Abstract
Although first described in 1944 (the year the description of infantile autism), Asperger’s syndrome attracted little attention until the publication by Lorna Wing in early 1980. Over time, different views of the definition of Asperger’s syndrome developed. By the time of the Third Edition of the American Psychiatric Association’s Diagnostic and Statistical Manual and the Tenth Edition of the World Health Organization’s International Classification of Disease, enough information had accumulated to include the condition within the broader autism category. Asperger’s syndrome remained a focus of research interest and debate until its exclusion in the DSM-5 in 2013. We argue that the decision to remove Asperger’s syndrome 10 years ago as a distinct condition was premature. A discussion of the tensions around defining Asperger’s and concerns now arising due to the lack of this diagnostic category for new cases is provided.
References
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, (4th ed., rev.). American Psychiatric Association.
American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders, (3rd ed.). American Psychiatric Association.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, (4th ed.). American Psychiatric Association.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, (4th ed.). American Psychiatric Association.
Asperger, H. (1944). Die „Autistischen psychopathen” im kindesalter. Archiv Für Psychiatrie Und Nervenkrankheiten, 117(1), 76–136.
Bi, X. A., Chen, J., Sun, Q., Liu, Y., Wang, Y., & Luo, X. (2018). Analysis of asperger syndrome using genetic-evolutionary random support vector machine cluster. Frontiers in Physiology, 9, 1646.
Bishop, D. V. (1989). Autism, Asperger’s syndrome and semantic-pragmatic disorder: Where are the boundaries? British Journal of Disorders of Communication, 24(2), 107–121.
Chiang, H. M., Tsai, L. Y., Cheung, Y. K., Brown, A., & Li, H. (2014). A meta-analysis of differences in IQ profiles between individuals with Asperger’s disorder and high-functioning autism. Journal of Autism and Developmental Disorders, 44, 1577–1596.
Donvan, J., & Zucker, C. (2016). In a different key: The story of autism. Crown Publishers/Random House.
Frith, U. (Ed.). (1991). Autism and Asperger syndrome. Cambridge University Press.
Fusco, G. (2013). Perceptions of the shift in Asperger syndrome nosology in DSM-5 Dissertation. Massachusetts School of Professional Psychology ProQuest Dissertations Publishing, 2013. 3595222.
Galligan, M. G., Feinstein, C., Sulkes, S. S., Bisagno, J. M., & Stein, M. T. (2013). Asperger syndrome and DSM-5: A dilemma for a college freshman. Journal of Developmental & Behavioral Pediatrics, 34(7), 529–532.
Giles, D. C. (2014). ‘DSM-V is taking away our identity’: The reaction of the online community to the proposed changes in the diagnosis of Asperger’s disorder. Health, 18(2), 179–195.
Gonzalez-Penas, J., Costas, J. C., Garcia-Alcon, A., Penzol, M. J., Rodriguez, J., Rodriguez-Fontenla, C., et al. (2020). Psychiatric comorbidities in Asperger syndrome are related with polygenic overlap and differ from other Autism subtypes. [Research Support, Non-U.S. Gov’t]. Transl Psychiatry Psychiatry, 10(1), 258. https://doi.org/10.1038/s41398-020-00939-7
Happé, F. (1991). The autobiographical writings of three Asperger syndrome adults: Problems of interpretation and implications for theory. Autism and Asperger syndrome (pp. 207–242). Cambridge University Press; US.
Hartwell, M., Keener, A., Coffey, S., Chesher, T., Torgerson, T., & Vassar, M. (2020). Brief report: Public awareness of Asperger syndrome following Greta Thunberg appearances. Journal of Autism & Developmental Disorders, 18, 18. https://doi.org/10.1007/s10803-020-04651-9
Hasegawa, C., Kikuchi, M., Yoshimura, Y., Hiraishi, H., Munesue, T., Nakatani, H., Higashida, H., Asada, M., Oi, M., Minabe, Y. (2015). Broader autism phenotype in mothers predicts social responsiveness in young children with autism spectrum disorders. Psychiatry and Clinical Neurosciences, 69(3), 136–144.
