Third, the diagnostic threshold would require endorsement of all

Third, the GDC-0941 concentration diagnostic threshold would require endorsement of all symptom

clusters in the Social/Communicative domain, instead of a longer list of individual symptoms from which an individual must meet a subset. Fourth, to meet criteria for an ASD, two of four symptom clusters in the RBB domain must be endorsed, an increase from the current possibility of meeting criteria for PDD-NOS in the absence of symptoms in the RBB domain. Fifth, the revised diagnostic system adds a universal Inhibitors,research,lifescience,medical onset criterion (ie, symptoms present in “early childhood” though they may not “become fully manifest until social demands exceed limited capacities”) that was previously included only for Autistic Disorder. In addition to these changes to the ASDs, a distinct, Inhibitors,research,lifescience,medical novel diagnosis, Social Communication Disorder (SCD), is proposed for inclusion in DSM-5. 58This disorder, resembling current PDD-NOS without RBBs, would rule out individuals meeting criteria for ASD. It would be defined by pragmatic difficulties and marked problems in the use of verbal and nonverbal communication in naturalistic social contexts. For a diagnosis of SCD, these difficulties would have to impair interpersonal relationships and social comprehension, and would not be explained by more basic language difficulties (ie, deficits in sentence structure, grammar, or general cognitive ability). Deficits in social

Inhibitors,research,lifescience,medical communication would also need to be evaluated as significantly negatively influencing communication, social involvement, academic achievement, or occupational performance. Because these proposed changes alter the symptom profile required to meet diagnostic threshold for an ASD, it is possible that the population of individuals meeting criteria for ASD could change according to Inhibitors,research,lifescience,medical the new criteria. Several studies have examined this possibility by contrasting DSM-TV-TR criteria and proposed DSM-5 criteria in clinic and research samples. Our own research group Inhibitors,research,lifescience,medical re-examined the large data set collected as part of the DSM-IV field

trial.59 We evaluated sensitivity and specificity by creating an algorithm mapping symptom checklists collected during the field trial onto proposed DSM-5 diagnostic criteria. The algorithm suggested that 60.6% of individuals clinically diagnosed with an ASD met revised diagnostic until criteria; 94.9% of individuals without a clinical diagnosis were accurately excluded from the spectrum. Sensitivity varied by diagnostic subgroup such that individuals with milder forms of autism (Asperger’s Disorder = .25; PDD-NOS = .28) were less likely to meet criteria than individuals with classic autism (Autistic Disorder =.76). Individuals with cognitive impairment (IQ <70 = .70) were more likely to meet criteria than individuals with normative intellectual abilities (IQ ≥70 = .46). Similar results were obtained by Mattila and colleagues in a smaller study that relied on a previous version of the proposed criteria.

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