In 2013, when the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) was released, the entire diagnostic category containing diagnoses such as autism and Asperger’s disorder, formally known as the pervasive developmental disorders, was revamped. The category now used to diagnose individuals with these types of disorders is known as autism spectrum disorder (ASD). Individuals with these types of developmental disorders are grouped under this diagnosis according to a continuum of symptoms ranging from mild to severe. The category of pervasive developmental disorders was dropped, and all of the diagnoses in that category where assumed under the ASD label. All of the individuals once diagnosed with Asperger’s disorder, autism, and other pervasive developmental disorders are now diagnosed under the ASD label and according to the severity of their symptoms. No new diagnoses of Asperger’s disorder are being made since the development of the DSM-5, and individuals who were diagnosed with Asperger’s disorder prior to the DSM – 5 retain their diagnostic label but are treated according to new specifications.
Thus, the information in this article actually applies to a disorder that is no longer being diagnosed and the diagnostic criteria for Asperger’s disorder are now rolled up into the new ASD diagnosis. This article will discuss the conceptualization of Asperger’s disorder from an earlier version of the DSM: the DSM-IV-TR; however, it must be emphasized that this diagnosis is no longer extant.
The reasoning for the change was that new research apparently did not support a separate diagnosis for both Asperger’s disorder and autism spectrum disorders, and there was a lack of continuity in the way these diagnoses were being made. The resulting change in the DSM-5 was designed to reflect the new research findings and to make the diagnostic process more descriptive and more efficient. The DSM-5 does contain another diagnosis, social communication disorder, which contains many of the features of the previous Asperger’s diagnosis. However, it is not the same diagnosis as the Asperger’s syndrome that appears in the earlier editions of the DSM.
It is important to understand that the diagnosis of any psychiatric or psychological disorder can only be made by a trained and licensed mental health professional. The information provided in this article is designed to be used for educational purposes only
According to the DSM-IV-TR, the essential features of Asperger’s syndrome are severe impairment in social interaction and the development of repetitive and restrictive patterns of behavior, interests, and/or activities.
In order to receive a diagnosis of Asperger’s disorder, the individual would need to display the following symptoms:
- Impairment in social interaction, as displayed by at least two of the following:
- Displaying impairment in the use of nonverbal behaviors, including eye contact, body posture, facial expressions and, and other gestures commonly used in social interaction
- Failing to develop relationships with peers that are appropriate to the person’s developmental level
- Lacking spontaneous behaviors, such as seeking to share interests, sharing achievements, sharing enjoyment, etc., with other people
- Lacking social or emotional reciprocity
- Repetitive and stereotyped patterns that include at least one of the following:
- A preoccupation with at least one stereotyped and restrictive pattern of interest that is considered to be out of the ordinary in its intensity or in its concentration
- An inflexible adherence to routines or rituals that have no function
- Repetitive and stereotyped motor behaviors, such as hand flapping, complex body movements, twisting, etc.
- A continuing preoccupation with parts of things as opposed to the whole object
In addition, the individual does not display a significant developmental delay associated with language or in other areas of cognition and/or age-appropriate self-help skills. The person’s behavior results in significant impairment in their functioning at school, in their relationships, or in other areas, and the person’s symptoms are not better explained by some other psychological or psychiatric disorder or a medical condition.
Individuals diagnosed with Asperger’s syndrome displayed a continuum of deficits that ranged from mild to severe. They typically were very preoccupied with very circumscribed interests; however, they lacked a number of other social skills and often appeared to be intrusive when discussing their interests with others. Unlike individuals who were diagnosed with autism, these individuals do not demonstrate severe issues with verbal functioning but display many of the issues with social functioning and the restricted interests that are often seen in autism. Many of these individuals have difficulty functioning without significant assistance, and they often have a number of difficulties in forming appropriate relationships with their peers.
Asperger’s Syndrome and Substance Abuse
Most of the diagnoses in the DSM are associated with a greater risk for the development of substance abuse or substance use disorders; however, Asperger’s syndrome is not associated with a significant risk for the development of substance use disorders. Overall, the research has determined that these individuals do not engage in the types of sensation-seeking behaviors that are associated with substance use disorders. These individuals are not prone to taking substances for their psychoactive effects. The highest proportion of individuals diagnosed with Asperger’s syndrome that show an increased risk for self-stimulation that might manifest as a substance abuse were male subjects who were a bit unruly. However, individuals with this diagnosis are not particularly prone to developing substance use disorders as a group.
These findings are not meant to suggest that no individual who was diagnosed with Asperger’s disorder could develop a substance use disorder; however, the majority of individuals with this diagnosis are not prone to developing substance use disorders. Obviously, there are isolated cases where this does occur.
However, it should be noted that individuals diagnosed with Asperger’s disorder might be more prone to developing other types of addictive behaviors, such as process addictions. For example, individuals with Asperger’s disorder could be at a greater risk to develop compulsive behaviors associated with video games and even gambling if their restricted interests encompass some of the aspects of these types of process addictive behaviors. This type of addictive behavior would be more consistent with the pattern of restricted interests that these individuals display as well as the intensity and focus of these interests, and it would coincide with their overall presentation. In fact, some of the restricted interests that these individuals routinely display are often very similar to the types of compulsive behaviors that occur in process addictions.
Thus, the bottom line is that as a group, individuals diagnosed with Asperger’s syndrome are not at a significantlyincreased risk to develop substance use disorders. There is potential for them to develop other forms of addictive behaviors.