Skip to main content
Top
Published in: Molecular Autism 1/2013

Open Access 01-12-2013 | Review

Autism in DSM-5: progress and challenges

Authors: Fred R Volkmar, Brian Reichow

Published in: Molecular Autism | Issue 1/2013

Login to get access

Abstract

Background

Since Kanner’s first description of autism there have been a number of changes in approaches to diagnosis with certain key continuities . Since the Fourth edition of the Diagnostic and Statistical Manual (DSM-IV) appeared in 1994 there has been an explosion in research publications. The advent of changes in DSM-5 presents some important moves forward as well as some potential challenges.

Methods

The various relevant studies are summarized.

Results

If research diagnostic instruments are available, many (but not all) cases with a DSM-IV diagnosis of autism continue to have this diagnosis. The overall efficiency of this system falls if only one source of information is available and, particularly, if the criteria are used outside the research context. The impact is probably greatest among the most cognitively able cases and those with less classic autism presentations.

Conclusions

Significant discontinuities in diagnostic practice raise significant problems for both research and clinical services. For DSM-5, the impact of these changes remains unclear.
Literature
1.
go back to reference Rutter M, Schopler E: Classification of pervasive developmental disorders: some concepts and practical considerations. Special issue: classification and diagnosis. J Autism Dev Disord. 1992, 22: 459-482. 10.1007/BF01046322.CrossRefPubMed Rutter M, Schopler E: Classification of pervasive developmental disorders: some concepts and practical considerations. Special issue: classification and diagnosis. J Autism Dev Disord. 1992, 22: 459-482. 10.1007/BF01046322.CrossRefPubMed
2.
go back to reference Rutter M: Research review: child psychiatric diagnosis and classification: concepts, findings, challenges and potential. J Child Psychol Psychiatry. 2011, 52: 647-660. 10.1111/j.1469-7610.2011.02367.x.CrossRefPubMed Rutter M: Research review: child psychiatric diagnosis and classification: concepts, findings, challenges and potential. J Child Psychol Psychiatry. 2011, 52: 647-660. 10.1111/j.1469-7610.2011.02367.x.CrossRefPubMed
3.
go back to reference Volkmar FR, Klin A: Issues in the classification of autism and related conditions. Handbook of Autism and Pervasive Developmental Disorders. Edited by: Volkmar FR. 2005, Hoboken, NJ: Wiley, 5-41. Volkmar FR, Klin A: Issues in the classification of autism and related conditions. Handbook of Autism and Pervasive Developmental Disorders. Edited by: Volkmar FR. 2005, Hoboken, NJ: Wiley, 5-41.
4.
go back to reference Kanner L: Autistic disturbances of affective contact. Nervous Child. 1943, 2: 217-250. Kanner L: Autistic disturbances of affective contact. Nervous Child. 1943, 2: 217-250.
5.
go back to reference Cohen DJ, Young JG: Neurochemistry and child psychiatry. J Am Acad Child Psychiatry. 1977, 16: 353-411. 10.1016/S0002-7138(09)61596-X.CrossRefPubMed Cohen DJ, Young JG: Neurochemistry and child psychiatry. J Am Acad Child Psychiatry. 1977, 16: 353-411. 10.1016/S0002-7138(09)61596-X.CrossRefPubMed
6.
go back to reference Folstein S, Rutter M: Genetic influences and infantile autism. Nature. 1977, 265: 726-728. 10.1038/265726a0.CrossRefPubMed Folstein S, Rutter M: Genetic influences and infantile autism. Nature. 1977, 265: 726-728. 10.1038/265726a0.CrossRefPubMed
7.
