The new DSM-5 does more than just update the mental disorder map, it seismically shifts the landscape, with ripples that impact treatments, services, insurance, and education. As an example, the new category of Social (Pragmatic) Communication Disorder is a vast unknown to clinicians like me, since I can’t predict how often I’ll see clients with that diagnosis, nor if it will be used extensively to re-diagnose those who no longer fit into other categories. Helen Tager-Flusberg, in the Simons Foundation Autism Research Initiative special report on the DSM- 5, wrote an interesting review of the history of Social (Pragmatic) Communication Disorder from a research perspective, while John Elder Robison, on his Psychology Today blog, takes his straight-forward and practical analysis and discusses the issue that “we need to make a decision about what services will support people with the new diagnosis. Otherwise we risk doing that population a great disservice – giving them a diagnosis that leaves them nowhere, with no indicated services or therapy.”
Simon Baron-Cohen also raises the issue of services for those with SCD, but in general praises the new DSM for its combination of social and communication symptoms into one category, as well as the addition of severity levels and intellectual impairment specifiers for autism. Within the same special report, Ari Ne’eman talks about the advantages of merging Asperger’s, PDD-NOS and Autism Spectrum, and how they could result in more school and Medicaid services for those formerly identified with Asperger’s.
But far beyond these practical matters, are people: individuals, families, couples, from supportive self advocacy groups, like ASAN and GRASP, to parents support groups in so many communities, and even to how a wife thinks about her own husband’s emotional processing. Personal stories will be different, because of the words written in a 947 page book. How will the new DSM-5 impact you?