New guidelines under consideration for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) would place the mental disorder Asperger’s syndrome into a more general diagnosis of autism spectrum disorders, the American Psychiatric Association recently announced. This was just one of many controversial revisions suggested for the Bible of the psychiatric profession, due to be published in 2013.
The DSM is the definitive reference used by psychologists for the diagnosis of mental disorders. The manual also provides the basis for utilization review and reimbursement policies by insurance companies, as well as guidance for pharmaceutical companies looking for opportunities in the development of new psychiatric drugs.
The DSM-5 draft was ten years in the making,and committee members involved in its creation agreed to limit their income from pharmaceutical committee sources to $10,000 a year to rule out the possibility of undue influence.
Asperger’s Syndrome: High Functioning Autistic Spectrum Disorder?
It’s estimated that two out of every 10,000 children born in the United States has Asperger’s, and the proposed revisions in the diagnostic criteria took many in the Asperger’s community by surprise. Some advocates voice concerns that since a diagnosis of autism is far more stigmatizing than Asperger’s, the proposed changes may mean that fewer patients on the high functioning end of the autism scale will seek out diagnosis or treatment.
“We need to be compassionate and sensitive about this,” Geraldine Dawson, chief science officer at Autism Speaks, told the Los Angeles Times. “For some, the change will be very disruptive and distressing. They participate in support groups that identify with a particular label.”
Asperger’s Syndrome first found its way into the fourth edition of the DSM in 1994. Its diagnostic criteria included both the difficulties with social interactions as well as the restricted and repetitive patterns of behavior and interests present in classical autism diagnoses – but did not couple these symptoms with any delay in linguistic and cognitive development. Scientists working on the current DSM revision maintain, however, that there is no scientific evidence to distinguish Asperger’s syndrome from high functioning autism, arguing instead that the former is merely a relatively mild manifestation of the latter.
The new diagnostic criteria for autism spectrum disorders focus solely on social interaction and communication, and the presence of “fixated” i.e. repetitive interests and behaviors.
Biological Markers, Addiction Disorders, Binge Eating
Other controversial changes have been suggested for DSM-5. Among the most ground breaking would be the inclusion, for the very first time, of biological markers in psychiatric diagnosis – specifically brain scan signatures for the diagnosis of Alzheimer’s disease. Other DSM-5 changes proposed include pulling “substance abuse” and “substance dependence” into a single category, to be named “addiction and related disorders;” introducing new classifications for learning and personality disorders; and making compulsive gambling and binge eating new diagnoses.
National Eating Disorders Association chief executive Lynn Grefe is all in favor of the changes. “About 15 million people have binge-eating disorder. Hopefully, (this) would help them get the help that they need.”
You can offer your own opinions of the revised DSM-5. A draft of the document is available for public comment online at www.dsm5.org between now and April 20.
Helping Psychology is brought to you by Argosy University. Argosy University offers a wide selection of bachelor’s, master’s, and doctoral degree programs in a variety of psychology concentrations at 19 locations across the nation.
