DSM vs. Gillberg

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DSM criteria for AS (probably everibody already read that, but...):

I'm diagnosed by use of the ICD-10 which I think is best so I'm not that biased.

I do however am to that much of a fan of Gillberg's criteria seeing how they demand motor coordination problems which not every autistic person will meet. They also allow the speech delay and demand routines which means that many people who have plain classical autism are classified as having AS instead and that those without significant abnormal routines but a strong special interest that's said to be typical for AS cannot be diagnosed with AS.

Gillberg's criteria widen the spectrum of AS dramatically so that it would include people who would otherwise be easily diagnosed with classical autism or PDD-NOS. I don't see how this helps the understanding of ASDs.

They use Gillberg's at Attwood's for AS, just FYI and all. That was the first time I've ever heard of said criteria.

For the most part, it is close to the DSM-IV-TR if you include the expanded text, i.e., criterions B 3 and 4 from the DSM are rarely seen in AS. A problem arises with criterions D and E, as many people with AS seem to have problems with speech and self-help skills compared to their peers.

None of them seem to focus on any of the ABILITIES or STRENGTHS autistic people have

The gillberg criteria seems less rigid. Perhaps more people would fit the criteria of gillberg than the DSM. I am diagnosed with PDD-NOS because I do not fit the restricted interests part of the DSM criteria. Everyone is different, and I don't believe that just because someone deviates slightly from the DSM criteria it means they shouldn't be diagnosed with Asperger's.

A lot of people on this board would agree with me, there seems to be a large number of people who are confused about whether or not they have Aspeger's, because they deviate slightly from the profile.

positive criteria:

Unusually blunt yet remaining honest and trustworthy
above average intelligence with most in the superior or gifted range
intense concentration in one particular area of interest
independence of mind
insatiable curiousity
ability to store large amounts of factual information

most notable: deviates from social group settings
and enjoys self-guided pursuits to an extreme degree


How that's for criteria?

I did not read the DSM criteria closely enough, for some reason I had the preconceived notion that you had to fit most of the criteria described in the DSM, I didn't see it was 2 for A and 1 for B.

As far as the Gillberg criteria allowing for those with mental retardation: normal people are on a range of mentally ret*d to normal to above normal in intelligence. A person can have MR without any actual brain damage or a specific condition, it is just a normal occurrence determined by their genes. So I don't see why a person with Asperger's couldn't fall into the mentally ret*d range of intelligence in some cases.

A non-autistic mentally ret*d person develops social skills according to their level of cognitive development, aspie's do not.

Why couldn't an Aspie have MR, be normal, or be above normal just like anyone else?

Also, I do not see why a person with Asperger's could not develop schizophrenia. The DSM rule about schizophrenia seems more a tool to differentiate between those who have social problems due to schizophrenia. Presumably a person could have Asperger's and still go on to develop schizophrenia at around age 20 when most schizophrenics have their first break with reality.

I sort of like the Gillberg criteria. They seem to fit me and my daughter very well. We also seem to "fit" the DSM-V-TR criteria, as well. I sort of am a fan of considering both scales, to a degree. I think that a wise therapist probably knows that you can't really "pigeon hole" a diagnosis. These criteria would probably be best utilized as a representation of the "average" characteristics of someone with AS. However, I realize that there have to be cut points for everything.

I guess I will leave this up to the academics in the field to decide, however. I am "self diagnosed" and think that having a professional diagnosis would be a good idea because I don't think that it is wise to diagnose yourself and then claim to BE someone with Asperger's. I think that it is definately a plus to have a formal diagnosis. However, to be fair, I realize that it is often difficult for an adult to find someone to evaluate them or someone who will listen to their rationale for feeling that they may have AS. I am in the group that is having a hard time finding someone to evaluate me. My therapist was more than happy to refer me and so was my family doctor.... there is just a serious "lack" of people to be refered to in the first place.....

Sorry to stray from the topic......

I have seen some research that suggest those with Pervasive Developmental Disorders are more likely to develop psychosis.

http://www.ncbi.nlm.nih.gov/pubmed/15985922

Here is the abstract on an article published in the Journal of Psychiatric Practice. It suggests that those with PDD are more likely to exhibit schizophrenia-like psychosis. Whether or not this can also be applied to Asperger's Syndrome is yet to be understood.

There are a number of references noting the similarity between the negative symptoms of schizophrenia and AS/autism, which often results in misdiagnosis. This is generally recognised.

For example,

Ramsey, J. M., Andresen, N. C. & Rapoport J. L. (1986) Thought, language, communication and affective flattening in autistic adults. Archives of General Psychiatry, 43, 741–777

Fitzgerald, M., & Corvin, A., Advances in Psychiatric Treatment(2001), vol. 7, pp. 310–318

There have even been studies based on this similarity, e.g.,

Rausch J. L. et al., Open-label risperidone for Asperger's disorder : Negative symptom spectrum response, The Journal of clinical psychiatry (2005), vol. 66, no12, pp. 1592-1597