 to see if things were
eliminated or just moved around and
renamed.
Below you'll read diagnostic criteria for
Aspergers according to the current DSM 4
in the left column. You'll read the
comparable diagnostic criteria for Autism
according to the DSM 4 in the right
column. Then underneath each criterion,
you'll read about the proposed,
corresponding DSM 5 criterion for Autism.
Social Communication
Autism
Criterion
impairme
Criterion
functioni
Criterion
functioni
commun
Restricted, Repetitive
Patterns of Behavior,
Interests, or Activities
Aspergers in the DSM 4
Autism
Criterion
repetitive
behavior
The DSM 4
demonstra
them. Tho
of the beh
5 adds on
requires tw
Autism
Criterion
impairme
manifest
following
delay
devel
in ind
mark
initiat
other
stere
langu
lack o
believ
appro
Note: Criterion D for Aspergers has been
in debate for years. Tony
Attwood, theresearcher of Aspergers, says
that kids with Aspergers may have a delay
in language.
It looks to me like the American
Psychiatric Association has removed the
debated criterion and moved it into its
own diagnosis of Late Language
Emergence (LLE). See the next paragraph
below. (You can read about my son's
experience with delay in language on
the Autism Aspergers page.)
Delay in Cognitive
Development or Self-Help
Skills
Aspergers in the DSM 4
Criterion E: There is no clinically
significant delay in cognitive
development or in the development of
age-appropriate self-help skills, adaptive
behavior (other than social interaction),
and curiosity about the environment in
childhood.
Note: In his book titled The Complete
Guide to Asperger's Syndrome copyright
2007, Tony Attwood discusses the history
of the Aspergers diagnosis, which includes
delay in self-help skills, and therefore
seems to disagree with Criterion E in the
DSM 4.
Other Criteria
Autism
Criterion
functioni
play.
Autism
Criterion
better ac
or Childh
Outline of
Neurodevelopmental Disorders
When I saw how the proposed DSM 5
outlines Autism, ADHD, and Late
Language Emergence, everything made
more sense to me. (Notice
that Aspergers and PDD-NOS have been
eliminated.) I hope that reading the
Do I say "Aspergers" or
"Autism"?
Do I continue to say "Aspergers"? or do I
change to the one of the new DSM 5
diagnoses? I guess that all depends to
whom you're talking.
DSM 5
The Recently Updated Manual of
Mental Disorders
The DSM 5 is the recently revised Diagnostic and
Statistical Manual of Mental Disorders, which the
Good Change
One of the changes that the Association has made is
a good one. That's the removal of "clinically
significant delays in language" from the definition of
Autism.
The delay in language has been one of the
significant differences cited between Aspergers and
Autism according to the current DSM 4. Aspergers
supposedly has no delay but Autism does. However,
current research does not support that distinction. A
delay in language may or may not happen with
Aspergers.
One draft of the DSM 5 moved this diagnostic
criteria into a new diagnosis of Late Language
Emergence with a recommendation for early and
continuing intervention. I loved it!
However, the Neurodevelopmental Disorders work
group has since removed the Late Language
Emergence diagnosis. Now the child would probably
get a diagnosis of Speech Disorder or possibly of
Language Disorder. You can read the entire outline
of the DSM 5 Neurodevelopmental Disorders for
yourself.
Bad Change
What is not so good is the tighter criteria for social
communication, which is half of the definition of
Autism. This is the change that parents complain
about and that you read about in the news.
Summary of Changes
If you're like me, then reading the outline will help
you understand how the Association has changed
DSM 5 Outline of
Neurodevelopmental
Disorders
When I saw how the proposed DSM 5 outlines the
neurodevelopmental disorders of Autism, ADHD,
Autism Behaviors
According to the Proposed
DSM 5
Autism Behaviors are the second part of the
proposed DSM 5's definition of Autism Spectrum
Disorder, specifically "restricted, repetitive patterns
of behavior, interests, or activities." The first part is
about social communication.
*DSM stands for Diagnostic and Statistical Manual, which is
published by the American Psychiatric Association and used
by professionals to diagnose mental health conditions. The
manual not only affects decisions that doctors make but also
what the insurance companies will cover. The DSM 4 is the
recently retired manual. You can learn more about it on
the DSM 4 page.
DSM 5 was just published.
NOTE: Tony Attwood, the current researcher of Aspergers
Syndrome, does not agree with the elimination of Aspergers
Syndrome from the manual.
Read more on the DSM 4 page, the DSM 5 page, and the ICD
10 page.
Communication, for which a child with PDDNOS might be diagnosed under the new criteria.
However, there is no equivalent new diagnosis for
children who have "restricted, repetitive patterns of
behavior, interests, or activities." I guess the
researchers find that if children have the latter, they
always also have social communication disorder.
Here's a side-by-side comparison of the DSM 4 and
the DSM 5's criteria for the Autism behaviors listed
in the second part of the definitions of Autism and
Aspergers.
as manifested by at
following:
Highly restricted
that are abnorm
focus (such as st
or preoccupation
objects, excessiv
or perseverative
Excessive adhere
ritualized pattern
nonverbal behav
resistance to cha
motoric rituals, i
route or food, re
or extreme distre
changes)
Stereotyped or r
motor movemen
objects (such as
stereotypies, ech
use of objects, o
phrases)
Hyper-or hypo-re
input or unusual
aspects of enviro
apparent indiffer
pain/heat/cold, a
specific sounds o
excessive smellin
objects, fascinat
spinning objects)
Outline of Neurodevelopmental
Disorders
When I saw how the proposed DSM 5
outlines Autism, ADHD, and Late Language
Emergence, everything made more sense to me.
(Notice that Aspergers and PDD-NOS have been
eliminated.) I hope that reading the outline helps
you, too. You may want to compare it to the
current DSM 4.
Find a Therapist
Learn more about treatments for anxiety and
depression.
DSM-5
Disorders
Anxiety Disorders
Separation Anxiety Disorder
Selective Mutism
Specific Phobia
Social Anxiety Disorder (Social Phobia)
Panic Disorder
Panic Attack (Specifier)
Agoraphobia
Generalized Anxiety Disorder
Substance/Medication-Induced Anxiety Disorder
Anxiety Disorder Due to Another Medical Condition
Other Specified Anxiety Disorder
Unspecified Anxiety Disorder
Obsessive-Compulsive and Related Disorders
Obsessive-Compulsive Disorder
Body Dysmorphic Disorder
Hoarding Disorder
Trichotillomania (Hair-Pulling Disorder)
Excoriation (Skin-Picking) Disorder
Substance/Medication-Induced Obsessive-Compulsive and
Related Disorder
Obsessive-Compulsive and Related Disorder Due to Another
Medical Condition
Other Specified Obsessive-Compulsive and Related Disorder
Unspecified Obsessive-Compulsive and Related Disorder
Trauma- and Stressor-Related Disorders
Reactive Attachment Disorder
Disinhibited Social Engagement Disorder
Posttraumatic Stress Disorder
Acute Stress Disorder
Adjustment Disorders