Journal of the American Academy of Child & Adolescent Psychiatry
New researchSensitivity and Specificity of Proposed DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
Section snippets
Method
The data for the analyses in this study were obtained from the multisite field trial of the DSM-IV.28 In the context of the field trial, 977 patients were evaluated for possible PDD. This re-analysis focused on 933 cases, omitting individuals diagnosed with non-autistic PDDs (Rett's disorder, n = 13; childhood disintegrative disorder, n = 16), as well as individuals with missing data required for the present analyses (n = 15). Characteristics of the sample are presented in Table 1. The sample
Results
Sensitivity and specificity for the DSM-5 algorithm are displayed in Table 2, with 95% confidence intervals (CI) displayed in Table 4. Based on DSM-5 diagnostic criteria for ASD, 398 of 657 clinically diagnosed cases (60.6%; 95% CI = 57%–64%) met the proposed criteria for ASD, with 259 cases (39.4%) failing to meet diagnostic threshold. In terms of specificity, the proposed DSM-5 criteria accurately excluded 262 of 276 individuals (94.9%; 95% CI = 92%–97%). Exploratory analyses were conducted
Discussion
The current study examined the impact of the proposed changes to the diagnostic criteria for ASD in DSM-5. We focused on 933 cases referred for evaluation for the presence of a PDD in the DSM-IV field trial. From this sample, we contrasted 657 who had been clinically diagnosed with an ASD and a comparison sample of 276 individuals who received a clinical diagnosis not on the autism spectrum. From 61 individual checklist items rated by these field trial evaluators, we created an algorithm
References (35)
Outcome research in Asperger syndrome and autism
Child Adolesc Psychiatr Clin North Am
(2003)- et al.
The DSM-III-R field trial of pervasive developmental disorders
J Am Acad Child Adolesc Psychiatry
(1990) Brief report: Should Asperger syndrome be excluded from the forthcoming DSM-V?
Res Autism Spect Disord
(2011)- et al.
Autism spectrum disorders in the DSM-V: better or worse than the DSM-IV?
Res Dev Disabil
(2011) Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, United States, 2006
MMWR Surveill Summ
(2009)- et al.
Prevalence of autism spectrum disorders in a total population sample
Am J Psychiatry
(2011) - et al.
The autism epidemic: fact or artifact?
J Am Acad Child Adolesc Psychiatry
(1997) Epidemiological studies of pervasive developmental disorders
Diagnostic and Statistical Manual of Mental Disorders: DSM-IV
(1994)Should the DSM V drop Asperger syndrome?
J Autism Dev Disord
(2010)
Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR
Did Asperger's cases have Asperger disorder?A research note
J Child Psychol Psychiatry
Exploring the boundaries of pervasive developmental disorder not otherwise specified: analyses of data from the DSM-IV Autistic Field Trial
J Autism Dev Disord
Diagnostic and Statistical Manual of Mental Disorders: DSM-III
Resarch diagnostic criteria
Arch Gen Psychiatry
Diagnostic and Statistical Manual of Mental Disorders: DSM-III-R
DSM-IV in progress: autism and the pervasive developmental disorders
Hosp Commun Psychiatry
Cited by (285)
Functional Connectome–Based Predictive Modeling in Autism
2022, Biological PsychiatrySensitivity and specificity of DSM-5 diagnostic criteria for autism spectrum disorder in a child and adolescent sample
2021, Revista de Psiquiatria y Salud MentalClinical presentations of social communication disorder: A case series
2021, Asian Journal of PsychiatryDifferential diagnosis on the autism spectrum: Theorizing an “ordinary autism”
2021, Evolution PsychiatriqueSeeing the forest and the trees: Disentangling autism phenotypes in the age of DSM-5
2021, Development and PsychopathologyWhither Asperger’s Post DSM-5? An Opinion Piece
2024, Review Journal of Autism and Developmental Disorders
This article was reviewed under and accepted by Deputy Editor Douglas K. Novins, MD.
The study was supported by National Institute of Mental Health (NIMH) grants K23MH086785 (JCM) and P50MH081756 (FRV), a National Alliance for Research on Schizophrenia and Depression Atherton Young Investigator Award (JCM), and National Institute of Child Health and Human Development grant P50HD003008 (FRV).
This article is discussed in an editorial by Dr. David H. Skuse on page 344 and in a commentary by Dr. Susan E. Swedo and colleagues on page 347.
Disclosure: Dr. McPartland has received research support from the National Institute of Child Health and Human Development, the Simons Foundation, the National Alliance for Research on Schizophrenia and Depression, and the National Institute of Mental Health. He has received royalties from Guilford Press and Lambert Academic Publishing. He has received lecture honoraria for presentations on autism. Dr. Volkmar has received lecture honoraria for presentations on autism. He receives book royalties from several publishers and serves as the editor of the Journal of Autism and Developmental Disorders. He is also supported by federal grants, including Autism Center of Excellence (P50 MH081756), on which he serves as Principal Investigator. Dr. Reichow has served as a consultant for the Institute of Education Sciences – Small Business Innovation Research. He has received royalties from Springer and Henry Stewart Talks. He has received lecture honoraria for presentations on autism.