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Ferrara R, Nappo R, Ansermet F, Ricci P, Massoni F, Carbone G, Sparaci A, Nonnis E, Ricci L, Ricci S. The Impact of
DSM-5
on the Diagnosis of Autism Spectrum Disorder. Psychiatr Ann 2021. [DOI: 10.3928/00485713-20201205-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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2
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Kalungi A, Womersley JS, Kinyanda E, Joloba ML, Ssembajjwe W, Nsubuga RN, Levin J, Kaleebu P, Kidd M, Seedat S, Hemmings SMJ. Internalizing Mental Disorders and Accelerated Cellular Aging Among Perinatally HIV-Infected Youth in Uganda. Front Genet 2019; 10:705. [PMID: 31428136 PMCID: PMC6688656 DOI: 10.3389/fgene.2019.00705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 07/03/2019] [Indexed: 11/15/2022] Open
Abstract
Introduction: Internalizing mental disorders (IMDs) in HIV+ children and adolescents are associated with impaired quality of life and non-adherence to anti-retroviral treatment. Telomere length is a biomarker of cellular aging, and shorter telomere length has been associated with IMDs. However, the nature of this association has yet to be elucidated. Objective: We determined the longitudinal association between IMDs and relative telomere length (rTL) and the influence of chronic stress among Ugandan perinatally HIV-infected youth (PHIY). Methods: IMDs (depressive disorders, anxiety disorders, and post-traumatic stress disorder) and IMDs were assessed using the locally adapted Child and Adolescent Symptom Inventory-5. In 368 PHIY with any IMD and 368 age- and sex-matched PHIY controls without any psychiatric disorder, rTL was assessed using quantitative polymerase chain reaction. Hierarchical cluster analysis was used to generate the three chronic stress classes (mild, moderate, and severe). t-tests were used to assess the difference between baseline and 12 month rTL and the mean difference in rTL between cases and controls both at baseline and at 12 months. Linear regression analysis was used to model the effects of chronic stress on the association between IMDs and rTL, controlling for age and sex. Results: We observed longer rTL among cases of IMDs compared with controls (p < 0.001). We also observed a statistically significant reduction in rTL between baseline and 12 months in the combined sample of cases and controls (p < 0.001). The same statistical difference was observed when cases and controls were individually analyzed (p < 0.001). We found no significant difference in rTL between cases and controls at 12 months (p = 0.117). We found no significant influence of chronic stress on the association between IMDs and rTL at both baseline and 12 months. Conclusion: rTL is longer among cases of IMDs compared with age- and sex-matched controls. We observed a significant attrition in rTL over 12 months, which seems to be driven by the presence of any IMDs. There is a need for future longitudinal and experimental studies to understand the mechanisms driving our findings.
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Affiliation(s)
- Allan Kalungi
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.,Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Medical Microbiology, Makerere University, Kampala, Uganda
| | | | - Eugene Kinyanda
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses L Joloba
- Department of Medical Microbiology, Makerere University, Kampala, Uganda.,School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Wilber Ssembajjwe
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Statistics and Data Science Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Rebecca N Nsubuga
- Statistics and Data Science Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Jonathan Levin
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | | | - Martin Kidd
- Centre for Statistical Consultation, Department of Statistics and Actuarial Sciences University of Stellenbosch, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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3
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Tachibana Y, Miyazaki C, Mikami M, Ota E, Mori R, Hwang Y, Terasaka A, Kobayashi E, Kamio Y. Meta-analyses of individual versus group interventions for pre-school children with autism spectrum disorder (ASD). PLoS One 2018; 13:e0196272. [PMID: 29763417 PMCID: PMC5953451 DOI: 10.1371/journal.pone.0196272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 04/10/2018] [Indexed: 12/03/2022] Open
Abstract
There is little evidence regarding the effects of individual and group intervention for children with autism spectrum disorder (ASD) on important outcomes. We performed meta-analyses using a random effects model to investigate the effectiveness of the individual and group intervention studies and to compare the effectiveness of these two types if possible. The main analysis which excluded studies at a high risk of bias (Analysis I) included 14 randomised controlled trials targeting children with ASD≤6 years of age (594 children). The results suggested that both individual and group interventions showed significant effects compared to the control condition on "reciprocity of social interaction towards others" (standard mean difference[SMD] [95%confidence interval{CI}] = 0.59[0.25, 0.93], p = 0.16; 0.45[0.02, 0.88], p = 0.39, respectively). Only individual interventions showed significant effects compared to the control condition on "parental synchrony" (SMD [95%CI] = 0.99 [0.70, 1.29], p<0.01). Our results showed no significant differences between individual and group interventions in effects on "autism general symptoms" (no study available for group intervention), "developmental quotient" (no study available for group intervention), "expressive language" (p = 0.56), "receptive language" (p = 0.29), "reciprocity of social interaction towards others" (p = 0.62), or "adaptive behaviour" (p = 0.43). We also performed sensitivity analyses including studies that had been excluded due to being at a high risk of potential bias (Analysis II). The results suggested that "reciprocity of social interactions towards others" showed significant effects for individual intervention compared to the control condition (0.50[0.31,0.69], p<0.001) but not for group intervention (0.23[-0.33, 0.78], p = 0.42). Individual