DSM change justified due to pandemic of AS misdiagnosis

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Please cite the study that indicates that 75% of individuals with a documented dx of an autism spectrum disorder under DSM-IV and/or DSM-IV-TR would not meet the ASD standard, as published in the final DSM-5.

If I correctly read the rest of the paragraph(s) above, you're argueing that some post-2000 Aspies should'nt qualify for a clinical dx, but that they should have some sort of "ASD, but okay today" dx instead.

What's the point of this "purgatory" dx? Is it to acknowledge that an individual has documented communication and processing differences from the "baseline"? If that's the case, then how do you have a clinical dx that is'nt a dx?

They already have "in remission" and "residual" for that. If you have AS traits and no longer need a diagnosis, most psychologists won't give you one, though it might be in your records that you were diagnosable as a child. There's no sense in diagnosing a bunch of random nerds who don't need help with an ASD they don't have.

Just to clarify, I said "autistic people." I meant people diagnosed with other labels on the spectrum as well as people diagnosed with AS.

Sorry - I should have said "Asperger's" not ASD. There have been several studies done actually finding different sized reductions, this is just the first one that came to mind - I think because it's one of the larger ones (using a bigger sample).


McPartland, Reichow and Volkmar, 2012

This study looked at the records of 657 individuals, aged 12 months-43 years who participated in the clinical trials for the DSM-IV. It re-evaluated those individuals using the DSM-5 criteria and found that 39.4% would no longer qualify for a diagnosis on the autism spectrum. Those most affected by the change had IQ’s >70; sex and age were comparable in those meeting and not meeting the new criteria. By diagnosis, the new criteria excluded 24.2% of those with Autistic Disorder, 75% of those with Asperger’s disorder and 71.7% of those with PDD-NOS. One criticism of this study is that, since the DSM-IV criteria did not include a sensory criterion, no data was collected in the original files that might have fulfilled that criterion for the DSM-5.

I suspected that was the one.

It's unclear if they used the final DSM-5 guidence, and it's also unclear how they made the evaluation. It's not like they re-interviewed the individuals (which is pretty much standard operating procedure to perform a dx in the first place).

And that's assuming that you accept DSM-5 as valid, which many individuals do not. APA has no legal power of their own.

Cheers, I'll read the methodology section of that one carefully as soon as I'm out of exams - close now!! In terms of the DSM V as a whole, I'm still very much on the fence as I haven't read enough about it yet to form a proper opinion.

Agreed and nicely put.



I have never said or implied this, either in the OP or any of my subsequent posts on this thread, or anywhere else on WP. I'm not going to add another clarification post because I feel I have added enough.

Clinically significant distress or impairment means that person feels either/or clinically distressed or experienced clinical impairment in daily functioning due to AS. Yourself as described above actually fits both categories "torment or hell inside" = distress, "stimming all the time at home" = functioning.

The idea of people somehow "deserving" or "not deserving" a diagnosis is kind of ridiculous don't you think? This kind of terminology again comes from the subconscious perception of Asperger's as a culture rather than a psychiatric illness, with having an Asperger's diagnosis somehow thought equivalent to being given membership to a desirable group, rather than being diagnosed with an illness for the purpose of treatment and working towards curing it (this is what psychiatric illness is).

Aspergers as it is perceived now by the general public no longer fits this profile. The growth of asperger's culture in and of itself is not a bad thing at worst, and can be a really good thing at best, but it should not be reliant on diagnosis of a psychiatric disorder in large groups of people who do not and have never needed treatment.

The above are people who should not be diagnosed with a psychiatric condition. Note that this does not include people who have experienced problems in the past, people who hide their problems, people who cope fine but really struggle to do so - and that struggle causes some form of distress, etc etc. I argue also that people who have experienced problems and been diagnosed in the past but have not for a long time should be able to choose to "downgrade" their diagnosis while still being classified as being on the spectrum (as asperger's can't be "cured" or "disappear") if they feel it is appropriate. Again repeating myself, but I consider myself to fall under this category - and it feels kind of silly have a diagnosis for a psychiatric condition when, although experiencing severe distress in the past, I am not currently experiencing severe distress from it (I still have many problems, sure, but I don't feel they are severe enough to warrant psychiatric diagnosis - which I consider to be a serious thing).

