New DSM-5 Criteria For Autism -- Who Will Be Left Behind?

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Sweetleaf
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02 Mar 2013, 1:20 pm

whirlingmind wrote:
empathy is known to be affected in autism, otherwise why do you think they use the Empathy Quotient as part of the SBC tests for Asperger's? There is plenty of research out there about how empathy is impaired in people on the spectrum (whatever the actual truth of the matter is).


I think they should look more into the possibility of having trouble expressing empathy, instead of a supposed lack of it or impaired ability to experience it. Or maybe sometimes its a case of wrong empathy like because we are different we might not quite understand how things effect others emotionally and might tends towards thinking they would feel how we would feel about it for instance.


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02 Mar 2013, 1:29 pm

whirlingmind wrote:
Ichinin wrote:
[A lack of empathy is not something you want to associate with Autism. Its a distinct diagnosis criteria for Psychopathy.


...empathy is known to be affected in autism, otherwise why do you think they use the Empathy Quotient as part of the SBC tests for Asperger's?


Really? I've heard lots of other words for it, like Emotional Quota, Facial blindness or Theory of Mind. It has many names. I call it Social Reciprocity. But the fact of the matter is that it can be picked up by training in ASDs.

Whatever it is called, Empathy is the wrong word. I seriously do not want to associate myself with people that have ASPD.

Maby there is a subset of autistics that have a lowered empathy, but then, is it really autism? Some people here on the forum also have TOO MUCH empathy and can get very upset - so is your definition of EQ really valid?


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Ettina
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02 Mar 2013, 2:12 pm

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Whatever it is called, Empathy is the wrong word. I seriously do not want to associate myself with people that have ASPD.


Well, researchers divide empathy into cognitive and affective empathy. But personally I agree. Cognitive empathy shouldn't really be called empathy.

Oh, and a minor nitpick - not all ASPDs have impaired empathy (of either kind). Some just have impaired emotion-regulation and/or bias towards assuming hostility.



OJani
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02 Mar 2013, 3:10 pm

Ettina wrote:
Quote:
Whatever it is called, Empathy is the wrong word. I seriously do not want to associate myself with people that have ASPD.


Well, researchers divide empathy into cognitive and affective empathy. But personally I agree. Cognitive empathy shouldn't really be called empathy.

Oh, and a minor nitpick - not all ASPDs have impaired empathy (of either kind). Some just have impaired emotion-regulation and/or bias towards assuming hostility.

I'd say autistic people tend to have impaired cognitive empathy while ASPDs tend to have impaired affective empathy, but the whole picture must be more complicated than that. It was a rather enlightening episode in my life recently when I had the (unsought) opportunity to observe two (supposed) ASPDs very closely.



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02 Mar 2013, 3:12 pm

aghogday wrote:
(...)
As an example this is what the expanded text in the DSMIV looks like for autistic disorder and Asperger's syndrome, as quoted in the links below. It is much more detailed than the basic criteria set. It includes expanded text for diagnostic features directly associated with the basic criteria set, as well as associated features, and other information.

https://sites.google.com/site/gavinboll ... for-autism
https://sites.google.com/site/gavinboll ... -aspergers

Thank you for the links.



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02 Mar 2013, 7:00 pm

I am definitely not an expert, but one thing I did notice about section A is that it says "deficits in" not "lack of". Which maybe means that a "milder" case could still fit the criteria.



StuartN wrote:
Ichinin wrote:
mrL wrote:
I havent got access to the latest draft of DSM5 (if anyone do, please post a link).


DSM-V - Autism Spectrum Disorder

Must meet criteria A, B, C, and D:

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction,
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people

B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:

1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
4. Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D. Symptoms together limit and impair everyday functioning.



StuartN
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02 Mar 2013, 7:47 pm

Ettina wrote:
The author seems to think any disability that could potentially impact social interaction counts as a social disability (which, if taken to its extreme, could mean lumping in kids with purely physical disabilities on the autism spectrum simply because other kids think drooling is gross).


