Pontus,

Do you by "death of the identity" mean that which is the opposite of immortality; that the aspergerians (more than others) tend to believe in immortality?

Best regards,

Christer Svennerlind

Best Humberto,

The more I read your answers, the more i love You :-)

As a father to a ypung man with this diagnosis as well as a scientist it´s hard for me accept this lack of arguments. Not least, considering the personality type often found at Aspergians, that is, for example, the deep need for explanations and in this case arguments. I strongly believe that not many other medical disciplines would accept these way of handling diagnostics.

Until further notice,

Carl Jon Pontus Höglund

Nobody is happy with current nosology in DSM, not even the authors. The direction is more toward getting some sort of classification more similar to other areas of medicine in the mid- and long-term (in the director's comment linked below). All the problems with DSM and discussions about it show two things:

1. We still don't know much about mental health.

2. Acronyms are misleading. DSM was never intended as a handbook of psychiatry. It's a statistical manual. A way to communicate between practitioners, researchers, insurance companies, government, grant agencies etc. DSM categories were never intended as natural kinds like 'cholera' or 'ischemic brain injury'. Unfortunately they keep being taken as such.

http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

Christer,

No, I did not mean that persons diagnosed with Asperger´s syndrome (AS) believe in immortality to a larger extent than others - I guess that my question suffer from vaugeness as usually :-)

What I meant was rather that many of them who I have had the pleasure of getting to know with AS, do explicitly approve of the description of themself as expressed in the criteria for this daignosis.

My main question is though if there are any good arguments for including AS into the Autism Spectrum and thereby closing (at least for the moment) the door for persons to get that diagnosis - if there are any argumets at all (see Humberto´s answer above).

Best regards, Pontus 

Pontus, this paper just came out i just had a quick look at it and I think it is quite relevant.

http://link.springer.com/journal/12152/9/1/page/1

The biggest reason for removing the diagnosis of AS, AD and PDD-NOS was that many studies had shown that HFA/AS probably are more similar than different and that at follow-ups many change diagnosis within the PDD chapter of the DSM-IV. Studies indicated that a single concept of ASD might be better than dividing the ASD group into subgroups.

On the other hand, many with AS do not want to change their diagnostic label to ASD, many studies have shown that many with milder AS or PDD-NOS will not fit within the concept of DSM-5 ASD.

The merging of the former subgroups into a single category of autism spectrum is based on the assumption, that they cannot be reliably differentiated from one another. Using only the DSM-IV-Critera this may be correct but somehow tautological. The DSM-IV-Criteria for Aspergers disorder did not include important aspects of Aspergers original "autistic psychopathy" , the subgroup was only definded as an autistic disorder without developmental delays.

In my daily work as a clinical psychologist the dimensional spectrum approeach is not useful: Nobody will deny that a symptom-spectrum is real-but: Human perception (and diagnosing too) ist differentiation and clustering (remember e.g. the mach-cells to divide a continuum of gray) and i am afraid that the spectrum concept opens the door for everybody tu use his own algorithm for diagnosis ("looks somehow autistic") 

Adam - great clarification!

Could you please add some publications of the latter in your answer (many studies have shown that many with milder AS or PDD-NOS will not fit within the concept of DSM-5 ASD)?!

Pontus

Research and clinical practice in the field of autism suggests that the disorder manifests on a spectrum, ranging from low-severity / high-functioning autism to severe / low-functioning autism. Since Asperger´s syndrome (AS) is a form of low-severity / high functioning autism, it was reasonable to integrate AS into the umbrella term "autism spectrum disorder" (ASD).

This is the official justification for integrating all autism-related diagnoses into a single umbrella term (please follow the link below).

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwijoq2jjvPMAhVBa1IKHVopBSoQFgggMAA&url=http%3A%2F%2Fwww.dsm5.org%2FDocuments%2FAutism%2520Spectrum%2520Disorder%2520Fact%2520Sheet.pdf&usg=AFQjCNHjS9B4BReKN2K-8dJZ-BDfQejx6g&sig2=oZyphFxkRfAsgYmlH3F9zQ

a syndrome is something that needs much more research and lacks the definitive parameters to make a diagnostic. By grouping all these developmental disorders on a spectrum the chance to find the response might increase, but by putting comorbid pathologies into the equasion they also introduced new problems. The classic autism and Asperger syndrome are quite different when it comes to intelligence, coping strategies etc.

I'm afraid a political agenda was at work too.

On the other hand the theory of mind (ToM), the genetic aspects, the extreme male brain and the epigenetic workings are key to the entire spectrum but probably also for ADD, synethesy etc

The diagnostic is already quite reliable, but the finger needs to be put on the brain workings and the dna sequences that cause the brain to function differentely...

The question is also antropological. What is the degree of social disorder and why is it an increasing problem within society, education etc In other words is the society turning genetic diversity into a problem because of social structures etc

Update of my previous post:

The links I posted in the past no longer work. However, this statement by the members of the DSM Neurodevelopmental Disorders Work Group might help shed some light:

"In DSM-5, Asperger‘s disorder, pervasive developmental disorder (not otherwise specified) and childhood disintegrative disorder were 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. The new category is expected to help clinicians more accurately diagnose people with relevant symptoms and behaviors by recognizing the differences from person to person, instead of providing general labels that tend not to be consistently applied across different clinics and centers."

Link to full statement: https://www.psychiatry.org/newsroom/news-releases/commentary-takes-issue-with-criticism-of-new-autism-definition