intervention also showed significant effects on "parental synchrony" (0.98[0.30,1.66], p = 0.005) in the sensitivity analysis. The results also suggested no significant difference on all the outcomes between the individual and group interventions. We also reanalysed the data using cluster-robust standard errors as sensitivity analyses (Analysis III). Analysis III showed no significant effects in the intervention condition compared to the control condition on all the outcomes for both individual and group interventions. When Analysis II was reanalysed using cluster-robust standard errors (Analysis IV), individual interventions showed significant effects compared to the control condition on "reciprocity of social interaction towards others" and "parental synchrony" (mean estimate[95%CI], robust standard error, p = 0.50[0.20, 0.81], 0.13, 0.006; and 1.06[0.08, 2.05], 0.42, 0.04, respectively), and none of the outcomes showed significant effects under the intervention condition compared to the control condition for group interventions. The discrepancies in the results between the main analysis (Analysis I) and the sensitivity analyses (Analyses II, III, and IV) may be due to the small number of included studies. Since the outcome of "reciprocity of social interaction towards others" can be a dependent variable that is usually measured in a context-bound setting with the child's parent, we cannot conclude that individual interventions for pre-school children with ASD have significant effects on generalised skills for engaging in reciprocal interactions with others, even if the interventions have significant effects on the outcome. However, the outcomes of "reciprocity of social interaction towards others" may be promising targets for both individual and group interventions involving pre-school children with ASD. "Parental synchrony" may also be a promising target for individual interventions. TRIAL REGISTRATION (CRD42011001349).
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Affiliation(s)
- Yoshiyuki Tachibana
- Division of Infant and Toddler Mental Health, Department of Psychosocial Medicine, National Centre for Child Health and Development, Tokyo, Japan
- Smart Aging International Research Center, IDAC, Tohoku University, Sendai, Japan
- Department of Child and Adolescent Mental Health, National Center for Neurology and Psychiatry, Tokyo, Japan
| | - Celine Miyazaki
- Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Masashi Mikami
- Department of Biostatistics, Clinical Research Centre, National Centre for Child Health and Development, Tokyo, Japan
| | - Erika Ota
- Department of Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan
| | - Rintaro Mori
- Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yeonhee Hwang
- Department of Education, Tohoku Fukushi University, Sendai, Japan
| | - Akiko Terasaka
- Department of Educational Collaboration, Osaka Kyoiku University, Osaka, Japan
| | - Eriko Kobayashi
- Division of Infant and Toddler Mental Health, Department of Psychosocial Medicine, National Centre for Child Health and Development, Tokyo, Japan
| | - Yoko Kamio
- Department of Child and Adolescent Mental Health, National Center for Neurology and Psychiatry, Tokyo, Japan
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4
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Tachibana Y, Miyazaki C, Ota E, Mori R, Hwang Y, Kobayashi E, Terasaka A, Tang J, Kamio Y. A systematic review and meta-analysis of comprehensive interventions for pre-school children with autism spectrum disorder (ASD). PLoS One 2017; 12:e0186502. [PMID: 29211740 PMCID: PMC5718481 DOI: 10.1371/journal.pone.0186502] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 10/03/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There has an increasing number of published trials on psychosocial intervention programmes for pre-school children with autism spectrum disorder (ASD). To achieve better quality of unbiased evidence for the effectiveness of ASD interventions, it is necessary to conduct a comprehensive review that covers studies with adequate quality standards, such as randomised controlled trials (RCTs), and different types of intervention In this study, we categorize interventions for ASD as behavioural, social-communication focused, and multimodal developmental based on Howlin's classification of early interventions for children with ASD. The aim of this study was to compare these three models and investigate the strengths and weaknesses of each type of intervention and to identify the approaches that contribute to a successful outcome for children with autism. METHODS We performed a systematic review and meta-analysis. We included RCTs targeting children with ASD 6 years old or younger. A random effects model was used to present the effect estimate for the outcomes. This study also performed combined meta-analyses of all the three models to investigate the overall effectiveness of the intervention programmes. RESULTS 32 randomized controlled studies were found to be eligible for inclusion. The synthesized data included 594 children from 14 RCTs. There was no statistically significant difference in the effects on autism general symptoms between the social-communication-focused model and the multimodal developmental model (p = 0.83). The results suggest that there is evidence of an effect on 'reciprocity of social interaction towards others' (standard mean difference [95% confidential interval] = 0.53[0.29,0.78], p<0.01) and 'parental synchrony' (SMD = 0.99[0.70,1.29], p<0.01). CONCLUSION The small number of studies included in the present study limited the ability to make inferences when comparing the three models and investigating the strengths and weaknesses of each type of intervention with respect to important outcomes. Since the outcome of 'reciprocity of social interaction towards others' could be a dependent variable that might be context-bound to interactions with the child's parent, we cannot conclude the interventions for pre-school children with ASD have significant effects on a generalized skill to engage in reciprocal interactions with others. However, the outcomes of 'reciprocity of social interaction towards others' and 'parental synchrony' may be promising targets for interventions involving pre-school children with ASD. TRIAL REGISTRATION Prospero CRD42011001349.
