New in DSM-5 is the explicit recognition of the “spectrum" nature of autism, subsuming and replacing the DSM-IV Pervasive Developmental Disorder (PDD) categorical subgroups of “autistic disorder," “Asperger's disorder," “pervasive developmental disorder not otherwise specified," and “childhood disintegrative disorder" into a single umbrella term “Autism Spectrum Disorder" (ASD). Here we reflect on what the revision may mean for research, and for understanding the nature of autism.
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Although this manual is primarily designed for creating a common language for clinical practice, it is also often used in research settings to define the conditions to be studied. While acknowledging concerns about issues such as diagnostic inflation and financial conflicts of interest, DSM-5 is now “set in stone" and will be published in May 2013. The two international psychiatric classification systems (the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases ) remain useful for making clinical diagnoses, but each time these classification systems are revised, the new definitions inevitably subtly change the nature of how the conditions are construed. The biology of autism cannot yet be used diagnostically, and so-like most psychiatric conditions-autism is defined by behavior.