go back to reference Volkmar FR, Klin A, Siegel B, Szatmari P, Lord C, Campbell M, Freeman BJ, Cicchetti DV, Rutter M, Kline W: Field trial for autistic disorder in DSM-IV. Am J Psychiatry. 1994, 151: 1361-1367.CrossRefPubMed Volkmar FR, Klin A, Siegel B, Szatmari P, Lord C, Campbell M, Freeman BJ, Cicchetti DV, Rutter M, Kline W: Field trial for autistic disorder in DSM-IV. Am J Psychiatry. 1994, 151: 1361-1367.CrossRefPubMed
8.
go back to reference Sharma S, Woolfson LM, Hunter SC: Confusion and inconsistency in diagnosis of Asperger syndrome: a review of studies from 1981 to 2010. Autism. 2012, 16: 465-486. 10.1177/1362361311411935.CrossRefPubMed Sharma S, Woolfson LM, Hunter SC: Confusion and inconsistency in diagnosis of Asperger syndrome: a review of studies from 1981 to 2010. Autism. 2012, 16: 465-486. 10.1177/1362361311411935.CrossRefPubMed
9.
go back to reference Rutter M: Debate and argument: there are connections between brain and mind and it is important that Rett syndrome be classified somewhere [comment]. J Child Psychol Psychiatry. 1994, 35: 379-381. 10.1111/j.1469-7610.1994.tb01170.x.CrossRefPubMed Rutter M: Debate and argument: there are connections between brain and mind and it is important that Rett syndrome be classified somewhere [comment]. J Child Psychol Psychiatry. 1994, 35: 379-381. 10.1111/j.1469-7610.1994.tb01170.x.CrossRefPubMed
10.
go back to reference Regier DA, Narrow WE, Kuhl EA, Kupfer DJ: The Conceptual Evolution of DSM-5. 2010, Arlington, VA: American Psychiatric Publishing Regier DA, Narrow WE, Kuhl EA, Kupfer DJ: The Conceptual Evolution of DSM-5. 2010, Arlington, VA: American Psychiatric Publishing
11.
go back to reference Ritvo ER: Postponing the proposed changes in DSM 5 for autistic spectrum disorder until new scientific evidence adequately supports them. J Autism Dev Disord. 2012, 42: 2021-2022. 10.1007/s10803-012-1613-x.CrossRefPubMed Ritvo ER: Postponing the proposed changes in DSM 5 for autistic spectrum disorder until new scientific evidence adequately supports them. J Autism Dev Disord. 2012, 42: 2021-2022. 10.1007/s10803-012-1613-x.CrossRefPubMed
12.
go back to reference Singer E: Diagnosis: redefining autism. Nature. S12-S13. 10.1038/491S12a. Singer E: Diagnosis: redefining autism. Nature. S12-S13. 10.1038/491S12a.
13.
go back to reference Lord C, Jones RM: Annual research review: re-thinking the classification of autism spectrum disorders. J Child Psychol Psychiatry. 2012, 53: 490-509. 10.1111/j.1469-7610.2012.02547.x.PubMedCentralCrossRefPubMed Lord C, Jones RM: Annual research review: re-thinking the classification of autism spectrum disorders. J Child Psychol Psychiatry. 2012, 53: 490-509. 10.1111/j.1469-7610.2012.02547.x.PubMedCentralCrossRefPubMed
14.
go back to reference Norris M, Lecavalier L, Edwards MC: The structure of autism symptoms as measured by the autism diagnostic observation schedule. J Autism Dev Disord. 2012, 42: 1075-1086. 10.1007/s10803-011-1348-0.CrossRefPubMed Norris M, Lecavalier L, Edwards MC: The structure of autism symptoms as measured by the autism diagnostic observation schedule. J Autism Dev Disord. 2012, 42: 1075-1086. 10.1007/s10803-011-1348-0.CrossRefPubMed
15.
go back to reference Rutter M: Diagnosis and definition of childhood autism. J Autism Childhood Schizophr. 1978, 8: 139-161. 10.1007/BF01537863.CrossRef Rutter M: Diagnosis and definition of childhood autism. J Autism Childhood Schizophr. 1978, 8: 139-161. 10.1007/BF01537863.CrossRef
16.
go back to reference First M, Frances A, Pincus HA: Guidebook DSM-IV-TR. 2004, Washington, DC: American Psychiatric Association First M, Frances A, Pincus HA: Guidebook DSM-IV-TR. 2004, Washington, DC: American Psychiatric Association
17.