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Affiliation(s)
- Yoshiyuki Tachibana
- Division of Infant and Toddler Mental Health, Department of Psychosocial Medicine, National Centre for Child Health and Development, Tokyo, Japan
- Smart Aging International Research Center, IDAC, Tohoku University, Sendai, Japan
- Department of Child and Adolescent Mental Health, National Center for Neurology and Psychiatry, Tokyo, Japan
| | - Celine Miyazaki
- Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Erika Ota
- Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Rintaro Mori
- Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yeonhee Hwang
- Department of Education, Tohoku Fukushi University, Sendai, Japan
| | - Eriko Kobayashi
- Division of Infant and Toddler Mental Health, Department of Psychosocial Medicine, National Centre for Child Health and Development, Tokyo, Japan
| | - Akiko Terasaka
- Department of Educational Collaboration, Osaka Kyoiku University, Osaka, Japan
| | - Julian Tang
- Department of Education for Clinical Research, National Centre for Child Health and Development, Tokyo, Japan
| | - Yoko Kamio
- Department of Child and Adolescent Mental Health, National Center for Neurology and Psychiatry, Tokyo, Japan
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5
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Burns CO, Matson JL. An evaluation of the clinical application of the DSM-5 for the diagnosis of autism spectrum disorder. Expert Rev Neurother 2017; 17:909-917. [PMID: 28678629 DOI: 10.1080/14737175.2017.1351301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The changes to the diagnostic criteria for autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were met with much controversy by researchers, clinicians, and families of individuals with ASD. The goal of this paper is to review the literature on the impact of these changes. Areas covered: This paper reviews the major changes to diagnostic criteria from DSM-IV-TR to DSM-5. It emphasizes how these changes are hypothesized to impact prevalence rates, as well as trends in characteristics of individuals who would have met previous criteria for ASD but no longer qualify for a diagnosis under DSM-5. Policy issues such as access to services and research considerations are also briefly reviewed. Expert commentary: Researchers have found that the DSM-5 diagnostic criteria for ASD may significantly impact which children receive diagnoses, which in turn affects access to services that address impairments characteristic of this disorder. Despite the fact that the DSM-5 has now been in use for four years, fewer recent studies were identified than was expected. Future research should continue to focus on the impact of changes in criteria, as well as on translational scientific advances across disciplines.
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Affiliation(s)
- Claire O Burns
- a Louisiana State University , Department of Psychology, Clinical Psychology , Baton Rouge , LA , USA
| | - Johnny L Matson
- a Louisiana State University , Department of Psychology, Clinical Psychology , Baton Rouge , LA , USA
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6
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Christiansz JA, Gray KM, Taffe J, Tonge BJ. Autism Spectrum Disorder in the DSM-5: Diagnostic Sensitivity and Specificity in Early Childhood. J Autism Dev Disord 2017; 46:2054-2063. [PMID: 26861716 DOI: 10.1007/s10803-016-2734-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Changes to the DSM-5 Autism Spectrum Disorder (ASD) criteria raised concerns among parents and practitioners that the criteria may exclude some children with Pervasive Developmental Disorder (PDD). Few studies have examined DSM-5 sensitivity and specificity in children less than 5 years of age. This study evaluated 185 children aged 20-55 months with DSM-IV PDD or developmental delay. Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) data was assigned to DSM-5 subdomains. Children displaying the required symptomatology were classified with DSM-5 ASD. DSM-IV clinical diagnoses were compared to DSM-5 classifications. Using combined ADI-R/ADOS information, sensitivity was .84 and specificity was .54. Comorbid behaviour and emotional problems were significantly lower in children with PDD that did not meet DSM-5 criteria.