21% of all school children in the UK are labelled as having Special Educational Needs, and 14% of all US school children.



OddDuckNash99
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02 Mar 2013, 8:06 pm

I think that the DSM-5 is pretty much annihilating everything. At least the DSM-IV had SOME logic to it, but I fail to see any sense in any decision the DSM-5 is planning. I mean, taking out the mood disorder category?! That just BAFFLES me. Kraepelin is probably rolling over in his grave. :shameonyou:


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Chloe33
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02 Apr 2013, 3:24 am

The DSM-V isn't going to be that bad, i think changes were made to make it easier on clinicians to diagnose people. Also changes were made to replace names of disorders to be more sounding politically .

To my knowledge the DSM-V isn't removing the mood disorders category.

"A proposed new diagnostic category, temper dysregulation with dysphoria (TDD), within the Mood Disorders section of the manual. The new criteria are based on a decade of research on severe mood dysregulation, and may help clinicians better differentiate children with these symptoms from those with bipolar disorder or oppositional defiant disorder."
http://en.wikipedia.org/wiki/DSM-5

Aspergers would fall into the Autism spectrum. Here's the wikipedia criteria:
http://en.wikipedia.org/wiki/Diagnosis_ ... s_to_DSM-5

One of the proposed changes to DSM-5 is to do away with Asperger syndrome as a separate diagnosis and fold it under autism spectrum disorders, with severity measures within the broader diagnosis.[33]
In the proposed revision, individuals must meet the criteria in sections A, B, C and D to receive a diagnosis of Autism Spectrum Disorder .[34]
A. Deficits in social communication and interaction not caused by general developmental delays. Must have all 3 areas of symptoms present.[34]
1) Deficits in social-emotional reciprocity; failure to have a back and forth conversation.[34]
2) Deficits in nonverbal communication such as abnormal eye contact and body language or difficulty using and understanding nonverbal communication, and lack of facial expressions or gestures.[34]
3) Deficits in creating and maintaining relationships appropriate to developmental level (apart from relationships with caregivers). This may include trouble adjusting behavior to suit different social contexts, difficulties with imaginative play and making friends, and a lack of interest in other people.[34]
B. Demonstration of restricted and repetitive patterns of behavior, interest or activities. Must present two of the following.[34]
1) Repetitive speech, repetitive motor movements or repetitive use of objects (echolalia, idiosyncratic phrases).[34]
2) Adherence to routines, ritualized patterns of verbal or nonverbal behavior, or strong resistance to change (insists on eating the same food, repetitive questioning, or great distress at small changes).[34]
3) Fixated interests that are abnormally intense of focus (strong attachment to unusual objects, restricted interests).[34]
4) Over or under reactivity to sensory input or abnormal interest in sensory aspects of environment (such as indifference to pain, heat or cold, negative response to certain sounds or textures, extreme smelling or touching of objects, fascination with lights or spinning objects).[34]
C. Symptoms must be present in early childhood (May not become apparent until social demand exceeds limited capacity).[34]
D. Symptoms collectively limit and hinder everyday functioning.[34]

The proposed removal of Asperger’s Syndrome from the DSM has been controversial as it is commonly used by health insurers, researchers, state agencies, schools, and individuals with the disorder.[35] Experts are concerned that eliminating the Asperger’s label will prevent mildly affected people from being evaluated for Autism.[35]"

How are they going to work this? Start re-evaluating those with Aspergers? That would take a lot of time to do...



OddDuckNash99
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02 Apr 2013, 7:49 am

Chloe33 wrote:
To my knowledge the DSM-V isn't removing the mood disorders category.

When I submitted my criticisms on their website, their plan was to have a "Depressive Disorders" category and a "Bipolar Disorders" category, not a mood disorders category that was all-encompassing. I haven't heard that they've changed this plan.


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