DSM-IV Controversy

DSM-IV-TR vs. DSM-5
Debate on the Changes in Autism Diagnosis

I. Introduction
A. What is the DSM? According to the American Psychiatric Association the Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States. The DSM consists of three major components:
1. The diagnostic classification is the list of the mental disorders that are officially part of the DSM system.
2. A set of diagnostic criteria indicate what symptoms must be present (and for how long) as well as symptoms, disorders, and conditions that must not be present in order to qualify for a particular diagnosis.
3. The descriptive text that accompanies each disorder
“ Since the inclusion of Asperger’s Disorder in the DSM-IV in 1994, there has been ongoing controversy about the Asperger’s disorder label.” (Kite, 1693)
1. Miller and Ozonoff in 1997 applied DSM-IV Asperger criteria to the four cases described in Asperger’s original paper from 1944. They found that all four individuals met DSM-IV criteria for Autistic Disorder and none met Asperger criteria. This is largely due to the precedent rule that says Asperger’s Disorder is ruled out if the person meets the Autistic criteria. (Ozonoff, e5)
2. Gilchrist and colleagues in 2001 found that 80% of their Asperger group met DSM-IV Autistic Disorder criteria. Their HFA (high-functioning Autism) and Asperger’s groups performed similarly illustrationg the confusion that Asperger’s is really just High Functioning Autism. (Ozonoff, e5) This goes along with the new Spectrum diagnosis.
3. Prior and colleagues in 1998 used a cluster analysis approach to diagnosing autism along the newer Spectrum diagnosis. They identified three clusters differing in their level of impairment, severity of symptoms, and level of cognitive function, NOT in the nature of their symptoms. These results are directly supportive of the DSM-5. (Ozonoff,
Of the 547 health and education professionals participating in Kite et al. study, 93.4% of participants answered that there was a difference between Autism and Asperger's Disorder. (Kite, 1694)
5. Ghaziuddin has researched the differences between the two diagnoses on multiple occasions. His findings have suggested that persons with Asperger's often have a distinct style of social interaction, active but odd rather than that of Autism where the children are passive and aloof. He states that the two conditions differ not only in the degree of severity but also in the quality of their social impairment. (Ghaziuddin, 141) Other distinct Asperger's traits include idiosyncratic interests often sophisticated and intellectual and a communication style that is pedantic and verbose.
6. The new Social Communication Disorder was created to help catch the children who would no longer fall under the new ASD criteria. "It seems logically and internally inconsistent for the DSM-5, which explicitly takes a dimensional approach, to introduce a separate category that is so qualitatively similar to another condition." (Ozonoff, e6) SCD does not fit what we know about Asperger's