Re-conceptualizing ASD Within a Dimensional Framework: Positive, Negative, and Cognitive Feature Clusters

Abstract

Introduction of the National Institute of Mental Health’s Research Domain Criteria and revision of diagnostic classification for Autism Spectrum Disorder in the latest diagnostic manual call for a new way of conceptualizing heterogeneous ASD features. We propose a novel conceptualization of ASD, borrowing from the schizophrenia literature in clustering ASD features along positive, negative, and cognitive dimensions. We argue that this dimensional conceptualization can offer improved ability to classify, diagnose, and treat, to apply and predict response to treatment, and to explore underlying neural and genetic alterations that may contribute to particular feature clusters. We suggest the proposed conceptualization can advance the field in a manner that may prove clinically and biologically useful for understanding and addressing heterogeneity within ASD.

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Acknowledgments

This work is funded by grants from the Brain and Behavior Research Foundation NARSAD Young Investigator Award (JHF), Autism Science Foundation Research Mini Enhancement Grant (JHF), NIMH R01 MH107426-01 (JCM), NIMH R01 MH100173 (JCM), NIMH R01 MH100173-02S1 (JCM), Patterson Trust 13-002909 (JCM), NIH DP50D012109-02 (AA), National Alliance for Research on Schizophrenia and Depression Young Investigator Award (AA), and the Yale Center for Clinical Investigation (AA). The authors would like to acknowledge discussions with both clinical and research colleagues, whose thoughts and ideas have been invaluable in developing and refining the conceptualization proposed in this paper.

Author Contributions

JHF and JW initially conceptualized this framework and all authors contributed to its refinement for this manuscript. JHF wrote this manuscript with substantial intellectual contributions and revisions from JM, AA, and JW. All authors have given approval of the final version.

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Correspondence to Jennifer H. Foss-Feig or James C. McPartland.

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Foss-Feig, J.H., McPartland, J.C., Anticevic, A. et al. Re-conceptualizing ASD Within a Dimensional Framework: Positive, Negative, and Cognitive Feature Clusters. J Autism Dev Disord 46, 342–351 (2016). https://doi.org/10.1007/s10803-015-2539-x

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Keywords

  • Autism spectrum disorder
  • Symptoms
  • Heterogeneity
  • Classification
  • Diagnosis
  • RDoC