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![The 5th edition, published in 2013, set out to simplify and modernise the nosology of autism-related disorders, replacing the DSM-IV’s cluster of Pervasive Developmental Disorders (PDDs) — Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, Rett’s Disorder[1] and PDD-Not Otherwise Specified (PDD-NOS) — with a single diagnosis: Autism Spectrum Disorder (ASD). The intent was, in principle, laudable: a spectrum captures gradation and avoids splits between “high-” and “low-functioning” labels. In practice, DSM-5 produced a conceptual flattening by collapsing important distinctions and introduced criteria so under-specified they undermine diagnostic coherence – creating a set of internal contradictions that have done more to muddy than to clarify diagnosis.](https://static.wixstatic.com/media/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.png/v1/fill/w_1332,h_1000,fp_0.50_0.50,q_35,blur_30,enc_avif,quality_auto/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.png)
![The 5th edition, published in 2013, set out to simplify and modernise the nosology of autism-related disorders, replacing the DSM-IV’s cluster of Pervasive Developmental Disorders (PDDs) — Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, Rett’s Disorder[1] and PDD-Not Otherwise Specified (PDD-NOS) — with a single diagnosis: Autism Spectrum Disorder (ASD). The intent was, in principle, laudable: a spectrum captures gradation and avoids splits between “high-” and “low-functioning” labels. In practice, DSM-5 produced a conceptual flattening by collapsing important distinctions and introduced criteria so under-specified they undermine diagnostic coherence – creating a set of internal contradictions that have done more to muddy than to clarify diagnosis.](https://static.wixstatic.com/media/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.png/v1/fill/w_1364,h_1024,fp_0.50_0.50,q_95,enc_avif,quality_auto/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.png)
When a Spectrum Becomes a Vacuum: How DSM-5 Broke Autism Diagnosis and Fed a Diagnostic Epidemic
A Simplification That Simplifies Nothing The 5 th edition, published in 2013, set out to simplify and modernise the nosology of autism-related disorders, replacing the DSM-IV’s cluster of Pervasive Developmental Disorders (PDDs) — Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, Rett’s Disorder [ 1 ] and PDD-Not Otherwise Specified (PDD-NOS) — with a single diagnosis: Autism Spectrum Disorder (ASD). The intent was, in principle, laudable: a spectrum
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