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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_333,h_250,fp_0.50_0.50,q_35,blur_30,enc_avif,quality_auto/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.webp)
![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_514,h_386,fp_0.50_0.50,q_95,enc_avif,quality_auto/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.webp)
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
Nov 238 min read


Diagnostic Stability of Autism Before the Concept of Spectrum
The question of how stable an autism diagnosis is over time has long been debated. While many families and clinicians view an autism diagnosis as lifelong, research suggests that diagnostic stability—how consistently a diagnosis persists over time—depends heavily on which diagnostic framework is used. Emerging evidence indicates that before the introduction of the broader ASD category in the DSM-5 (APA 2013), autism diagnoses were more stable and predictable. Before DSM-5: D
Nov 73 min read


Regression in Autism (3):
In most cases, ASD is diagnosed between 15 and 30 months. Some children exhibit typical early development, only to lose acquired language and social skills between 15 and 30 months. These cases qualify as regressive autism.
However, there are instances of late onset autism where individuals appear to develop typically until adolescence or even adulthood before displaying symptoms consistent with autism. In such cases, an identifiable neurological insult, such as, e.g, herpes
Jul 107 min read


Regression in Autism (1):
Complex developmental path s Regression in autism refers to the loss of previously acquired developmental skills—such as spoken...
Jun 295 min read


Alexithymia and Autism (2): The complex interplay
Alexithymia is considered a “sub-clinical phenomenon” (Silani et al. 2008) and doesn’t identify a personality disorder per se but is a personality trait that is dimensional in nature (Taylor et al. 1991). Alexithymia is not a symptom of autism, but rather an independent construct that frequently co-occurs with autism. Although alexithymia has similar symptoms , it is distinct from autism – it is neither a necessary nor sufficient feature for an autism diagnosis, and there a
Nov 28, 20245 min read


Alexithymia and Autism (1): Intersections of two distinct conditions
The connection between alexithymia and ASD was initially explored in the 1990s through clinical studies on individuals with eating disorders, specifically anorexia nervosa (AN). The studies revealed the co-occurrence of eating disorders with deficiencies in social competence and identified some traits that were considered typical of ASD, [ 1 ] such as empathy problems, as well as some features considered typical of alexithymia, such as difficulty verbalising emotions, ide
Nov 24, 20244 min read


Narcissistic Personality Disorder and Autism (1):
Overlapping symptoms and differences Narcissistic Personality Disorder (NPD) and ASD are two distinct condition. However, they share...
Mar 21, 20246 min read


Personality Disorders and Autism: (2)
Overlaps, prevalence and comorbidity Overlapping symptoms It is now recognised that ASD and personality disorders (PDs) have a variety of...
Feb 23, 20245 min read


Personality Disorders and Autism (1):
Is there a hidden connection? Personality Disorders (PDs) and ASDs are distinct yet interconnected psychiatric disorders/ psychological...
Feb 17, 20247 min read


Autism and Dementia: (1) Prevalence
- Hello, where are you? - I am at home. - At home? Where? - I have one home, in England. Why? What’s happened? - Why did you leave without saying ‘goodbye’? It was great when you and your daughter came to see me. We visited friends and had fun. I was preparing your farewell party, but you left. You could have said goodbye… Thus began my conversation with my childhood friend (B.). We have be
Mar 18, 20234 min read
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