Confused About the Changes in the DSM-5, and What it Means if Your Child has Asperger’s?
This week, the American Psychiatric Association (APA) announced some of the changes they will be making to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May of 2013; the first major overhaul of the manual since 1994.
While many media outlets have shocked the public into believing the diagnosis of Asperger’s Syndrome was going to be completely eliminated from the DSM-5 with headlines like “Asperger’s syndrome dropped from American Psychiatric Association manual” (cbsnews.com), “Asperger’s syndrome to be dropped from mental disorders manual (DSM-5)” (life.nationalpost.com), and “Asperger’s syndrome dropped from psychiatrists’ handbook the DSM” (guardian.co.uk); the truth is, it is simply being reclassified under the umbrella of autism spectrum disorder.
In a news release, dated March 27, the 13 member panel of the DSM-5 Neurodevelopmental Disorders Work Group proposed “autism, Asperger‘s disorder, pervasive developmental disorder (not otherwise specified) and childhood disintegrative disorder be consolidated within the overarching category of ASD. The change signals how symptoms of these disorders represent a continuum from mild to severe, rather than being distinct disorders.” (dsm5.org) The letter goes on to explain that it should be easier for mental health workers to more consistently apply a diagnosis to a patient across varying clinics.
As for how the new classification of Asperger‘s Syndrome will affect your family, one expert, Dr. Geraldine Dawson, wrote on Autism Speaks’ website, “We are reassured that the DSM-5 committee has stated that all individuals who currently have a diagnosis on the autism spectrum, including those with Asperger syndrome, will be able to retain an ASD diagnosis,” she continues, “This means that no one with a current diagnosis on the autism spectrum should “lose” their diagnosis because of the changes in diagnostic criteria.” (cbsnews.com)
Other changes to the manual will include hoarding disorder, disruptive mood dysregulation disorder (DMDD), excoriation, Major Depressive Disorder, binge eating, Minor Neurocognitive Disorder, and Generalized Anxiety Disorder. I am not certain about you, but the addition of new psychological disorders does not excite me. In a world where we are forever trying to eliminate diseases like cancer, HIV/AIDS, and polio; why are we inventing new illnesses of the mind instead of trying to find a cure?
For example according to Allen Frances, Professor Emeritus, Duke University, normal grief, such as what we would normally expect to suffer over the loss of a loved one, will now be classified as Major Depressive Disorder. (huffingpost.com) Aren’t there times when we need to experience, to feel, to live, and to work through some of the ups and downs of life without receiving a diagnosis from the DSM? Of course you are depressed, Mrs. Smith, your husband of 48 years has just passed; no, you do not need a pill, you need time to grieve.
Then, there is excoriation, a skin-picking disorder. Honestly, to me, this sounds a lot like an obsessive compulsive type disorder. If Asperger’s Syndrome, which sounds considerably more serious, can go under the umbrella of autism spectrum disorder, or ASD; then why can’t excoriation go under the umbrella of OCD as well? For that matter, hoarding sounds like a compulsion, too.
Hoarding, though, is an interesting one; in my family, we have always just called them packrats. We have certainly family members who refuse to part with things, we embrace their quirkiness; somehow, we do not have to elevate it to the level of “mental illness”.
Remember not very long ago, instead of saying your child had ADD (before they changed it to ADHD); you just said he had “ants in his pants” and told him to go outside and play to burn off some energy? Now, it’s take him to therapy and pop another pill.