No more Aspergers in the DSM V

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Sure, but that's a pretty tall order.

I will be upfront and ask those people who think it's a good idea, why they want people like me off the spectrum. I will not reach the criteria for autism, and instead of the relief to have a quite guilt free diagnosis I will have to go back to being labeled schizoid, lazy and oppositional. I lived that life before, and it is quite horrid when you have a lot of pressure to deal with everything an NT should and when you can't it is seen as you don't want to, you want to be LAZY AND BAD. Like.. how will that help me?

Why will you not satisfy the criteria for ASD? I ask because I don't know anything about your situation.

If you look at the proposed revision and compare it to the DSM IV criteria, the new proposed criteria are much more restrictive. Rather than including more of the spectrum, they seem to include far less. There is however, a section on Severity that is still not filled in. And the proposed revision is in no way finalized yet.
http://www.dsm5.org/ProposedRevisions/P ... px?rid=94#

If autism were to be diagnosed according to the proposed criteria, I would not fit within its parameters.

I think it's still a little early and we don't know how this - if it even comes into effect as laid out currently - will be interpreted in the field. I know for example that the doctor who diagnosed me doesn't follow the DSM to the letter and uses all the circumstances and experiences surrounding each persons case to make a decision.

Incidentally what are your symptoms, Bee? Like to know how you stack up against me.

I believe the industry is doing a better job understanding the difference between a Personality Disorder and Autism, not that there can't be co-morbids, but there is in fact a big difference between the two. I think this is where a lot of confusion lies.

I don't understand how anyone diagnosed as autistic couldn't fit the new criteria. It's extremely basic. You don't have autism because you are odd, you have autism because you're impaired in social communication and have restricted behaviour and interests starting in childhood. And that's basically what it calls for.

I don't know your personal situation, but I don't see how people would suddenly lose their diagnosis just because of this. Besides, this criteria is FAR better than the current aspergers criteria (which assumes that we have no language delay and that we have age appropriate self care skills). I'm glad that you are aware that the new criteria still has yet to be completed.





Why is that? Why should we aspies hide behind our loveably nerdy image (btw, tokenism isn't helpful against stigma either) while those diagnosed with autistic disorder get treated like they are not even sentient because of a stigmatised label? Yes, changing opinions is hard but it's hard for every minority group to get people to treat them with dignity and respect. I don't fear the autism label - in fact, I embrace it. I think if we embraced it more often then there would be less stigma attatched to it because them people will recognise that every autistic person is an individual and not some stereotype.

In response to frag



I would hope that people would still help you with your problems. Also, I'm sure that you would still have your diagnosis because, let's face it, what is the difference between AS and HFA? None that I can tell. Technically speaking, I should be labeled HFA ( I was first diagnosed with autistic disorder) but I got the label of AS because it was convenient and perceived as more appropriate (remember that HFA is not really a diagnostic category). However, after all the years, the most people think of me is that I'm a little eccentric and quirky. I fit the quirky, slightly nerdy stereotype of aspergers(but not quirky enough to win an Oscar, mind you). Nobody is going to call you bad or lazy just because you don't currently fit a description in a book. Those who diagnosed you know that you have those problems. Your loved ones will know that you have these problems (whether they accept it or not). If people do call you bad or lazy because a freaking book has a few technicalities that might possibly exclude you from a particular diagnosis, they are idiots and deserve to accidentally stand on dog poo.

With that being said, I'm confident that you diagnostician will still treat you for autism.




Yes, THANK YOU!! !! !

I must admit, I'm pondering this as well. I think that I'm fairly 'borderline', but at the same time, I will still fit the new criteria.

Example I





Example II





Note that my examples are hypothetical - it is very possible that, in real world, nobody has this combination of symptoms

This is the current definition of AS:
http://www.dsm5.org/ProposedRevisions/P ... px?rid=97#

The new criteria require that one meet all criteria instead of only several, and I fail on that count. (I am borderline even with the current definition of AS, but with the new proposal I just fall off the cliff).