go back to reference Huerta M, Bishop SL, Duncan A, Hus V, Lord C: Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. Am J Psychiatry. 2012, 169: 1056-1064. 10.1176/appi.ajp.2012.12020276.CrossRefPubMed Huerta M, Bishop SL, Duncan A, Hus V, Lord C: Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. Am J Psychiatry. 2012, 169: 1056-1064. 10.1176/appi.ajp.2012.12020276.CrossRefPubMed
18.
go back to reference Regier DA, Narrow WE, Clarke DE, Kraemer HC, Kuramoto SJ, Kuhl EA, Kupfer DJ: DSM-5 field trials in the United States and Canada. Part II: test–retest reliability of selected categorical diagnoses. Am J Psychiatry. 2013, 170 (1): 59-70. 10.1176/appi.ajp.2012.12070999.CrossRefPubMed Regier DA, Narrow WE, Clarke DE, Kraemer HC, Kuramoto SJ, Kuhl EA, Kupfer DJ: DSM-5 field trials in the United States and Canada. Part II: test–retest reliability of selected categorical diagnoses. Am J Psychiatry. 2013, 170 (1): 59-70. 10.1176/appi.ajp.2012.12070999.CrossRefPubMed
19.
go back to reference Frances A: Better safe than sorry. Aust N Z J Psychiatry. 2012, 46: 695-696. 10.1177/0004867412453775.CrossRefPubMed Frances A: Better safe than sorry. Aust N Z J Psychiatry. 2012, 46: 695-696. 10.1177/0004867412453775.CrossRefPubMed
20.
go back to reference Jones KD: A critique of the DSM-5 field trials. J Nerv Ment Dis. 2012, 200: 517-519. 10.1097/NMD.0b013e318257c699.CrossRefPubMed Jones KD: A critique of the DSM-5 field trials. J Nerv Ment Dis. 2012, 200: 517-519. 10.1097/NMD.0b013e318257c699.CrossRefPubMed
21.
go back to reference Frazier TW, Youngstrom EA, Speer L, Embacher R, Law P, Constantino J, Findling RL, Hardan AY, Eng C: Validation of proposed DSM-5 criteria for autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2012, 51: 28-40. 10.1016/j.jaac.2011.09.021.PubMedCentralCrossRefPubMed Frazier TW, Youngstrom EA, Speer L, Embacher R, Law P, Constantino J, Findling RL, Hardan AY, Eng C: Validation of proposed DSM-5 criteria for autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2012, 51: 28-40. 10.1016/j.jaac.2011.09.021.PubMedCentralCrossRefPubMed
22.
go back to reference Mattila M-L, Kielinen M, Linna SL, Jussila K, Ebeling H, Bloigu R, Joseph RM, Moilanen I: Autism spectrum disorders according to DSM-IV-TR and comparison with DSM-5 draft criteria: an epidemiological study. J Am Acad Child Adolesc Psychiatry. 2011, 50: 583-592. 10.1016/j.jaac.2011.04.001. e11CrossRefPubMed Mattila M-L, Kielinen M, Linna SL, Jussila K, Ebeling H, Bloigu R, Joseph RM, Moilanen I: Autism spectrum disorders according to DSM-IV-TR and comparison with DSM-5 draft criteria: an epidemiological study. J Am Acad Child Adolesc Psychiatry. 2011, 50: 583-592. 10.1016/j.jaac.2011.04.001. e11CrossRefPubMed
23.
go back to reference Worley JA, Matson JL: Comparing symptoms of autism spectrum disorders using the current DSM-IV-TR diagnostic criteria and the proposed DSM-V diagnostic criteria. Res Autism Spectr Disord. 2012, 6 (2): 965-970. 10.1016/j.rasd.2011.12.012.CrossRef Worley JA, Matson JL: Comparing symptoms of autism spectrum disorders using the current DSM-IV-TR diagnostic criteria and the proposed DSM-V diagnostic criteria. Res Autism Spectr Disord. 2012, 6 (2): 965-970. 10.1016/j.rasd.2011.12.012.CrossRef
24.
go back to reference McPartland JC, Reichow B, Volkmar FR: Sensitivity and specificity of proposed DSM-5 diagnostic criteria for autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2012, 51: 368-383. 10.1016/j.jaac.2012.01.007.PubMedCentralCrossRefPubMed McPartland JC, Reichow B, Volkmar FR: Sensitivity and specificity of proposed DSM-5 diagnostic criteria for autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2012, 51: 368-383. 10.1016/j.jaac.2012.01.007.PubMedCentralCrossRefPubMed