This "large group of people" who wrongfully received the diagnosis doesn't appear to exist, though.

A problem with that is that is not much clear what "misdiagnosis" actually mean.

a)That some person was diagnosed but he did not really matched the criteria in the DSM-IV and/or in the ICD-10?

b) That some person was diagnosed by the criteria of the DSM-IV by he does not match the criteria of the DSM-5 (for people outside of the US, replace by ICD-10 and ICD-11 when the ICD-11 comes out)?

c) That some person was diagnosed and matched the criteria, but did not really has the neurological difference associated to AS?

In the case a), there is indeed many cases of disagreement between doctors about if someone has AS or not. However, by what I have read, the typical disagreement is not between "AS or non-autistic", but between "AS or other ASD" (but I could be wrong in that detail)

In the case b), is largely arbitrary to say that someone who matched the DSM-IV but not the DSM-5 was misdiagnosed, instead of the opposite

The case c) could be the more "correct" concept of "misdiagnosis", but attending that until now nobody identified the neurological difference associated to AS (it is not even know is AS is one neurological difference, or if is a catch-all diagnosis lumping people with several unrelated neurological differences), it is irrelevant in practice.

My friend attended a conference called the Woodview Stages of Autism conference in Ontario, Canada. At this conference Peter Szatmari spoke about a study that looked at people diagnosed with PDD NOS, Asperger's and Autsistic Disorder using DSM IV criteria. The study did s thorough analyses of these people;s developmental histories and found that over half of the PDD-NOS cases did not meet the criteria (and so had been misdiagnosed). A small but still significant portion of people diagnosed with Asperger's Syndrome didn't meet criteria and an even smaller percentage of people diagnosed with Autistic Disorder didn't meet criteria based on their developmental histories. I can't find this study by a quick search but if you want to confirm that this was said at a recent conference on autism by Peter Szatmari you should email him. PETER'S PAGE

I agree.

Thanks much. I guess that's me told.

I found an abstract of a 1994 paper that appears to examine 977 cases of DSM-III (Note: prior to DSM-IV) on google, is that the paper? The details appear consistent with your description, except for being 19 years ago and the same debate in an earlier DSM handbook.

http://europepmc.org/abstract/MED/80674 ... lRqcQdYL.6

I'm sorry I don't have any better details than that. My friend is going to call me eventually (she's not feeling well today) with the exact % of people who didn't meet criteria in each group and the sample sizes.

Also I just wanted to say I don't think anyone is just faking a diagnosis to try to be cool (or at-least the majority of people are not doing that IMO). I just think some people might have a disorder with similar symptoms or just have some autistic traits and not the full disorder and since ASD is in the media and the recent studies (it's a kind of fad diagnosis) some doctors have lately dafualted to it perhaps doing not so thorough analyses. The other thing might be tgha some people just hear about it , recognize and relate to a few symptoms and say "oh, that's me, for sure" whereas if Schizoid PD or ADHD or something else was constantly in the news and on the media and being researched the people might do the same with that disorder. I;'m not saying these people aren't really suffering or that they're faking or anything. They;re just being human beings who want to have an identity and a name for their problems but some of them might be on the wrong track is all.

Last edited by daydreamer84 on 16 Jun 2013, 7:06 pm, edited 2 times in total.

This link works for the page Palpatine linked:

http://europepmc.org/abstract/MED/8067493/

AgentPalpatine's link said I was timed out.

Here's the text:

I'm pretty sure it's not because she said the study was based on DSM IV TR criteria and was mentioned at a conference this year as recent data. E-mail Peter Szatmari if you want to know more. I'll email my friend tomorrow and try for more details.