Confused by what exactly is meant by DSMIV criteria

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Can you explain exactly how you meet the criteria? I'm not so sure my definitions/examples of the criteria are the same as the DSMIV's. I "fail to develop peer relationships appropriate to developmental level", "lack of social or emotional reciprocity", and "encompass a preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus" but have previously self diagnosed myself as having schizoid personality disorder or social anxiety disorder because the "symptoms" overlap.


(I) Qualitative impairment in social interaction, as manifested by at least two of the following:

(A) 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
(B) failure to develop peer relationships appropriate to developmental level
(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
(D) lack of social or emotional reciprocity

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objects

Remember that you don't have to meet all these criteria to have an ASD. And some criteria won't apply to you for the full 100%, but maybe only to an extent. Furthermore, other factors in your mind and your personality, as well as the progress you make throughout your life, may affect how the 'symptoms' listed will manifest themselves, and sometimes they're cancelled out.
But I guess only the experts, the psychiatrists, will be able to paint a picture of it, and even then it's an educated interpretation of things. An approximation, if you will, since no two minds are the same. But an official diagnosis tends to be a good indication.


Now, as for me:

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
I had this strongly as a child. Wouldn't look someone in the eye, couldn't grasp gestures and body language. I was either too rigid in my movement, or too 'fluttery', stims such as arm flapping, rubbing my knees, rocking back and forth.
failure to develop peer relationships appropriate to developmental level
'Failure' shouldn't necessarily be taken in its most negative sense here. I had some friendships with my peers as a child, although making friends was not something that came natural to me. Now, as a young adult, I have very few friends, and still find it difficult to approach strangers and start up deeper relationships.
a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
Yes, this does apply. More to the point, when I was a child, I found it difficult to share. I wouldn't share toys or food from my own accord.
lack of social or emotional reciprocity
Yes, especially earlier in life, I had trouble with the concept of reciprocative emotions such as thankfulness, shame, and guilt.

encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
Had this, and to an effect still do. The so-called special interests.
apparently inflexible adherence to specific, nonfunctional routines or rituals
Recognisable too. Need not elaborate.
stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
Had those, as mentioned above, but now they're all but gone.
persistent preoccupation with parts of objects
No, don't have that one.

So, to sum it up, there are certain symptoms that are present clearly, others that are not quite so pronounced, or even have faded with time and learning, and there is one symptom among the above that I never exhibited. The sum total of the criteria, (pluys the criteria you didn't mention in your post), will enable the headshrinkers to come up with an appropriate diagnosis (you hope).

OK, I'll bite... I'm PDD-NOS, halfway in between autism and Asperger's, so I'll use the autism list and explain that. They are very much similar.

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

I don't use eye contact because it's harder to listen when I look at the eyes. I tend to have a rather stiff posture, and don't use too many hand gestures. I also don't read much off other people's body language, and focus almost entirely on their words to understand them. However, if I tune out their words, I can get some information from their body language.
I didn't really engage in social relationships until sixth grade, when some other girls basically "adopted" me. I didn't actively seek out friendships until about age 19, when I made my first real friends. I still socialize only about once a week, in a structured situation involving shared interests, and have an easier time relating to professors than to fellow students.I do not have this symptom.
I don't automatically copy the emotions of people around me: I don't catch the enthusiasm of fans at a sports game or a play; I don't catch the sadness of others at a funeral. I don't seek out social contact very much, though this may just be because I am quite introverted. I prefer to be alone much of the time, and require solitude to "recharge" my energy.

Qualitative impairments in communication as manifested by at least one of the following:
I did not have this symptom; I developed speech sometime between age one and two, though much of it was scripted.
As a young child, I had the ability to answer questions in a scripted fashion; as I got older, I learned how to have a conversation. I still have major problems with conversational timing, and I interrupt constantly, without meaning to. Initiating a conversation was a problem until my pre-teen years, but is not a problem now.
I have this trait, but only mildly. I did use "pre-recorded" phrases as a young child--things I said the same way every time because it was easier than making up a new phrase every time--but they were used appropriately; I knew their meaning. I also tend to create neologisms ("new words"--making up my own words) on occasion, but not at such a high level that it's clinically significant. My language as a child was highly pedantic, sounding as though I were reading a book out loud. As I've grown older, I've taught myself colloquial speech, but I still have some odd expressions--for example, I may mistakenly use colloquialisms from British English, or ones that are outdated, or put a highly technical word into what should be a casual sentence.
If I ever had this trait, it wasn't very strong. I did get "stuck" on the same theme in my play for months at a time--there are dozens and dozens of childhood photos of me pretending to be a surgeon with my dolls--but it was imaginative play. Today I am quite imaginative, and like to play role-playing games.

Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
One of my strongest traits. I can get so obsessed with something that I spend all my waking hours on it. I don't have life-long obsessions; I go through obsessional phases. When I have an obsession, I become an expert on it, gather information about it. I tend to know more about it than people who have spent years studying it, because of the intensity of my obsession.
Hmph. Nonfunctional, my butt. Yeah, I do things the same way every time; but it's functional for me--I don't lose track of what I'm doing. If I didn't do things the same way every time, I'd never get anything done. Included here would be my problems with transitions--I have a very, very hard time switching from one activity to another, and coping with change. It took me a year to get used to a new apartment, for example; and I had a significant amount of stress due only to having to change my route to school every day.
Yes, I stim. Pretty constantly. I rock and stare at shiny things and flick my fingers and twitch various muscles; I tug at eyebrows and eyelashes, and can be utterly captivated by totally mundane things like the shiny sand grains in a sidewalk.
Detail-oriented--that's me. I see small things that most people don't see; I understand things by collecting tiny bits of information about them and then putting them together. I don't know what "good enough" is, because I can't see the big picture; so I go for perfection every time, and that makes me much more accurate but much slower than most other people. I tend to get either A's or F's at school.

Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.
I had delays/abnormal functioning in social interaction, and to a milder degree in language. Since my mom reports my being a "difficult baby"--i.e., difficult to calm when crying--even before the age of one, I fit the prior-to-3 criterion too.

The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.
Neither of which I have, and both of which are very rare anyway.

So there you have it... Technically I fit criteria for autistic disorder, barely; but I look so much like an Aspie, complete with verbal>performance IQ subscore gap, that PDD-NOS is probably the best diagnosis for me. In the past, I've been diagnosed with AS for the most part, and PDD-NOS and classic autism on occasion. I agree most with PDD-NOS, which puts me in the 60% majority of the autism spectrum--people who have autism, but who can't really be placed in a specific subtype.

I have not been diagnosed yet, but have been referred for further evaluation. I prefer to work with the new proposed criteria for Autism spectrum disorder the yet unpublished DSM-V, as I find its theoretical basis, well... sounder.

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction.

I am very bad with the "back and forth conversation" thing. I always monologue... In general, I am very bad at showing my emotions; however, I think I have a smaller range than most, so maybe it is not a question of just showing them.

2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.

I tend to have overexpressive body language, I think. Well, more like body movements simultaneous and coordinated to my speech... My mother always said I didn't make eye contact when I was little, but I never thought it was true. Maybe I just didn't understand what she meant. In any case, she has stopped, so either she got bored, or I learned it despite my lack of effort and understanding.

3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people

I don't have any close friend at the moment (physically close, at least; no one within 200 km). I rarely had more than one at any given time.

B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:

1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).

Maybe a little, but I do not know whether it is really pathological. I often "have fun with my language", and use expressions in my own way, but I don't think this is enough. Also, I do some things that might qualify as "motor stereotypies"/stimming, like rocking on my chair, play with my hands and a few others, but I don't know if this is "enough".

2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

I don't particular like change, but I don't believe it is pathological. I mean... my mother's colleague seem to like inertia too. I remember some situations when I reacted badly to changes, but I never understood them as reactions to "change". I don't know. Maybe.

I do have certain habbits. For example, I always sit at the same chair at supper, and will ask show unsatisfaction and irritation if someone takes it. But then, so does my grandmother's partner...

3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

I think so.

At the moment, my main interest is history. In conversaitons, I will often make comparisaons to history. I think this is justified, because the past holds many answers and inspirations for the present to consider. But then, maybe it isn't when people say they would like the government to build a new hockey stadium, and I answer it would be a great place to massacre political opponents, as a reference to Theodosius the Great and the Thessalonica massacre...

Now, I also see similarities with how I felt about hockey some time ago: watched every game, had very little to talk about but hockey, knew the statistics of most players on my favourite team. Idem with video games, though that has proven stable since elementary school. I have to actively stop myself from talking about it, because I was said my games interest no one.

(I had started a thread on that topic a while ago.)

4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

I hate sunlight, and excessive light in general. Heat, also. I don't like when some parts of my skin touch my skin, especially my thighs and around my groin. Some noises make me anxious, but the worse is the sound of a crowd talking. That completely overwhelms me.

I am hypo-sensitive to smell. I rarely notice strange smells. When other people can't stand a smell, I generally don't care, if I even notice it at all.

I like spinning things, too. I don't think this is pathological, in my case, however.

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

I have some data from my parents confirming some early signs around age 2-3. Although it varies a lot, I can reliably point to incidents and memories from the earliest I can recall.

D. Symptoms together limit and impair everyday functioning.

This is mostly to justify treatment, I would imagine, but my anxiety can be overwhelming. There have been problems with group work, too.

Last edited by enrico_dandolo on 05 Mar 2012, 8:33 pm, edited 2 times in total.

Why don't you write what symptoms you do have, related to the specific criteria? Then I can happily share my unprofessional opinion if you qualify or not.

Read the book.

It gives examples.

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:

(A) 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
I have to think about what facial expression to use in each conversation. Sometimes I feel as if I am smiling too much or too little, or appear to have a "fake" expression to show that I have at least some interest what the person has to say. I don't use hand gestures but when I try to it also seems "fake" like I don't know where to put my arms. I tend to completely stare or frequently look away from the other person's eyes when speaking. I've recently learned to look away and back every three seconds - regular eye glances don't seem natural to me.