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Affiliation(s)
- Jessica A Christiansz
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia. .,Centre for Developmental Psychiatry and Psychology, Early in Life Mental Health Services, Monash Medical Centre, 246 Clayton Rd, Clayton, VIC, 31768, Australia.
| | - John Taffe
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia
| | - Bruce J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, VIC, Australia
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7
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Romero M, Aguilar JM, Del-Rey-Mejías Á, Mayoral F, Rapado M, Peciña M, Barbancho MÁ, Ruiz-Veguilla M, Lara JP. Psychiatric comorbidities in autism spectrum disorder: A comparative study between DSM-IV-TR and DSM-5 diagnosis. Int J Clin Health Psychol 2016; 16:266-275. [PMID: 30487870 PMCID: PMC6225088 DOI: 10.1016/j.ijchp.2016.03.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/29/2016] [Indexed: 12/19/2022] Open
Abstract
Background/Objective: The heterogeneous clinical presentations of individuals with Autism Spectrum Disorders (ASD) pose a significant challenge for sample characterization. Therefore the main goal of DSM-5 must be to identify subgroups of ASD, including comorbidity disorders and severity. The main goal of this study is to explore the psychiatric comorbidities and the severity of symptoms that could be relevant for the phenotype characterization in ASD and also to compare these results according to the different classification criteria between the DSM-IV-TR and the DSM-5. Method: A comparative study of severity and psychiatric comorbidities was carried out between a sample of participants that only met criteria for Pervasive Developmental Disorder (PDD) according to the DSM-IV-TR and a sample of participants that also met ASD criteria according to DSM-5 classification. The recruitment of children was via educational (N = 123). The psychiatric symptoms, comorbid disorders and severity of symptoms were assessed through The Nisonger Child Behavior Rating Form, clinical interview and The Inventory of Autism Spectrum Disorder, respectively. The psychiatric comorbidities considered were: anxiety, eating behavioural problems, self-aggressiveness, hetero–aggressiveness, self-harm, obsessive compulsive disorder and attention deficit and hyperactivity disorder. Results: Statistically significant differences between both groups were found regarding obsessive compulsive disorder, eating behavioural problems and severity. Conclusions: The results support the hypothesis that patients who meet the DSM-5 criteria have more severe symptoms, not only regarding the core autistic symptoms but also in relation with psychiatric comorbidities.
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Affiliation(s)
- Marina Romero
- King's College London, United Kingdom
- Universidad de Málaga, Andalucía TECH, IBIMA, Spain
- Corresponding author: Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.
| | | | | | | | - Marta Rapado
- Hospital General Universitario Gregorio Marañón Madrid, Spain
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8
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Zander E, Bölte S. The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis? J Autism Dev Disord 2016; 45:3634-43. [PMID: 26123009 DOI: 10.1007/s10803-015-2512-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The possible effect of the DSM-5 impairment criterion on diagnosing autism spectrum disorder (ASD) in young children was examined in 127 children aged 20-47 months with a DSM-IV-TR clinical consensus diagnosis of ASD. The composite score of the Vineland Adaptive Behavior Scales (VABS) served as a proxy for the DSM-5 impairment criterion. When applying a mild level of impairment (cutoff: 1 SD below the mean on the VABS), 88 % of the cases fulfilled the impairment criterion. Sixty-nine percent fulfilled the impairment criterion at a moderate level (1.5 SDs) and 33 % at a severe level (2 SDs). Findings indicate that a strict application of the new DSM-5 impairment criterion might compromise early diagnosis of ASD.
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Affiliation(s)
- Eric Zander
- Pediatric Neuropsychiatry Unit, Department of Children's and Women's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Gävlegatan 22B, 113 30, Stockholm, Sweden.
