On the Garbage that is the DSM-V

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Asperger's syndrome

You see the problem? The replacement is too severe to work for a spectrum disorder. The first for aspergers involves one or two of the folloqing for A and one of the following for B. This allows for this to be allowed for a diagnosis:
A:
(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
(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)
B:
(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

And that's it!

However for the supposed replacement all of this is required for a diagnosis:
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,
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.
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

And 3 out of four of these:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
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).
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).
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).[/quote]



The conclusion is that the diagnostic system is far too harsh. It will exclude the mild. They call it an autism spectrum disorder but in the first two categories only one thing is optional. Autism Spectrum in this diagnosis is a misnomer, and anyone who says otherwise works against the fact that there is only one optional characteristic, all of which imply severe issues when taken together.

Even more terrifying is the idea that there will be no support provided until the problem becomes very great, meaning that thousands will suffer and their condition get worse and worse until they at last fit the criteria.

The DSM-IV asperger's syndrome takes account of mildness that occurs by having options that are more specific and tailored to the person.

The assumption is (backed by research) that people diagnosed with AS already fit the new criteria. Just because you only need a few symptoms in the DSM-IV doesn't mean that most people diagnosed with AS don't actually have more symptoms than that.

Hopefully, if this is not true (it's already not true for a lot of children diagnosed with PDD-NOS, but I don't know what impact that has had on anything), they'll alter the criteria so people will get diagnosed.

im not sure what you mean when you say it makes a aspergers dx harder,i thought aspergers no longer exists in the new system

Remember that the DSM V works a little differently from the DSM IV in that it has dimensional scale that the severity of a disorder from mild to severe, so maybe not all of the criteria have to be severe enough to be noticeable. The workgroup that is working on the criteria believe that people who would of been diagnosed with Asperger's will still fit the criteria but at the mild end of the scale.

It still exists in the DSM V. It's just folded under a broader diagnosis of Autism Spectrum Disorder, which also includes Kanner's autism and PDD-NOS.

i though aspergers and pdd nos where now called level 1 ASD

From the looks of it, it will make it more difficult for people who would normally be diagnosed with Asperger's Syndrome to get a diagnosis and receive assistance. This is what I have been worried about.

And Verandi...think about what you just wrote. "Just because you only need a few symptoms in the DSM-IV doesn't mean that most people diagnosed with AS don't actually have more symptoms than that." Where does that leave the rest of us who DON'T? Frankly, I doubt that most people meet ALL of the criteria.

Exactly, it's an assumption that takes out the milder side. That's the whole purpose of my argument. And you don't know that most do.

The problem is not the criteria changes. They don't specifically exclude anyone who would currently qualify as Autistic.

The real problem is, has been, and will be probably for some time to come, the personal opinions of professionals making the actual diagnoses. There are already a large number of Autistics not being diagnosed. Proper training is a much bigger problem than the actual criteria. The whole purpose of simplifying the criteria is to help with simplifying professional interpretation of them.

I questioned the proposed DSM-V criteria myself for a while, but I now believe we need to give it a chance. There really isn't much point in crying that the sky is falling when we haven't even been hit on the head with anything yet.

I really believe now this is all much ado about nothing.

one thing i have thought is make it a 4 step disorder to include some of the milder A.S PDD-NOS and non verbal leaning disabilities like hyperlexia or semantic pragmatic disorder

yet the fact is that changing the criteria to only have autistic is the problem. It is cutting out the mild people, as I ahve already shown, and to suppose otherwise.


Apples and oranges. You're going to cut out the mild because enough people aren't being diagnosed with what they should have. That's not only an unrelated issue, but it's counter-productive. Simplifying something for trained psychologists seem laughable. It's like cutting out the detail to help the lowest common denominator.
The fact is that the new diagnosis cuts out those who have some of the issues but not all.

Why is it that when someone doesn't actually have an actual argument they say that a rational complaint is crying? Really should anyone be so crass?
You say that no one can know what will occur no because it hasn't occured yet. Have you heard of the word prediction? Predictions can often be very good you know. And the fact is that you have failed to debunk the obvious fact that the stringent system will cut out the aspies.

Percipi est esse. Congratulations, a logical fallacy. And a cliched remark of style to sound credible too.

So unlike before, you can present a milder degree of disfunction than before and still be diagnosed? My traits are mostly in social, my behavioral traits are there but to a milder degree.

I think that the DSM V criteria are pretty good. They make sense to me. I think that the DSM IV criteria are garbage. They are very disordered, and the profile of autism does not come across from the criteria.

:/ Percipi est esse. Also the DSM IV criteria are not garbage. They are ordered, short and not obfuscatory like the DSM V criteria.

The fact that you say iut doesn't come across as autism shows you haven't read it, because it was for asperger's syndrome, and the differences were enough to merit their own log in the DSM. Now people seem to try and ignore the existence of mild cases in their counter arguments.

I am sorry but you already could in the DSM IV. That's what the asperger's diagnosis is for. Furthermore despite the use of such levels, it is a superficial thing. THe fact is that the new diagnostic examples are overcomplicated, very specific and obfuscatory. The new DSM V fails to allow for the fact that children may have some but not all of the issues, like the asperger's diagnosis did.

Last edited by Gedrene on 19 Nov 2011, 6:03 pm, edited 1 time in total.

just remember these revisions of the dsm going inti effect next where created to address faults in the previous system.and likewise the faults in the dsm 5 can be revised in 2013 too