Comparing Symptoms of Autism Spectrum Disorders in a Developmentally Disabled Adult Population Using the Current DSM-IV-TR Diagnostic Criteria and the Proposed DSM-5 Diagnostic Criteria

Abstract

The American Psychiatric Association is making changes in the autism spectrum disorder (ASD) criteria for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In order to examine potential effects of the changing of the criteria, 330 adults with intellectual disability (ID) from two developmental centers were examined. However, due to the fact that the DSM-IV-TR/ICD-10 Checklist does not contain one of the restricted behavior items listed in the current proposed DSM-5 criteria, 41 participants were eliminated from the study. An additional 62 individuals were randomly removed from the study so that no one group was 1.5 times larger than any other group. This left a total of 227 individuals. These individuals were divided into three groups: those who met criteria for an ASD according to only DSM-IV-TR criteria, those who met criteria according to the proposed DSM-5 criteria, and controls with ID not meeting ASD criteria according to either diagnostic system. After statistical analysis, individuals in the DSM-5 group evinced significantly greater overall ASD core symptoms than those in the DSM-IV-TR group or controls. In addition, those in the DSM-IV-TR group exhibited significantly greater overall ASD core symptoms than those in the control group. Furthermore, we found that the percentage of adults diagnosed with ASD declined by 36.53% when using DSM-5 as compared to DSM-IV-TR criteria. Implications of these findings are discussed.

How Does Relaxing the Algorithm for Autism Affect DSM-V Prevalence Rates?

“…The type and number of symptoms clinicians look for when diagnosing autism often determines access to social and educational services. McPartland et al (2012), Matson, Belva et al (2012), Matson, Kozlowski et al (2012), and Worley and Matson (2012) have completed four studies comparing DSM-IV-TR and DSM-5 criteria for autism/autism spectrum disorders (ASDs). All of these studies show that according to the proposed algorithm, 30-45 % of children, adolescents, and adults classified with ASDs according to DSM-IV-TR criteria will not meet DSM-5 criteria for ASD.…”

Assessment and diagnosis of autism in developing countries: the Indonesian adaptation of Autism Detection in Early Childhood (ADEC)

“…These results are in line with the results of (to date) 11 other studies that have showed a median of 33% children with ASD who were not identified by the DSM-5 criteria (e.g., Frazier et al, 2012;Matson, Belva et al, 2012;Young & Rodi, 2013). …”

WhatDSM-5Could Mean to Children With Autism and Their Families

“…37 Several studies published in the peer-reviewed literature in 2012 suggest that at least 12% and potentially as many as 40% of children currently classified in one of the PDD subcategories will be reclassified or lose their diagnosis. [33][34][35][36][38][39][40][41][42] Some of these studies indicate that the specificity is likely to improve using DSM-5 criteria but that the sensitivity will potentially suffer, particularly for children with PDD not otherwise specified 43 ; however, these recent studies have various limitations, including using older data sets, applying older versions of DSM-5 criteria, and using different types of diagnostic determinations (eg, clinician, parent report). Huerta et al 44 published a largescale retrospective analysis of 4453 children with DSM-IV clinical PDD diagnoses and 690 with non-PDD diagnosis (eg, language disorder) and found that the proposed DSM-5 criteria identified 91% of children with clinical DSM-IV PDD diagnoses and that the specificity of the DSM-5 criteria was 0.63 as compared with 0.24 to 0.53 for DSM-IV.…”