- Child and Adolescent Psychiatry, Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.
| | - Sven Bölte
- Pediatric Neuropsychiatry Unit, Department of Children's and Women's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Gävlegatan 22B, 113 30, Stockholm, Sweden
- Child and Adolescent Psychiatry, Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
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9
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Smith IC, Reichow B, Volkmar FR. The Effects of DSM-5 Criteria on Number of Individuals Diagnosed with Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2016; 45:2541-52. [PMID: 25796195 DOI: 10.1007/s10803-015-2423-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A growing body of research has raised concerns about the number of individuals diagnosed with autism spectrum disorder (ASD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 criteria, published in May 2013. The current study systematically reviews 25 articles evaluating samples according to both DSM-IV-TR and DSM-5 ASD criteria. Consistent with previous reviews, the majority of included studies indicated between 50 and 75% of individuals will maintain diagnoses. We conducted visual analyses of subgroups using harvest plots and found the greatest decreases among high-functioning populations with IQs over 70 and/or previous diagnoses of PDD-NOS or Asperger's disorder. We discuss the potential research and clinical implications of reduced numbers of individuals diagnosed with ASD.
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Affiliation(s)
- Isaac C Smith
- Yale Child Study Center, 230 South Frontage Rd., New Haven, CT, 06520, USA,
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10
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A Meta-analysis of DSM-5 Autism Diagnoses in Relation to DSM-IV and DSM-IV-TR. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-016-0070-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Levy F. Child and adolescent changes to DSM-5. Asian J Psychiatr 2014; 11:87-92. [PMID: 25453709 DOI: 10.1016/j.ajp.2014.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/23/2014] [Accepted: 03/31/2014] [Indexed: 02/04/2023]
Abstract
AIM To describe child and adolescent changes to the DSM-5 and discuss controversial changes. METHOD Relevant changes to the structure and categorization of DSM-5 childhood conditions are examined, and controversial issues noted. RESULTS Important overlaps between a number of new conditions are described, and questions raised in relation to underlying assumptions about some new categories. CONCLUSION Further research is required to determine the validity of new conditions, and the clinical and service effects of structural changes, particularly in respect of overlapping disorders, and categorical vs severity descriptors.
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Affiliation(s)
- Florence Levy
- School of Psychiatry, University of New South Wales, Australia; Child and Family East, Prince of Wales Hospital, Australia.
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12
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Beighley JS, Matson JL, Rieske RD, Jang J, Cervantes PE, Goldin RL. Comparing challenging behavior in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5. Dev Neurorehabil 2013; 16:375-81. [PMID: 23477536 DOI: 10.3109/17518423.2012.760119] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the current study is to investigate challenging behavior in children who may no longer meet criteria for an autism spectrum disorder (ASD) diagnosis according to the proposed fifth edition of the Diagnostic and Statistical Manual (DSM-5). METHOD Children and adolescents (n = 459) were separated into three groups including those who met criteria for ASD according to the DSM-5 criteria (n = 219); those who will no longer qualify for an ASD diagnosis according to the DSM-5 but met criteria according to the DSM-IV-TR (n = 109); and a control group (n = 131). Scores on the Autism Spectrum Disorders - Problem Behaviors for Children (ASD-PB-C) were compared among groups. RESULTS The DSM-5 captured a slightly more impaired population in terms of problem behavior. CONCLUSION Implications regarding access to treatment for those no longer meeting criteria need to be taken into consideration in the coming months.
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Affiliation(s)
- Jennifer S Beighley
- Department of Psychology, Louisiana State University , Baton Rouge, LA , USA
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13
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Turygin NC, Matson JL, Adams H, Belva B. The effect of DSM-5 criteria on externalizing, internalizing, behavioral and adaptive symptoms in children diagnosed with autism. Dev Neurorehabil 2013; 16:277-82. [PMID: 23617257 DOI: 10.3109/17518423.2013.769281] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diagnostic criteria for autism spectrum disorders (ASDs) are changing with the fifth edition of the Diagnostic and Statistical Manual (DSM-5), which simplifies the diagnostic categories into social/emotional deficits and repetitive and restricted behavior. ASDs have been closely linked to a variety of other disorders, in particular externalizing disorders such as ADHD, and internalizing disorders including anxiety disorders and obsessive compulsive disorder. The present study examines the externalizing, internalizing, behavioral and adaptive symptoms of children with ASD. METHOD Children diagnosed with the DSM-IV who do not meet diagnostic criteria for DSM-5 and were compared to a non-ASD sample and a sample of those who meet the new criteria. Differences were examined between the three experimental groups with respect to internalizing, externalizing, behavioral severity and adaptive behavior. RESULTS No significant differences were observed between the DSM-5 and DSM-IV groups with respect to composite and subscale scores on the externalizing, behavior severity index and adaptive behavior domains of the Behavior Assessment System for Children, Second Edition. CONCLUSIONS Significantly more impairment was evident for both ASD groups compared to the no-ASD group.
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Affiliation(s)
- Nicole C Turygin
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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