Autism in DSM-5-TR, what has changed?
DOI:
https://doi.org/10.33448/rsd-v13i9.46866Keywords:
Autism; Classification; DSM; Diagnosis; Autistic spectrum.Abstract
The nosology of Autism Spectrum Disorder (ASD) is historically very recent, having first appeared as a category of its own in 1980, and was previously considered to be a type of childhood schizophrenia. Autism is now understood as a neurodevelopmental condition whose most striking characteristic is a persistent deficit in communication and social interaction skills, affecting 1 in 36 children, according to the CDC. The most widely accepted definition and criteria for the disorder rest on the main manuals, namely the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Code of Diseases (ICD), which seek to adapt to new scientific and socio-cultural updates, with the aim of making diagnostic models clearer and more reliable. In 2022, the revision of the fifth edition of the DSM (DSM-5-TR) was published, which led to some changes regarding both the criteria and the wording of the condition for ASD. In this sense, the aim of this article is to present a study of the changes brought about by the DSM-5-TR in the category of ASD, as well as to discuss the contexts and reasons behind these changes.
References
Aftab, A., & Ryznar, E. (2021). Conceptual and historical evolution of psychiatric nosology. International Review of Psychiatry, 33(5), 486–499.
American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders (3th ed.).
American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3th ed.,text rev.).
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.).
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.,text rev.).
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
American Psychiatric Association (2022a). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
American Psychiatric Association (2022b). Autism Spectrum Disorder. Recuperado em: 5 set. 2024. https://www.psychiatry.org/getmedia/d48f7fa6-b6c8-4f6c-888b-b0adfeb9f5b6/APA-DSM5TR-AutismSpectrumDisorder.pdf.
Bettelheim, B. (1967). The Empty Fortress (Simon and Schuster, Ed.).
Bell, J. (2014). Doing Your Research Project: A guide for first-time researchers. McGraw-hill education (UK).
Bleuler, P. E. (1911). Dementia praecox or the group of schizophrenias.
Bougeard, C., Picarel-Blanchot, F., Schmid, R., Campbell, R., & Buitelaar, J. (2021). Prevalence of autism spectrum disorder and co-morbidities in children and adolescents: a systematic literature review. Frontiers in Psychiatry, 12, 744709.
Carey, B. (2012). New definition of autism will exclude many, study suggests. New York Times.
Caruana, N., Stieglitz Ham, H., Brock, J., Woolgar, A., Kloth, N., Palermo, R., & McArthur, G. (2018). Joint attention difficulties in autistic adults: An interactive eye-tracking study. Autism, 22(4), 502–512.
Cassidy, S., Bradley, P., Robinson, J., Allison, C., McHugh, M., & Baron-Cohen, S. (2014). Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic: a clinical cohort study. The Lancet Psychiatry, 1(2), 142–147.
Cridland, E. K., Jones, S. C., Caputi, P. & Magee, C. A. (2014). Investigating the experiences of girls with autism spectrum disorders during adolescence. Journal of Autism and Developmental Disorders, 44, 1261-1274
Culpin, I., Mars, B., Pearson, R. M., Golding, J., Heron, J., Bubak, I., Carpenter, P., Magnusson, C., Gunnell, D., & Rai, D. (2018). Autistic traits and suicidal thoughts, plans, and self-harm in late adolescence: population-based cohort study. Journal of the American Academy of Child & Adolescent Psychiatry, 57(5), 313–320.
Duvall, S. W., Greene, R. K., Phelps, R., Rutter, T. M., Markwardt, S., Grieser Painter, J., Cordova, M., Calame, B., Doyle, O., & Nigg, J. T. (2024). Factors Associated with Confirmed and Unconfirmed Autism Spectrum Disorder Diagnosis in Children Volunteering for Research. Journal of Autism and Developmental Disorders, 1–13.