Hosseini, S. A., & Molla, M. (2020). Asperger Syndrome. In StatPearls. StatPearls Publishing.
Ingersoll, B., & Wainer, A. (2014). The broader autism phenotype. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelphrey (Eds.) Handbook of autism and pervasive developmental disorders, Volume 1: Diagnosis, development, and brain mechanisms (4th ed., pp. 28–56). John Wiley & Sons Inc.
Kamand, M., Ilieva, M., Louise Forsberg, S., Thomassen, M., Meyer, M., Fex Svenningsen, Å., & Maria Michel, T. (2020). Derivation of induced pluripotent stem cells (SDUKIi003-A) from a 20-year-old male patient diagnosed with Asperger syndrome. Stem Cell Res 48, 101974. https://doi.org/10.1016/j.scr.2020.101974
Kamp-Becker, I., Stroth, S., Stehr, T., & Weber, L. (2020). Blessing or curse? The World Wide Web as information source for autism and Asperger Syndrome. Zeitschrift Fur Kinder-Und Jugendpsychiatrie Und Psychotherapie, 48(2), 133–143. https://doi.org/10.1024/1422-4917/a000693
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2(3), 217–250.
Khanzada, N. S., Butler, M. G., & Manzardo, A. M. (2017). GeneAnalytics pathway analysis and genetic overlap among autism spectrum disorder, bipolar disorder and schizophrenia. International Journal of Molecular Sciences, 18(3), 527.
Klin, A., Volkmar, F. R., Sparrow, S. S., Cicchetti, D. V., & Rourke, B. P. (1995). Validity and neuropsychological characterization of Asperger syndrome: Convergence with nonverbal learning disabilities syndrome. Journal of Child Psychology and Psychiatry, 36(7), 1127–1140.
Klin, A., Sparrow, S. S., Marans, W. D., Carter, A., & Volkmar, F. R. (2000). Assessment issues in children and adolescents with Asperger syndrome. In A. Klin & F. R. Volkmar (Eds.), Asperger syndrome (pp. 309–339). The Guilford Press.
Klin, A., Pauls, D., Schultz, R., & Volkmar, F. (2005). Three diagnostic approaches to Asperger syndrome: Implications for research. Journal of Autism and Developmental Disorders, 35, 221–234.
Klin, A., & Volkmar, F. R. (2000). Treatment and intervention guidelines for individuals with Asperger syndrome. In A. Klin, F.R. Volkmar, S. Sparrow (Eds) Asperger syndrome (pp. 340–366). Guilford Publishers.
Lin, I. C., Tseng, L. Y., & Lee, Y. T. (2020). Post-traumatic stress disorder in an adolescent with Asperger syndrome. [Case Reports]. Psychiatria Danubina, 32(3–4), 436–437, https://doi.org/10.24869/psyd.2020.436.
Linton, K. F., Krcek, T. E., Sensui, L. M., & Spillers, J. L. (2014). Opinions of people who self-identify with autism and Asperger’s on DSM-5 criteria. Research on Social Work Practice, 24(1), 67–77.
Lovisetto, F., Guala, A., Facciotto, G., & Zonta, S. (2020). COVID-19 and psychiatric illness: Rectal foreign bodies (30 stylus batteries) in a young male patient affected by Asperger syndrome. [Case Reports]. Journal of Surgical Case Reports, 2020(10), rjaa345, https://doi.org/10.1093/jscr/rjaa345.
Maddox, B. B., Miyazaki, Y., & White, S. W. (2017). Long-term effects of CBT on social impairment in adolescents with ASD. Journal of Autism and Developmental Disorders, 47, 3872–3882.
Mayes, S. D., Calhoun, S. L., & Crites, D. L. (2001). Does DSM-IV Asperger’s disorder exist? Non-significance of early speech delay in children with autism and normal intelligence and implications for DSM-IV Asperger’s disorder. Journal of Abnormal Child Psychology, 29(3), 263–271.
