A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder
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DOI：
10.1007/s10803-017-3200-7
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发表时间：
2017-09-01
影响因子：
3.9
通讯作者：
Handen, Benjamin L.
中科院分区：
文献类型：
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作者：
Mazurek, Micah O.;Lu, Frances;Handen, Benjamin L.
从DSM-IV到DSM-5的自闭症谱系障碍（ASD）标准的过渡引发了对这些变化的潜在影响的相当大的关注。本研究的目的是解决以前的研究的局限性，通过前瞻性地检查DSM-IV和最终的DSM-5标准的一致性，对439名儿童的自闭症诊断评估的连续样本。一致性和不一致性进行了评估，使用一致的诊断电池。DSM-5标准表现出优异的总体特异性和良好的灵敏度相对于DSM-IV标准。符合DSM-IV标准的儿童对自闭症的敏感性和特异性最强，但对符合DSM-IV标准的儿童对自闭症和广泛性发育障碍的敏感性和特异性较差。高智商、年龄大、女性和不太明显的ASD症状与更大的不一致性相关。
The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.