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Journal of Autism and Developmental Disorders

, Volume 22, Issue 4, pp 507–523 | Cite as

A review of the DSM-III-R criteria for autistic disorder

  • Peter Szatmari
Article

Abstract

The objective of this paper is to review the psychometric properties of the new DSM-III-R criteria for autism. Five data sets were evaluated according to a set of methodological criteria. The results indicate that the DSM-III-R criteria for autistic disorder have, on average, very good sensitivity, but much lower specificity. The implications of this are (a) greater numbers of children diagnosed as autistic; (b) greater numbers of children misdiagnosed as autistic; and (c) greater heterogeneity among samples of autistic children. In essence, the DSM-III-R criteria act more like screening tests than diagnostic criteria. Conceptual and methodologic issues in the evaluation of diagnostic criteria are discussed.

Keywords

Psychometric Property Screen Test Good Sensitivity Methodologic Issue Lower Specificity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. American Psychiatric Association. (1980).Diagnostic and statistical manual of mental disorders (3rd. ed.). Washington, DC: Author.Google Scholar
  2. American Psychiatric Association. (1987).Diagnostic and statistical manual of mental disorders (3rd. ed., Rev.). Washington, DC: Author.Google Scholar
  3. Bender, L. (1947). Childhood schizophrenia: Clinical study of one hundred schizophrenic children.American Journal of Orthopsychiatry, 17, 40–56.Google Scholar
  4. Boyle, M. H., Offord, D. R., Racine, Y., Fleming, J. E., Szatmari, P., & Sanford, M. (1992). Evaluation of the revised Ontario Child Health Study Scales.Journal of Child Psychology and Psychiatry (In press).Google Scholar
  5. Brunshaw, J. M., & Szatmari, P. (1988). The agreement between behavior checklists and structured psychiatric interviews for children.Canadian Journal of Psychiatry, 33, 474–481.Google Scholar
  6. Cicchetti, D. V., & Sparrow, S. S. (1981). Developing criteria for establishing interrater reliability of specific items. Application to assessment of adaptive behavior.American Journal of Mental Deficiency Research, 8, 127–137.Google Scholar
  7. Creak, M. (1961). Schizophrenia syndrome in children: Progress report of a working party.Cerebral Palsy Bulletin, 3, 501–504.Google Scholar
  8. Denckla, M. B. (1986). New diagnostic criteria for autism and behavioral disorders: Guidelines for research protocols.Journal of the American Academy of Child and Adolescent Psychiatry, 25, 221–224.Google Scholar
  9. Factor, D. C., Freeman, N. L., & Kardash, A. (1989). Brief report: A comparison of DSM-III and DSM-III-R criteria for autism.Journal of Autism and Developmental Disorders, 19, 637–640.Google Scholar
  10. Feinstein, A. R. (1977). A critical overview of diagnosis in psychiatry. In V. Rakoff, H. C. Stancer, & H. B. Kedrand (Eds.),Psychiatric Diagnosis. New York; Brunner-Mazel.Google Scholar
  11. Galen, R. S., & Gambino, S. R. (1975).Beyond normality: The predictive value and efficiency of medical diagnoses. New York; Wiley.Google Scholar
  12. Hertzig, M., Snow, M. E., New, E., & Shapiro, T. (1989). DSM-III and DSM-III-R: Diagnosis of autism and PDD in nursery school children.Journal of the American Academy of Child and Adolescent Psychiatry, 29, 123–136.Google Scholar
  13. Kanner, L. (1943). Autistic disturbances of affective contact.Nervous Child, 2, 217–250.Google Scholar
  14. Ritvo, E. R., & Freeman, B. J. (1977). National Autistic Society definition of the syndrome of autism.Journal of Pediatric Psychology, 2, 146–148.Google Scholar
  15. Robins, L. H. (1985). Epidemiology: Reflections on testing the validity of psychiatric interviews.Archives of General Psychiatry, 42, 918–929.Google Scholar
  16. Rutter, M. (1978). Diagnosis and definition. In M. Rutter & E. Schopler (Eds.),Autism: A reappraisal of concepts and treatment. New York: Plenum Press.Google Scholar
  17. Sackett, D. L., Haynes, R. B., & Tugwell, P. (1985). The interpretation of diagnostic data. InClinical epidemiology: A basic science for medicine. Toronto: Little, Brown.Google Scholar
  18. Shrout, P. E., & Fleiss, J. L. (1981). Reliability and case detection. In J. K. Wing, P. Bebbington, & L. N. Robins (Eds.),What is a case? London: Grant McIntyre.Google Scholar
  19. Siegel, B., Vukicevic, J., Elliott, G. R., & Kraemer, H. C. (1989). The use of signal detection theory to assess DSM-III-R criteria for autistic disorder.Journal of the American Academy of Child and Adolescent Psychiatry, 28, 542–548.Google Scholar
  20. Spitzer, R. L., & Siegel, B. (1990). The DSM-III-R field trial of pervasive developmental disorders.Journal of the American Academy of Child and Adolescent Psychiatry, 29, 855–862.Google Scholar
  21. Spitznagel, E. L., & Helzer, J. E. (1985). A proposed solution to the base rate problem in the kappa statistic.Archives of General Psychiatry, 42, 725–728.Google Scholar
  22. Szatmari, P. (1989, October).Differential diagnosis of Asperger syndrome and autistic disorder using DSM-III-R. Paper presented at the meeting of the American Academy of Child and Adolescent Psychiatry, New York.Google Scholar
  23. Szatmari, P. (1992). The validity of autistic spectrum disorders: A literature review.Journal of Autism and Developmental Disorders, 22, 583–600.Google Scholar
  24. Volkmar, F., Cohen, D. J., & Paul, R. (1986). An evaluation of DSM-III criteria for infantile autism.Journal of the American Academy of Child Psychiatry, 25, 190–197.Google Scholar
  25. Volkmar, F. R., Bregman, J., Cohen, D. J., & Cicchetti, D. V. (1988). DSM-III and DSM-III-R diagnoses of autism.American Journal of Psychiatry, 145, 1404–1408.Google Scholar
  26. Walter, S. D., & Irwig, L. M. (1988). Estimation of test error rates, disease prevalence and relative risk from misclassified data: A review.Journal of Clinical Epidemiology, 41, 923–937.Google Scholar
  27. Waterhouse, L., Wing, L., Spitzer, R., & Siegel, B. (1992). Pervasive developmental disorders. From DSM-III to DSM-III-R. Journal of Autism and Developmental Disorders, 22, 525–549.Google Scholar
  28. World Health Organization. (1978). InMental disorders: Glossary and guide to their classification in accordance with the ninth revision of the international classification of diseases. Geneva: Author.Google Scholar

Copyright information

© Plenum Publishing Corporation 1992

Authors and Affiliations

  • Peter Szatmari
    • 1
  1. 1.Department of PsychiatryMcMaster University, Patterson Building, Chedoke-McMaster HospitalsHamiltonCanada

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