McPartland, J. C., Reichow, B., & Volkmar, F. R. (2012). Sensitivity and specificity of proposed DSM-5 diagnostic criteria for autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 51(4), 368–383.
Miller, J. N., & Ozonoff, S. (1997). Did Asperger’s cases have Asperger disorder? A research note. Journal of Child Psychology and Psychiatry, 38(2), 247–251.
Nieminen-von Wendt, T., Metsähonkala, L., Kulomäki, T., Aalto, S., Autti, T., Vanhala, R., & Von Wendt, L. (2003). Changes in cerebral blood flow in Asperger syndrome during theory of mind tasks presented by the auditory route. European Child & Adolescent Psychiatry, 12, 178–189.
Nilsson, M., Handest, P., Carlsson, J., Nylander, L., Pedersen, L., Mortensen, E. L., et al. (2020b). Well-being and self-disorders in schizotypal disorder and Asperger syndrome/autism spectrum disorder. Journal of Nervous & Mental Disease, 208(5), 418–423. https://doi.org/10.1097/NMD.0000000000001145
Nilsson, M., Arnfred, S., Carlsson, J., Nylander, L., Pedersen, L., Mortensen, E. L., & Arnfred, S. (2020a). Self-disorders in Asperger syndrome compared to schizotypal disorder: A clinical study. [Research Support, Non-U.S. Gov't]. Schizophrenia Bulletin, 46(1), 121–129, https://doi.org/10.1093/schbul/sbz036.
Research Support, Non-U.S. Gov't]. Stem Cell Research, 48, 101974, https://doi.org/10.1016/j.scr.2020.101974.
Nunez-Gomez, P., Alvarez-Ruiz, A., Ortega-Mohedano, F., & Alvarez-Flores, E. P. (2020). Neuromarketing highlights in how Asperger syndrome youth perceive advertising. Frontiers in Psychology, 11, 2103. https://doi.org/10.3389/fpsyg.2020.02103
Ohan, J. L., Ellefson, S. E., & Corrigan, P. W. (2015). Brief report: The impact of changing from DSM-IV ‘Asperger’s’ to DSM-5 ‘autistic spectrum disorder’ diagnostic labels on stigma and treatment attitudes. Journal of Autism and Developmental Disorders, 45, 3384–3389.
Parellada, M. (2020). What does the future hold for Asperger syndrome? Revista De Psiquiatria y Salud Mental, 13(3), 115–117. https://doi.org/10.1016/j.rpsm.2019.05.002
Picot, M. C., Michelon, C., Bertet, H., Pernon, E., Fiard, D., Coutelle, R., et al. (2020). The French version of the revised ritvo autism and Asperger diagnostic scale: A psychometric validation and diagnostic accuracy study. Journal of Autism & Developmental Disorders, 29, 29. https://doi.org/10.1007/s10803-020-04518-z
Pisula, E., & Ziegart-Sadowska, K. (2015). Broader autism phenotype in siblings of children with ASD—A review. International Journal of Molecular Sciences, 16(6), 13217–13258.
American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders, (3rd ed., rev.). Washington, DC.
Rank, B., & Macnaughton, D. (1950). A clinical contribution to early ego development. The Psychoanalytic Study of the Child, 5(1), 53–65.
Rosen, N. E., Lord, C., & Volkmar, F. R. (2021). The diagnosis of autism: From Kanner to DSM-III to DSM-5 and beyond. Journal of Autism and Developmental Disorders, 51, 4253–4270.
Rourke, B. P. (1988). The syndrome of nonverbal learning disabilities: Developmental manifestations in neurological disease, disorder, and dysfunction. The Clinical Neuropsychologist, 2(4), 293–330.
Rutter, M., & Thapar, A. (2014). Genetics of autism spectrum disorders. In F.R. Volkmar et al. (Eds.), Handbook of autism and pervasive developmental disorders, Volume 1: Diagnosis, development, and brain mechanisms (pp. 112–128). John Wiley & Sons Inc; US: Hoboken, NJ.