Dworzynski, K., Ronald, A., Bolton, P., & Happé, F. (2012). How Different Are Girls and Boys Above and Below the Diagnostic Threshold for Autism Spectrum Disorders? Journal of the American Academy of Child & Adolescent Psychiatry, 51(8), 788–797. https://doi.org/10.1016/j.jaac.2012.05.018
Gilman, S. R., Iossifov, I., Levy, D., Ronemus, M., Wigler, M., & Vitkup, D. (2011). Rare De Novo Variants Associated with Autism Implicate a Large Functional Network of Genes Involved in Formation and Function of Synapses. Neuron, 70(5), 898–907. https://doi.org/10.1016/j.neuron.2011.05.021
Greaves-Lord, K., Skuse, D., & Mandy, W. (2022). Innovations of the ICD-11 in the field of autism spectrum disorder: a psychological approach. Clinical Psychology in Europe, 4(Spec Issue).
Halladay, A. K., Bishop, S., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., Messinger, D., Pelphrey, K., Sanders, S. J., Singer, A. T., Taylor, J. L., & Szatmari, P. (2015). Sex and gender differences in autism spectrum disorder: summarizing evidence gaps and identifying emerging areas of priority. Molecular Autism, 6(1), 36. https://doi.org/10.1186/s13229-015-0019-y
Hess, P. (2022). DSM-5 revision tweaks autism entry for clarity. Spectrum.
Hiller, R. M., Young, R. L., & Weber, N. (2015). Sex differences in pre-diagnosis concerns for children later diagnosed with autism spectrum disorder. Autism, 20(1), 75–84. https://doi.org/10.1177/1362361314568899
Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P., & Bölte, S. (2016). Premature mortality in autism spectrum disorder. The British Journal of Psychiatry, 208(3), 232–238.
Huerta, M., Bishop, S. L., Duncan, A., Hus, V., & Lord, C. (2012). Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. American Journal of Psychiatry, 169(10), 1056–1064.
Jacquemont, S., Coe, B. P., Hersch, M., Duyzend, M. H., Krumm, N., Bergmann, S., Beckmann, J. S., Rosenfeld, J. A., & Eichler, E. E. (2014). A Higher Mutational Burden in Females Supports a “Female Protective Model” in Neurodevelopmental Disorders. The American Journal of Human Genetics, 94(3), 415–425. https://doi.org/10.1016/j.ajhg.2014.02.001
Kale, M. S., & Korenstein, D. (2018). Overdiagnosis in primary care: framing the problem and finding solutions. BMJ, 362, k2820. https://doi.org/10.1136/bmj.k2820
Kanner, L. (1968). Autistic disturbances of affective contact. Acta Paedopsychiatrica, 35(4), 100–136.
Kataoka, S., Takuma, K., Hara, Y., Maeda, Y., Ago, Y., & Matsuda, T. (2013). Autism-like behaviours with transient histone hyperacetylation in mice treated prenatally with valproic acid. International Journal of Neuropsychopharmacology, 16(1), 91–103. https://doi.org/10.1017/S1461145711001714
Kirby, A. v, Bakian, A. v, Zhang, Y., Bilder, D. A., Keeshin, B. R., & Coon, H. (2019). A 20‐year study of suicide death in a statewide autism population. Autism Research, 12(4), 658–666.
Kirkovski, M., Enticott, P. G., & Fitzgerald, P. B. (2013). A Review of the Role of Female Gender in Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 43(11), 2584–2603. https://doi.org/10.1007/s10803-013-1811-1
Knickmeyer, R. C., Wheelwright, S., & Baron-Cohen, S. B. (2008). Sex-typical Play: Masculinization/Defeminization in Girls with an Autism Spectrum Condition. Journal of Autism and Developmental Disorders, 38(6), 1028–1035. https://doi.org/10.1007/s10803-007-0475-0
Kõlves, K., Fitzgerald, C., Nordentoft, M., Wood, S. J., & Erlangsen, A. (2021). Assessment of suicidal behaviors among individuals with autism spectrum disorder in Denmark. JAMA Network Open, 4(1), e2033565–e2033565.
