Tuesday, April 22, 2008

Rediagnosis ‘increases’ autism – most ‘autistic’ children probably have THIS or similar

The “this”? Schizoid personality disorder. It’s been a recognized personality disorder diagnosis for decades.

In the DSM-III, the previous version to the current one of the American Psychiatric Organization’s “bible,” you can also see the diagnosis of schizoid disorder of childhood. (PDF of entire DSM-III.) In fact, different websites note this phrase was once used for Asperger’s syndrome.

And, here’s what DSM-III had as diagnostic criteria:

Diagnostic criteria for Schizoid Disorder of Childhood or Adolescence
A. No close friend of similar age other than a relative or a similarly socially isolated child.
B. No apparent interest in making friends.
C. No pleasure from usual peer interactions.
D. General avoidance of nonfamilial social contacts, especially with peers.
E. No interest in activities that involve other children {such as team sports, clubs).
F. Duration of the disturbance of at least three months.
G. Not due to Pervasive Developmental Disorder; Conduct Disorder, Undersocialized, Nonaggressive; or any psychotic disorder, such as Schizophrenia,
H. If 18 or older, does not meet the criteria for Schizoid Personality Disorder.

So, we have a “relabeling” from DSM-III to DSM-IV on Asperger’s, which may easily be misdiagnosed as full-blown autism, and people claim there’s an epidemic, then start blaming vaccines, promoting alternative medicine, etc.

Going by what you can find around the web about adult-manifest SPD, I offer these insights

Causes? Unknown but likely multivalent. A relative with schizophrenia increases the likelihood for SPD, which indicates some genetic background. Environmental factors are likely involved. The time crunch of modern parenting may be a factor.

I will certainly venture that the increased genetic fragility of more and more women having later-life pregnancies is an issue. There may also be genetic fragility issues, or uterine stress issues, with test-tube conception.

And, without being too Freudian, other parenting and home-life issues may be contributory in many cases. (SPD may be a likely development of child abuse, too.)

Treatment? Talk therapy. Of course, schizoids are loners, so it’s tough to get them to stay in too long in one-on-one therapy. In group therapy, they may simply let others talk more and stay silent.

Medications are not indicated unless other mental health issues are also involved.