Characterizing Autism: A Re-Examination of the Diangosis and the Phenotype

In the 1970’s the psychiatric community took a bold step in creating the DSM-3, which for the first time provided standardized and reliable criteria for psychiatric diagnoses. Despite being an important improvement, it also created new problems. The diagnoses were created by consensus of committees rather than from data-driven evidence to ensure external validity. The framers warned that these diagnoses were “way stations” until better scientifically-based diagnoses could be made. Categories had unclear boundaries with other disorders and with normality. These categories, (which did not “carve nature at its joints”), created the new concept of co-morbidities. It is the rare patient who has only one diagnosis. The categorical diagnoses are poor at prognosis and treatment guidance and have a wide range of heterogeneity in their presentations. Despite these problems, the diagnoses have been reified and the failure to use these categories imposes severe restrictions and often skews the research that is done. In this symposium we intend to examine the diagnosis of DSM autism in light of the problems enumerated above, using evidence from clinical, genetic and brain circuit studies. We also will review some of the proposed alternatives to the categorical diagnoses, with special attention to the NIMH’s RDoCs.
Thursday, May 15, 2014: 1:30 PM-3:30 PM
Marquis BC (Marriott Marquis Atlanta)