Lai, M.-C., Lombardo, M. v, Ruigrok, A. N. v, Chakrabarti, B., Auyeung, B., Szatmari, P., Happé, F., & Baron-Cohen, S. (2016). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690–702. https://doi.org/10.1177/1362361316671012
Lockwood Estrin, G., Milner, V., Spain, D., Happé, F., & Colvert, E. (2021). Barriers to autism spectrum disorder diagnosis for young women and girls: A systematic review. Review Journal of Autism and Developmental Disorders, 8(4), 454–470.
Lord, C., Petkova, E., Hus, V., Gan, W., Lu, F., Martin, D. M., Ousley, O., Guy, L., Bernier, R., & Gerdts, J. (2012). A multisite study of the clinical diagnosis of different autism spectrum disorders. Archives of General Psychiatry, 69(3), 306–313.
Luciano, M. (2015). The ICD-11 beta draft is available online. World Psychiatry, 14(3), 375–376. https://doi.org/https://doi.org/10.1002/wps.20262
Lukmanji, S., Manji, S. A., Kadhim, S., Sauro, K. M., Wirrell, E. C., Kwon, C.-S., & Jette, N. (2019). The co-occurrence of epilepsy and autism: A systematic review. Epilepsy & Behavior, 98, 238–248.
Macintosh, K. E., & Dissanayake, C. (2004). The similarities and differences between autistic disorder and Asperger's disorder: A review of the empirical evidence. Journal of Child Psychology and Psychiatry, 45(3), 421–434. https://doi.org/10.1111/j.1469-7610.2004.00234.x
Maenner, M. J. (2023). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2020. MMWR. Surveillance Summaries, 72.
Mandy, W. P. L., Charman, T., & Skuse, D. H. (2012). Testing the construct validity of proposed criteria for DSM-5 autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 51(1), 41–50.
Merten, E. C., Cwik, J. C., Margraf, J., & Schneider, S. (2017). Overdiagnosis of mental disorders in children and adolescents (in developed countries). Child and Adolescent Psychiatry and Mental Health, 11, 1–11.
Ministério da Saúde (2022). Ministério da Saúde coordena tradução do novo Código Internacional de Doenças para a língua portuguesa. Recuperado em 19/08/2024. https://www.gov.br/saude/pt-br/assuntos/noticias/2022/julho/ministerio-da-saude-coordena-traducao-do-novo-codigo-internacional-de-doencas-para-a-lingua-portuguesa
Newell, V., Phillips, L., Jones, C., Townsend, E., Richards, C., & Cassidy, S. (2023). A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability. Molecular Autism, 14(1), 12.
Oliphant, R. Y. K., Smith, E. M., & Grahame, V. (2020). What is the Prevalence of Self-harming and Suicidal Behaviour in Under 18s with ASD, With or Without an Intellectual Disability? Journal of Autism and Developmental Disorders, 50(10), 3510–3524. https://doi.org/10.1007/s10803-020-04422-6
Ozonoff, S., South, M., & Miller, J. N. (2000). DSM-IV-defined Asperger syndrome: Cognitive, behavioral and early history differentiation from high-functioning autism. Autism, 4(1), 29–46.
Peden, A. E., & Willcox-Pidgeon, S. (2020). Autism spectrum disorder and unintentional fatal drowning of children and adolescents in Australia: an epidemiological analysis. Archives of Disease in Childhood, 105(9), 869–874.
Pelton, M. K., & Cassidy, S. A. (2017). Are autistic traits associated with suicidality? A test of the interpersonal-psychological theory of suicide in a non-clinical young adult sample. Autism Research, 10(11), 1891–1904. https://doi.org/https://doi.org/10.1002/aur.1828
Richa, S., Fahed, M., Khoury, E., & Mishara, B. (2014). Suicide in autism spectrum disorders. Archives of Suicide Research, 18(4), 327–339.