Sandson, T. A., Manoach, D. S., Price, B. H., Rentz, D., & Weintraub, S. (1994). Right hemisphere learning disability associated with left hemisphere dysfunction: Anomalous dominance and development. Journal of Neurology, Neurosurgery & Psychiatry, 57(9), 1129–1132.
Scarpa, A., White, S. W., & Attwood, T. (Eds.). (2013). CBT for children and adolescents with high-functioning autism spectrum disorders. Guilford Press.
Smith, O., & Jones, S. C. (2020). ‘Coming out’ with autism: Identity in people with an Asperger’s diagnosis after DSM-5. Journal of Autism and Developmental Disorders, 50, 592–602.
Spillers, J. L., Sensui, L. M., & Linton, K. F. (2014). Concerns about identity and services among people with autism and Asperger’s regarding DSM–5 changes. Journal of Social Work in Disability & Rehabilitation, 13(3), 247–260.
Szatmari, P. (1991). Asperger’s syndrome: Diagnosis, treatment, and outcome. Psychiatric Clinics of North America, 14(1), 81–93.
Szatmari, P., Bartolucci, G., Finlayson, A., & Krames, L. (1986). A vote for Asperger’s syndrome. Journal of Autism and Developmental Disorders, 16(4), 515–518.
Topal, Z., Demir Samurcu, N., Taskiran, S., Tufan, A. E., & Semerci, B. (2018). Social communication disorder: A narrative review on current insights. Neuropsychiatric Disease and Treatment, 14, 2039–2046. https://doi.org/10.2147/ndt.S121124
Tsai, L. Y., & Ghaziuddin, M. (2014). DSM-5 ASD moves forward into the past. Journal of Autism and Developmental Disorders, 44, 321–330.
Vaquerizo-Serrano, J., De Pablo, G. S., Singh, J., & Santosh, P. (2022). Catatonia in autism spectrum disorders: A systematic review and meta-analysis. European Psychiatry, 65(1), e4.
Volkmar, F. R., Klin, A., & McPartland, J. C. (2014). Asperger syndrome: An overview. Asperger syndrome: Assessing and treating high-functioning autism spectrum disorders (2nd ed., pp. 1–42). Guilford Press; US.
Volkmar, F. R., Woodbury-Smith, M., Macari, S. L., & Øien, R. A. (2021). Seeing the forest and the trees: Disentangling autism phenotypes in the age of DSM-5. Development and Psychopathology, 33(2), 625–633.
Volkmar, F. R., Klin, A., Siegel, B., Szatmari, P., Lord, C., Campbell, M., ... & Towbin, K. (1994). Field trial for autistic disorder in DSM-IV. The American Journal of Psychiatry, 151(9), 1361–1367.
Weintraub, S., & Mesulam, M. M. (1983). Developmental learning disabilities of the right hemisphere: Emotional, interpersonal, and cognitive components. Archives of Neurology, 40(8), 463–468.
Wing, L. (1981). Asperger’s syndrome: A clinical account. Psychological Medicine, 11(1), 115–129.
Wolff, S. (1995). Loners: The life path of unusual children. Routledge.
Woodbury-Smith, M., Klin, A., & Volkmar, F. (2005). Asperger’s syndrome: A comparison of clinical diagnoses and those made according to the ICD-10 and DSM-IV. Journal of Autism & Developmental Disorders, 35(2), 235–240.
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. World Health Organization.
Yuen, R. K., Szatmari, P., & Vorstman, J. A. (2019). Genetics of autism spectrum. In F. R. Volkmar (Ed.), Autism and pervasive developmental disorders (pp. 112–128). Cambridge University Press.
Acknowledgements
The authors thank Drs. Nancy Moss and Lisa Wiesner for their comments on an earlier version of this paper.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Volkmar, F.R., Woodbury-Smith, M. Whither Asperger’s Post DSM-5? An Opinion Piece. Rev J Autism Dev Disord (2024). https://doi.org/10.1007/s40489-023-00425-y
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40489-023-00425-y