Multiple-complex Developmental Disorder

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How many of you meet the criteria for McDD? The criteria I meet are made bold.


A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt.
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior.
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity.
4. Severely impaired regulation of feelings with significant and wide emotional variability.

B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C).
(A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. Lack of social or emotional reciprocity
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms
4. Persistent preoccupation with parts of objects

C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life.
2. Hallucinations and/or unusual perceptual experiences.
3. Negative symptoms (anhedonia, affective flattening, alogia, or avolition)
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter, etc.
5. Disorganized speech.

First, you might be interested in this: http://www.wrongplanet.net/postt91840.html

A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt.
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior.
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity.
4. Severely impaired regulation of feelings with significant and wide emotional variability.

B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C).
(A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. Lack of social or emotional reciprocity
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others - (formerly)
3. Stereotyped and repetitive use of language or idiosyncratic language - (still not gone)
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms
4. Persistent preoccupation with parts of objects

C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life.
2. Hallucinations and/or unusual perceptual experiences.
3. Negative symptoms (anhedonia, affective flattening - (as part of autism), alogia, or avolition)
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter - (not part of catatonic behaviour, but part of autism for me), etc.
5. Disorganized speech - (as part of autism).

Heh, I'm starting to think you could slap any old label on me, what with my problems! lol

A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt.
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior.
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity. 4. Severely impaired regulation of feelings with significant and wide emotional variability.

B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C). (A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. Lack of social or emotional reciprocity
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms
4. Persistent preoccupation with parts of objects

C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life.
2. Hallucinations and/or unusual perceptual experiences.
3. Negative symptoms (anhedonia, affective flattening, alogia, or avolition)
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter, etc.
5. Disorganized speech.

A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt.
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior.
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity.
4. Severely impaired regulation of feelings with significant and wide emotional variability.

B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C). (A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. Lack of social or emotional reciprocity
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms
4. Persistent preoccupation with parts of objects

C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life.
2. Hallucinations and/or unusual perceptual experiences.
3. Negative symptoms (anhedonia, affective flattening, alogia, or avolition)
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter, etc.
5. Disorganized speech.

I have McDD.

Any questions?

A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt.
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior.
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity.
4. Severely impaired regulation of feelings with significant and wide emotional variability.

B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C).
(A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. Lack of social or emotional reciprocity
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms
4. Persistent preoccupation with parts of objects

C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life.
2. Hallucinations and/or unusual perceptual experiences.
3. Negative symptoms (anhedonia, affective flattening, alogia, or avolition)
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter, etc.
5. Disorganized speech.

I'm currently dxed as Schizoaffective



A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt.
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior.
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity.
4. Severely impaired regulation of feelings with significant and wide emotional variability.

B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C).
(A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. Lack of social or emotional reciprocity
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms
4. Persistent preoccupation with parts of objects

C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life.
2. Hallucinations and/or unusual perceptual experiences.
3. Negative symptoms (anhedonia, affective flattening, alogia, or avolition)
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter, etc.
5. Disorganized speech.

Just plain old Autism spectrum DX for me.


A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt.
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior.
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity.
4. Severely impaired regulation of feelings with significant and wide emotional variability.

B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C).
(A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. Lack of social or emotional reciprocity
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms
4. Persistent preoccupation with parts of objects

C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life.
2. Hallucinations and/or unusual perceptual experiences.
3. Negative symptoms (anhedonia, affective flattening, alogia, or avolition)
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter, etc.
5. Disorganized speech.

I have no confidence in such a diagnostic critera. Many of the items would occur within the normal course of ASDs and I fail to see how one could be certain of the independence of such symptoms.

Meeting these criteria would be common for people with AS than not meeting them. Look at the incident of bullying, consider the behavioral and emotional effects and consider this in terms of the first criteria in section 1. Consider the third criteria, and the well known fact that such a symptom is common in plain old garden variety ASDs.

The second section will be met by everyone with AS or Kanner type Autism. The third section will be met by most. You only need two symptoms, and people with sensory disturbance (a lot of us) automatically meet one. If your intense interest happens to focus on fantasy subject matter, you could easily look as though you meet another.

Verdict, simple garden variety ASDs would often present indistinguishable to outside observation from what is described for this condition. The criteria as posited fail to distinguish simple ASDs from this multiplex thingie me bob. Perhaps the expanded description provides some means of distinguishing with a reliable degree of certainty, but I find it difficult to guess quite how.

Is there a reference/source for these particular criteria? The only place I can find them is Wiki.

The research literature includes studies on MCCD (which isn't in the DSM-IV) and lists the criteria; however, the ones I've read so far are very different to the criteria provided here.

This criteria can almost describe me because I think I'd meet enough of it to be diagnosed. I have had autistic symptoms along with a really intense fantasy life that has sometimes interferred with my ability to see reality. However, I was happier as a kid and didn't start developing some of the manic symptoms or paranoia until I was a teenager, after my experience of being bullied.

A. Regulation of emotion. (Affective symptoms) – two or more of the following.
1. Depressive symptoms such as consistent depressed mood, feelings of sadness or emptiness, thoughts of death, little interest or pleasure in activities, chronic fatigue, feelings of worthlessness or guilt. -kind of
2. Manic symptoms such as racing thoughts, irritability, distractibility, psychomotor agitation, impulsivity, sleep disturbances, feelings of grandiosity or extreme self worth, risky behavior. - very much
3. Anxious symptoms such as recurrent panic, intense inappropriate anxiety, dissociation, diffuse tension, paranoia, unusual fears and phobias that are peculiar in content or in intensity. - kind of
4. Severely impaired regulation of feelings with significant and wide emotional variability. -very much

B. Consistent impairments in social behavior and development (Autistic symptoms) - at least two from (A) and one from (B) or (C).
(A) Qualitative impairment in social interaction.
1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction -yes
2. Failure to develop peer relationships appropriate to developmental level -yes
3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people -kind of
4. Lack of social or emotional reciprocity -yes
(B) Qualitative impairments in communication.
1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime) -no
2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others -yes
3. Stereotyped and repetitive use of language or idiosyncratic language -kind of
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level -not much
(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities.
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus -very much
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals -yes
3. Stereotyped and repetitive motor mannerisms -somewhat
4. Persistent preoccupation with parts of objects -not really

C. Impaired cognitive processing (psychotic symptoms) – two or more of the following.
1. Delusions, including fantasies of personal omnipotence, thought insertion, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, referential ideation, and confusion between fantasy and real life. -yes
2. Hallucinations and/or unusual perceptual experiences. -yes, very much so if this includes dissociation
3. Negative symptoms (anhedonia, affective flattening, alogia, or avolition) -very much
4. Disorganized or catatonic behavior such as thought disorder symptoms, easy confusability, inappropriate emotions/facial expressions, uncontrollable laughter, etc. -somewhat
5. Disorganized speech. -somewhat

Im dx'ed with aspergers with co-morbid schizoaffective, adhd, and learning disorder. this dx would explain all those symptoms.

I don't understand this criteria. For when is it talking about? I don't think many 3 or 4 year olds have hallucinations and the like. If this happens later in life are you MCDD or must it be in childhood?