%0 Journal Article
%T Quantitative Nature of Social Vulnerability and Autism: An Important Paradigm Shift in the DSM-5 for Autism Spectrum Disorder
%A Shinji Ijichi
%A Naomi Ijichi
%A Yukina Ijichi
%A Kazumi Hirotaki
%A Hisami Sameshima
%A Yoichi Kawaike
%A Hirofumi Morioka
%J ISRN Neurology
%D 2013
%R 10.1155/2013/201719
%X In the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), autistic characteristics in social interaction and communication are described as qualitative impairments. However, the difference between autistics and nonautistics in the draft of the 5th edition (DSM-5 draft) is quantitative rather than qualitative. The word ˇ°qualitativeˇ± is deleted in the draft text, and it is specified that the relation between social demands and individual limited capacities is critical for symptom manifestation (criterion C). Because the proposed levels of support requirement in the draft are mere observable outcomes of social vulnerability, the boundary between level 1 and nonautistic condition is determined by the relation between social demands and individual capacities. In addition to the introduction of the single category (autism spectrum disorder (ASD)) to cover the entire case spectrum, the DSM-5 draft is clearly based on a conviction that ASD is indistinguishable from the normal behavioral range. This concise review provides an explanation for this implicit paradigm shift from qualitative to quantitative. Importantly, the conditional role of social demands for symptom manifestation in the draft can be plausibly interpreted using a unique liability-probability model. 1. Introduction The development process of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is nearing its conclusion, and it is already scheduled for release in May 2013 (http://www.dsm5.org/). Although there has been a lot of debate on the new draft criteria for autism spectrum disorder (ASD) [1¨C3], the official commentaries from the DSM-5 workgroup on neurodevelopmental disorders suggest minor additional revisions in the upcoming final version [4]. Because the proposals in the draft are supported by more than a decade of scientific evidences after the launch of DSM-IV, the implications in the draft proposals are significant, and it is quite meaningful to designate the implicit differences between the draft and the former version. In DSM-IV, autistic characteristics in social interaction and communication are described as qualitative impairments. However, the difference between autistics and nonautistics in the DSM-5 draft is quantitative rather than qualitative. The word ˇ°qualitativeˇ± is deleted in the draft text, and it is suggested that the diagnosis of ASD may not be confirmed until social demands exceed limited capacities as documented in the criterion C. The proposed levels of support requirement in the draft are mere observable
%U http://www.hindawi.com/journals/isrn.neurology/2013/201719/