Robinson, E. B., Lichtenstein, P., Anckarsäter, H., Happé, F., & Ronald, A. (2013). Examining and interpreting the female protective effect against autistic behavior. Proceedings of the National Academy of Sciences, 110(13), 5258–5262. https://doi.org/10.1073/pnas.1211070110
Rødgaard, E.-M., Jensen, K., Miskowiak, K. W., & Mottron, L. (2021). Autism comorbidities show elevated female-to-male odds ratios and are associated with the age of first autism diagnosis. Acta Psychiatrica Scandinavica, 144(5), 475–486. https://doi.org/https://doi.org/10.1111/acps.13345
Schoch, H., Kreibich, A. S., Ferri, S. L., White, R. S., Bohorquez, D., Banerjee, A., Port, R. G., Dow, H. C., Cordero, L., Pallathra, A. A., Kim, H., Li, H., Bilker, W. B., Hirano, S., Schultz, R. T., Borgmann-Winter, K., Hahn, C.-G., Feldmeyer, D., Carlson, G. C., … Brodkin, E. S. (2017). Sociability Deficits and Altered Amygdala Circuits in Mice Lacking Pcdh10, an Autism Associated Gene. Biological Psychiatry, 81(3), 193–202. https://doi.org/10.1016/j.biopsych.2016.06.008
Shavelle, R. M., Strauss, D. J., & Pickett, J. (2001). Causes of death in autism. Journal of Autism and Developmental Disorders, 31, 569–576.
Smeets, E. E. J., Pelc, K., & Dan, B. (2012). Rett syndrome. Molecular syndromology, 2(3-5), 113-127.
Smith, L. D, Hong, J., Greenberg, J. S., & Mailick, M. R. (2019). Mortality in individuals with autism spectrum disorder: Predictors over a 20-year period. Autism, 23(7), 1732–1739.
Smith, O., & Jones, S. C. (2020). ‘Coming out’with autism: Identity in people with an Asperger’s diagnosis after DSM-5. Journal of Autism and Developmental Disorders, 50(2), 592–602.
Snow, A. v, & Lecavalier, L. (2011). Comparing autism, PDD-NOS, and other developmental disabilities on parent-reported behavior problems: little evidence for ASD subtype validity. Journal of Autism and Developmental Disorders, 41, 302–310.
Szatmari, P., Bryson, S., Duku, E., Vaccarella, L., Zwaigenbaum, L., Bennett, T., & Boyle, M. H. (2009). Similar developmental trajectories in autism and Asperger syndrome: from early childhood to adolescence. Journal of Child Psychology and Psychiatry, 50(12), 1459–1467. https://doi.org/https://doi.org/10.1111/j.1469-7610.2009.02123.x
Szatmari, P., Bryson, S. E., Boyle, M. H., Streiner, D. L., & Duku, E. (2003). Predictors of outcome among high functioning children with autism and Asperger syndrome. Journal of Child Psychology and Psychiatry, 44(4), 520–528. https://doi.org/https://doi.org/10.1111/1469-7610.00141
Treml, J., Linde, K., Brähler, E., & Kersting, A. (2024). Prolonged grief disorder in ICD-11 and DSM-5-TR: differences in prevalence and diagnostic criteria. Frontiers in Psychiatry, 15, 1266132.
Walker, D. R., Thompson, A. N. N., Zwaigenbaum, L., Goldberg, J., Bryson, S. E., Mahoney, W. J., Strawbridge, C. P., & Szatmari, P. (2004). Specifying PDD-NOS: a comparison of PDD-NOS, Asperger syndrome, and autism. Journal of the American Academy of Child & Adolescent Psychiatry, 43(2), 172–180.
Weitlauf, A. S., Gotham, K. O., Vehorn, A. C., & Warren, Z. E. (2014). Brief report: DSM-5 “levels of support:” A comment on discrepant conceptualizations of severity in ASD. Journal of Autism and Developmental Disorders, 44(2), 471–476.
Young, H., Oreve, M.-J., & Speranza, M. (2018). Clinical characteristics and problems diagnosing autism spectrum disorder in girls. Archives de Pédiatrie, 25(6), 399–403.
Zeidan, J., Fombonne, E., Scorah, J., Ibrahim, A., Durkin, M. S., Saxena, S., Yusuf, A., Shih, A., & Elsabbagh, M. (2022). Global prevalence of autism: A systematic review update. Autism Research, 15(5), 778–790. https://doi.org/https://doi.org/10.1002/aur.2696
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