The DSM-V: Redefining the Autistic Spectrum

The following article was inspired by my posts, “Under New 2013 DSM-V, ‘Asperger’s’ Diagnosis to be Folded into ‘Autism Spectrum Disorder’,” “Estimates Indicate Redefinition of Autism Within Fifth Edition of DSM Manual Will Significantly Affect Diagnosis Numbers,” as well as the beginning portion of my post, “Debating About Changes to Autistic Spectrum Diagnoses in the New DSM-V“…

DSM-V

DSM-V

The official release of the new Diagnostic and Statistical Manual of Mental Disorders (DSM) V, due out in 2013, is quickly coming upon us! And, unsurprisingly, it’s more POLITICS than anything else!

Out: “Asperger’s Syndrome,” “PDD-NOS,” & “Autistic Disorder”
In: “Autistic Spectrum Disorder”

To begin, the Autistic Spectrum does not belong in the DSM, in the first place. No matter which end of the spectrum discuss, we are talking about a neurological syndrome, not a mental disorder! The very presence of the new definition within the DSM, much like the old ones it now covers, still implies the ridiculous notion that a “cure” is the always-desired route for a hard-wired neurological condition! Some may recall that I discussed this same point with regards to the DSM-V and Asperger’s syndrome in my November 2009  article, “Asperger’s Syndrome to Be Phased Out of DSM-V and Folded Into ‘Autism Spectrum Disorder’.” There is currently very little respect for the Neurodiversity movement within the higher ranks of the American Psychiatric Association!

Secondly, few in the media are discussing the impact that fully dropping the terms “Asperger’s syndrome” and “PDD-NOS” from medical jargon will have on the Autistic community. Many Autistic individuals strongly identify with the terms, and much of Autistic culture is based around them, so many will fight hard to keep them alive. Most, including myself, will continue to use the word “Asperger” regularly, regardless of the decisions of the American Psychiatric Society. The change in terminology will be unnecessarily polarizing in many ways.

Many strongly identify with the aforementioned phrases, personally, and among their peers, so they will not want see them go. Much of Autistic cuture is based around them, and large numbers will fight hard to keep them alive. Even more will battle against the next logical step for a DSM-IV-armed neurotypical society: ever-increasing popular usage of the degrading, inappropriate and inaccurate eugenicist phrases, “high-functioning” and “low-functioning” to distinguish Autistic individuals from each other. This will, of course, result in a large backlash from the Autistic community.

As far as symptoms go, the DSM-V’s new “Autistic Spectrum Disorder” combines most features of the DSM-IV’s “Autistic Disorder” and “Asperger’s Syndrome”. However, there is also the addition of a new and ominous criteria (D), requiring that “symptoms together limit and impair everyday functioning.” Such a factor will most assuredly reduce diagnostic rates for those on the spectrum, while an actual diagnosis will be difficult for any of those individuals who are able to successfully manage their Autistic symptom within our neurotypical society – no matter how difficult their daily struggle! Like I said: POLITICS! And, as is often the case, the Autistic community is caught right in the middle! The changes seem more about denial of available public services than anything else…

Here are the actual proposed DSM-V changes:
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=94#

Compare the changes to the various DSM-IV Autistic Spectrum definitions:
http://www.cdc.gov/ncbddd/autism/hcp-dsm.html

To the dismay of many, according to three separate research estimates based on the proposals of the new DSM-V, up to 75% of those previously diagnosed as having Asperger’s syndrome will no longer qualify as being on the Autistic Spectrum, as well as up to 85% of those with PDD-NOS:

Redefining Autism:
http://www.nytimes.com/interactive/2012/01/20/us/redefining-autism.html?ref=research

On a final note, rest assured that a great portion of the Autistic community will battle what appears to be the next logical step for a DSM-V-armed neurotypical society: ever-increasing popular usage of , “high-functioning” and “low-functioning” to distinguish Autistic individuals from each other. This will result in a large backlash from the Autistic community. How about acceptance of Neurodiversity, and equal opportunity in society?

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(All original portions of this work, by Rayn Kleipe, are licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, while all redistributed links, images, sounds, videos, and writings are protected under 17 U.S.C. § 107: Fair Use, or under Public Domain)

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