My social difficulties are my most significant symptom and have caused me terrible problems, but I don't think they are very accurately described when one simply says "deficits in nonverbal and verbal communication". That makes it sound like you have to be obviously strange or inappropriate in how you communicate socially, rather than just being lost at understanding the social dance and being left out of being able to participate in it. I think my social deficits are better explained by the current more nuanced definition of AS. I also don't lack social reciprocity, which in the current proposal is required for a DX.

I also don't have "Stereotyped motor or verbal behaviors, or unusual sensory behaviors." Though I have some strong sensory issues, they don't manifest in obvious behaviors. "Excessive adherence to routines and ritualized patterns of behavior." Nope. "Restricted, fixated interests" Yes.

The AS definition can be met with just one of the above three: "encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus"

And so on...

I'm assuming the current proposal will become more fleshed out and perhaps all of these concerns will go away then.

It doesn't bother me that everything will be under ASD because it's less confusing that way. People won't feel like they fit one diagnosis at one time and another one later. We will all just be ASD all the time.

I can do that as well, but I think it would be more insightful to hear from someone who is currently diagnosed and who feels that the new definition would exclude them. Other whys - as you say - it's all very hypothetical.

I don't agree. I too would say I'm lost when it comes to the social dance, but I also think that, basically, this is due to deficits in 'nonverbal and verbal communication' - mostly non-verbal in my case.


I could be wrong but my take on 'sensory behaviours', is that they're referring to sensory hyper sensitivities and you have already said you have these. In my case again, I always (repetitively) react to certain sounds and smells in the same way - they make me extremely nervous, angry, stressed or a combination of them all. This wouldn't be obvious to an outsider unless I was really stressed anyway, but it would be picked up in an assessment.

Based on what you've said, sound fairly similar to me. I do have a love of routine and I hate it when it's changed, it was much more serious when I was younger, now it's more of a case of it making me feel horrible on the inside. But even so, I don't think that I will have any issues with a future diagnosis and looking at what you have written, neither should you.

DSM IV - Asperger’s Disorder Y

A. Qualitative impairment in social interaction, as manifested by at least two of the following:

(1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction Y

(2) failure to develop peer relationships appropriate to developmental level N

(3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) Y

(4) lack of social or emotional reciprocity N

B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

(1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus Y

(2) apparently inflexible adherence to specific, nonfunctional routines or rituals Y?

(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) N

(4) persistent preoccupation with parts of objects N

C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.

D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).

E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood. Y

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia. Y

DSM V - Autism Spectrum Disorder N

Must meet criteria 1, 2, and 3:

1. Clinically significant, persistent deficits in social communication and interactions, as manifest by all of the following:

a. Marked deficits in nonverbal and verbal communication used for social interaction: Y?

b. Lack of social reciprocity; N

c. Failure to develop and maintain peer relationships appropriate to developmental level N

2. Restricted, repetitive patterns of behavior, interests, and activities, as manifested by at least TWO of the following:

a. Stereotyped motor or verbal behaviors, or unusual sensory behaviors N?

b. Excessive adherence to routines and ritualized patterns of behavior N?

c. Restricted, fixated interests Y

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

I suppose it may just be a matter of semantics. The definitions in the new proposal just seem less likely to ring true when trying to describe someone like myself. If I didn't already know about AS -- knowing allows me to understand what is meant by the terminology -- and a clinician asked me questions in those terms, I would probably reply no to many of them. (I understand that a doctor is supposed to do more than just ask the patient if they meet the criteria, but often that's what it boils down to. That's what the written assessment tests do after all -- essentially ask the patient to assess themselves -- and when I was diagnosed I was asked to fill out a bunch of them.)

I don't expect the changes will affect me personally, since I have no reason to go back for another diagnosis, and I don't receive services, but it could be a factor for undiagnosed people in the future, perhaps.