Roberto Keller - Psychopathology in Adolescents and Adults with Autism Spectrum Disorders

Editor

Roberto Keller

Psychopathology in Adolescents and Adults with Autism Spectrum Disorders

This book is dedicated to persons with autism, to their families who everyday stay with them along the life path, and to professionals who seriously work to improve their quality of life.

Roberto Keller

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a broad phenotype, based on a complex geneticepigenetic interaction. ASD diagnosis is highly stable over the lifetime and has a higher mortality rates, medical and psychiatric disorder comorbidity, and poorer overall outcome compared to general population [].

In accordance with the United Nations Convention on the Rights of Persons with Disabilities and the Charter for Persons with Autism (PWA) adopted by the European Parliament, a right to diagnostic clarification and treatment assistance applies across the entire autistic spectrum, including people with additional intellectual disability [].

In this text, even if we use medical words and a clinical approach, we know that the definition of person with autism (PWA) is the right one. Other Associations prefer the definition autistic person. Anyway, in this context, we are describing complex clinical situation and also severe form of autism with intellectual disability, epilepsy, language disorder, and psychiatric comorbidity, so medical terms are correctly allowed.

The diagnosis of ASD is clinically based on the course of neurodevelopment and the individuals current symptoms [].

Diagnostic criteria are defined in the current diagnostic manuals of the American Psychiatric Association (DSM) [].

ASD in DSM-5 [] is characterized byas first and core criterionpersistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifested by deficits in socialemotional reciprocity, in nonverbal communicative behaviors used for social interaction, and in developing and maintaining relationships.

The second criterion is the presence of restricted, repetitive patterns of behavior, interests, or activities, manifested by at least two of the following: (1) stereotyped or repetitive speech, motor movements, or use of objects; (2) excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (3) highly restricted, fixated interests that are abnormal in intensity or focus; (4) hyper- or hypo-reactivity to sensory inputs or unusual interest in sensory aspects of environment. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities, and together limit and impair everyday functioning).

The DSM-5 defines ASD as a unique cluster of disorders [].

Symptoms must be present in early childhood but may not become fully manifest until social demands exceed limited capacities (approximately age 8 and younger).