(B) failure to develop peer relationships appropriate to developmental level
My friends from 7-8 years old were always 2 to three years younger than me. I could always relate to them and not the older kids. I felt as if I could relate to teacher and adults more because they weren't "wild". I had friends my age in fifth and sixth grade and then only acquaintances from then to the present. As people grew out the the "childish" activities like with playing with video and card games, and watching anime, I found it more difficult to make friends. I was only interested in talking about what I cared about (games and anime) and I could not relate to people who only cared about sex, and drugs.

(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
This doesn't apply to me - I point out things of interest

(D) lack of social or emotional reciprocity
If someone were to smile and wave to me in a friendly manner, I would not wave back. I am not "emotionally cold", it just doesn't come natural to me for strangers . I have been able to do it with practice though. Its easy to do it with acquaintances. I don't understand why mainstream society enjoys doing the things they do. Its as if I cannot empathize with the motivations of general American culture. I'm not into sports, bars, etc. I would much rather read a book that go to a party with or without anxiety. Sometimes I have to put on a "fake face" for five minute encounters just so I don't appear to be too rude. When people talk about banal topics like getting drunk, or the latest gossip, I have nothing to contribute to the conversation.

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
I am very obsessed with anime, manga, video games, and novels. I don't know if that counts - its not the same as being interested in "train schedules".

(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
I follow the same routine everyday and do not like change - eating the same food, traveling the same route, sitting in the same spot. If my routine changes I feel disoriented and slightly insecure.

(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
I have never done any of those actions
(D) persistent preoccupation with parts of objects
This doesn't apply either.

Assuming that this is something that were also present when you were a young child (might have improved though) I would say that you qualify for this criteria.



You do not say much about how it is for you now, but the things you do describe sounds very much like a textbook example of this criteria.


It might be that you interpret this criteria a bit too literal. Remember that the DSM-definition is mainly developed to diagnose children. The fact that you as an adult are capable of this novel example acts does not have to exclude you in my opinion. Questions that are more relevant is for example "If you won a prize for a performance, would one of your first reactions be to tell your friends/family?" Or "If you was told that you would get to go on your dream holiday for free would one of your first natural thoughts be who to bring?". These being reverted questions, meaning that a "yes" answer would be indications of "normal" behavior.



This one can be a puzzle to measure. I would not say that having interests outside those typical in American culture is something which would make you qualify for a criteria in the DSM, luckily. More relevant questions here, I think, is do you use significantly less time interacting socially compared to other people at your age in your surroundings? Do you have trouble with maintaining two-ways relationships (relationships in which both give and take emotionally and literary)?

You only need two of the criteria however and as I wrote I think you probably have two, possibly all four.



Now this is actually something which I have planned on writing a blog post about for some time now, so it is interesting that you bring it up. Again, the DSM criteria for Asperger's is developed mainly for children and this is where it really suffers from it when evaluating older individuals (as far as I'm concerned). It is my opinion (which some clinicians share, others do not) that the focus/topic of the interest is completely and utterly irrelevant. Yes, in children it might give you a clue that something unusual is going on when the child is resiting train schedules. - But something is not abnormal or pathological for that reason! When we look at adult people in universities all over the world they take doctor degrees in the weirdest most narrow of subjects and they are successful doing so. What we find interesting is subjective and has nothing to do in an evaluation. What is worth looking at is the intensity: Do you find that your interest is so strong that you find yourself not able to perform other tasks you know you should do? Do other people think you use abnormal amounts of time on that/those interests? Do you have problem maintaining a good sleep schedule because of that interest? etc.

In other words: With the information you provided here I do not know if you qualify or not, but regardless I think it is a bad criteria.



I again miss information about your childhood in relations to this. Also in adults it is my opinion that it can be hard to measure this, since we can choose to live structured lives and there for do not experience the potential stress with big changes in routines. So I would ask you this: Imagine that when you are on your normal routine, 2 weeks before your birthday, you get surprised by your closest family. They have booked a vacation to Bahamas and want to take you to the airport, the flight leaves in two hours. Assuming that you had to go on the trip, how would you feel?



Given that I am in doubt if you qualify for criteria 2 (which requires one of the last A, B, C, D ( In the DSM-IV-TR it is the other way arond: The main criteria is called B and the underlying 1,2,3 and 4. Do not know if they changed it in the text revision or you did when posting it, either way) ), and I feel there lack some information about your childhood I am at this point in doubt if I would set the diagnosis.

I study psychology and find this very interesting (as I am also diagnosed) and good "practice" so I love to help out, but please keep in mind that I am not a licensed professional. Also, please excuse any spelling errors.

Last edited by psychegots on 07 Mar 2012, 2:51 am, edited 2 times in total.

I don't really meet the criteria. The DSM isn't for working you out, it's for diagnosing you with treatable illnesses. Don't take it too seriously.