Abstract
One of the central aims of autism research is to identify specific neurodevelopmental mechanisms that cause and explain the visible autistic signs and symptoms. In this short paper, I argue that the persistent search for autism-specific pathophysiologies has two fundamental difficulties. The first regards the growing gap between basic autism science and clinical practice. The second regards the difficulties with demarcating autism as a psychiatric condition. Instead of the unremitting search for the neurobiological basis of autism, I suggest that basic autism research should focus on experiences of impairment and distress, and on how these experiences relate to particular (autistic) behaviors in particular circumstances, regardless of whether we are dealing with an autism diagnosis or not.
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Notes
Of course, specific cases of autism need to be demarcated in some way. In clinical practice, this is done with DSM criteria including the criterion of clinical significance. That is, symptoms must cause clinically significant distress or impairment in social or occupational functioning. However, as the definition of mental disorder in DSM-5 (APA 2013) illustrates, distress and impairment in mental disorder are secondary and need to be caused by biological or psychological dysfunctions. The clinical significance criterion is seen as a currently necessary but imprecise and unscientific threshold for mental disorders.
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Verhoeff, B. Fundamental challenges for autism research: the science–practice gap, demarcating autism and the unsuccessful search for the neurobiological basis of autism. Med Health Care and Philos 18, 443–447 (2015). https://doi.org/10.1007/s11019-015-9636-7
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DOI: https://doi.org/10.1007/s11019-015-9636-7