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How well are DSM-5 diagnostic criteria for ASD represented in standardized diagnostic instruments?

Evers, Kris, Maljaars, Jarymke, Carrington, Sarah J., Carter, Alice S., Happé, Francesca, Steyaert, Jean, Leekam, Susan and Noens, Ilse 2021. How well are DSM-5 diagnostic criteria for ASD represented in standardized diagnostic instruments? European Child and Adolescent Psychiatry 30 , pp. 75-87. 10.1007/s00787-020-01481-z

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Five years after the publication of DSM-5 in 2013, three widely used diagnostic instruments have published algorithms designed to represent its (sub-)criteria for Autism Spectrum Disorder (ASD) in children and adolescents. This study aimed to: (1) establish the content validity of these three DSM-5-adapted algorithms, and (2) identify problems with the operationalization of DSM-5 diagnostic criteria in measurable and observable behaviors. Algorithm items of the Autism Diagnostic Observation Schedule—Second Edition (ADOS-2), Developmental, Dimensional and Diagnostic Interview (3di) and Diagnostic Interview for Social and Communication Disorders—11th edition (DISCO-11) were mapped onto DSM-5 sub-criteria. The development and decision-making rules integrated in their algorithms were then compared with DSM-5. Results demonstrated significant variability in the number and nature of sub-criteria covered by the ADOS-2, 3di and DISCO-11. In addition to differences in the development of algorithms and cut-off scores, instruments also differed in the extent to which they follow DSM-5 decision-making rules for diagnostic classification. We conclude that such differences in interpretation of DSM-5 criteria provide a challenge for symptom operationalization which will be most effectively overcome by consensus, testing and reformulation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Publisher: Springer Verlag
ISSN: 1018-8827
Date of First Compliant Deposit: 25 February 2020
Date of Acceptance: 22 January 2020
Last Modified: 05 Mar 2021 13:19

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