25.
go back to reference Matson JL, Hattier MA, Williams LW: How does relaxing the algorithm for autism affect DSM-V prevalence rates?. J Autism Dev Disord. 2012, 42: 1549-1556. 10.1007/s10803-012-1582-0.CrossRefPubMed Matson JL, Hattier MA, Williams LW: How does relaxing the algorithm for autism affect DSM-V prevalence rates?. J Autism Dev Disord. 2012, 42: 1549-1556. 10.1007/s10803-012-1582-0.CrossRefPubMed
26.
go back to reference Gibbs V, Aldridge F, Chandler F, Witzlsperger E, Smith K: An exploratory study comparing diagnostic outcomes for autism spectrum disorders under DSM-IV-TR with the proposed DSM-5 revision. J Autism Dev Disord. 2012, 42: 1750-1756. 10.1007/s10803-012-1560-6.CrossRefPubMed Gibbs V, Aldridge F, Chandler F, Witzlsperger E, Smith K: An exploratory study comparing diagnostic outcomes for autism spectrum disorders under DSM-IV-TR with the proposed DSM-5 revision. J Autism Dev Disord. 2012, 42: 1750-1756. 10.1007/s10803-012-1560-6.CrossRefPubMed
27.
go back to reference Taheri A, Perry A: Exploring the proposed DSM-5 criteria in a clinical sample. J Autism Dev Disord. 2012, 42: 1810-1817. 10.1007/s10803-012-1599-4.CrossRefPubMed Taheri A, Perry A: Exploring the proposed DSM-5 criteria in a clinical sample. J Autism Dev Disord. 2012, 42: 1810-1817. 10.1007/s10803-012-1599-4.CrossRefPubMed
28.
go back to reference Wilson CE, Gillan N, Spain D, Robertson D, Roberts G, Murphy CM, Maltezos S, Zinkstok J, Hohnston K, Dardani C, Ohlsen C, Deeley PQ, Craig M, Mendez MA, Happe F, Murphy DGM: Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an adult autism spectrum disorder diagnostic clinic. J Autism Dev Disord. 2013, Epub ahead of print Wilson CE, Gillan N, Spain D, Robertson D, Roberts G, Murphy CM, Maltezos S, Zinkstok J, Hohnston K, Dardani C, Ohlsen C, Deeley PQ, Craig M, Mendez MA, Happe F, Murphy DGM: Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an adult autism spectrum disorder diagnostic clinic. J Autism Dev Disord. 2013, Epub ahead of print
29.
go back to reference Mazefsky CA, McPartland JC, Gastgeb HZ, Minshew NJ: Brief Report: Comparability of DSM-IV and DSM-5 ASD Research Samples. J Autism Dev Disord. 2012, 43 (5): 1236-1242.CrossRef Mazefsky CA, McPartland JC, Gastgeb HZ, Minshew NJ: Brief Report: Comparability of DSM-IV and DSM-5 ASD Research Samples. J Autism Dev Disord. 2012, 43 (5): 1236-1242.CrossRef
30.
go back to reference Tsai LY: Sensitivity and specificity: DSM-IV versus DSM-5 criteria for autism spectrum disorder. Am J Psychiatry. 2012, 169: 1009-1011. 10.1176/appi.ajp.2012.12070922.CrossRefPubMed Tsai LY: Sensitivity and specificity: DSM-IV versus DSM-5 criteria for autism spectrum disorder. Am J Psychiatry. 2012, 169: 1009-1011. 10.1176/appi.ajp.2012.12070922.CrossRefPubMed
31.
go back to reference Barton MD, Robins D, Jashar D, Brennan L, Fein D: Sensitivity and specificity of proposed DSM-5 criteria for autism spectrum disorder in toddlers. J Autism Dev Disord. 2013, 43 (5): 1184-1195. 10.1007/s10803-013-1817-8.PubMedCentralCrossRefPubMed Barton MD, Robins D, Jashar D, Brennan L, Fein D: Sensitivity and specificity of proposed DSM-5 criteria for autism spectrum disorder in toddlers. J Autism Dev Disord. 2013, 43 (5): 1184-1195. 10.1007/s10803-013-1817-8.PubMedCentralCrossRefPubMed
Metadata
Title
Autism in DSM-5: progress and challenges
Authors
Fred R Volkmar
Brian Reichow
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Molecular Autism / Issue 1/2013
Electronic ISSN: 2040-2392
DOI
https://doi.org/10.1186/2040-2392-4-13

Other articles of this Issue 1/2013

Molecular Autism 1/2013 Go to the issue