Brief report: Thought disorder in asperger syndrome: Comparison with high-functioning autism (original) (raw)

Three Diagnostic Approaches to Asperger Syndrome: Implications for Research

Journal of Autism and Developmental Disorders, 2005

Objective: To examine the implications for research of the use of three alternative definitions for Asperger syndrome (AS). Differences across the three nosologic systems were examined in terms of diagnostic assignment, IQ profiles, comorbid symptoms, and familial aggregation of social and other psychiatric symptoms. Method: Standard data on diagnosis, intellectual functioning, comorbidity patterns, and family history were obtained on 65 individuals screened for a very high probability of having autism without mental retardation (or higher functioning autism, HFA) or AS. Diagnoses of AS were established based on three different approaches: DSM-IV, presence/absence of communicative phrase speech by 3 years, and a system designed to highlight prototypical features of AS. Results: Agreement between the three diagnostic systems was poor. AS could be differentiated from HFA (but not from PDD-NOS) on the basis of IQ profiles in two of the three systems. Differences in patterns of comorbid symptomatology were obtained in two of the three systems, although differences were primarily driven by the PDD-NOS category. Only one of the approaches yielded differences relative to aggregation of the ''broader phenotype'' in family members. Conclusions: Diagnostic assignments of AS based on three commonly used approaches have low agreement and lead to different results in comparisons of IQ profiles, patterns of comorbidity, and familial aggregation of psychiatric symptoms across the approach-specific resultant groups of HFA, AS, and PDD-NOS.

Behavioral, Cognitive and Neural Markers of Asperger Syndrome

Asperger syndrome (AS) is a subtype of Autism Spectrum Disorder (ASD) characterized by major problems in social and nonverbal communication, together with limited and repetitive forms of behavior and interests. The linguistic and cognitive development in AS is preserved which help us to differentiate it from other subtypes of ASD. However, significant effects of AS on cognitive abilities and brain functions still need to be researched. Although a clear cut pathology for Asperger has not been identified yet, recent studies have largely focused on brain imaging techniques to investigate AS. In this regard, we carried out a systematic review on behavioral, cognitive, and neural markers (specifically using MRI and fMRI) studies on AS. In this paper, behavior, motor skills and language capabilities of individuals with Asperger are compared to those in healthy controls. In addition, common findings across MRI and fMRI based studies associated with behavior and cognitive disabilities are highlighted.

The investigation and differential diagnosis of Asperger syndrome in adults

Deutsches Ärzteblatt international, 2013

As a result of the increased public interest in autism spectrum disorders (ASD), certain core manifestations of ASD--impaired social interaction and communication, bizarre interests--are now commonly recognized as being typical of autism, not only in children, but in adults as well. More often than before, general practitioners, neurologists, and psychiatrists find themselves being asked whether a patient is suffering from previously unrecognized Asperger syndrome (AS). The prevalence of ASD is estimated at 1%, and the ratio of diagnosed to undiagnosed cases at about 3:2. Little is known about the diagnostic evaluation of AS in adulthood. We selectively searched the Medline database for pertinent literature, paying special attention to diagnostic manuals and to the guideline of the United Kingdom's National Institute for Health and Care Excellence (NICE). Centrally important aspects of the diagnosis of AS include an assessment of the patient's ability to assume the emotional...

Neuropsychological aspects of Asperger Syndrome in adults: a review

Neuropsychological Trends

Despite distinctive clinical characteristics, Asperger Syndrome (AS) is actually included in the broad spectrum of Autism Spectrum Disorder. Usually, to evaluate AS in adulthood, diagnostic tools are referred to autistic traits; furthermore, AS' neuropsychological profile features are still unclear. The aim of the present review is to shed light on the cognitive characteristics of adults with AS. Limited number of studies have investigated the neuropsychological profile of adults with AS: individuals with AS have intellectual abilities in the normal range and show strengths in verbal memory, inhibitory control and decision making. Disagreement exists about the presence of deficits in attentional functions, visual-spatial memory, cognitive flexibility, planning and verbal fluency. The present work underlines the need for a neuropsychological assessment in order to delineate the cognitive profile of adults with AS, which could help in the diagnosis of AS in adulthood and to design rehabilitative protocols.

Defining the Behavioral Phenotype of Asperger Syndrome

Journal of Autism and Developmental Disorders, 2008

Asperger syndrome (AS) is characterized by social deficits and restricted interests in the absence of mental retardation and language delay. However, it is unclear to what extent the social deficits of AS differ from those of traditional autism. To address this issue, 58 subjects with AS were compared with 39 subjects with autism. Social deficits were classified according to Wing and Gould's method. Forty-six (79%) subjects with AS were rated as active but odd, while 32 (82%) with autism were described as aloof and passive, while a few subjects showed mixed features. Thus, despite the overlap between AS and autism, subjects with AS showed a distinct pattern of social impairment. Implications of these findings are discussed.

Diagnosis and differential diagnosis of Asperger’s syndrome

The DSM–IV diagnosis is based on impairment of social interaction and the presence of stereo-typical or repetitive behaviours (Box 2). Diagnosis requires that the impairment is clinically significant, occurs before 3 years of age and excludes clinically significant delay in language, cognition or other skills. The ICD–10 research criteria (World Health Organization, 1993) are virtually identical. By excluding speech and language difficulties, the DSM definition of Asperger disorder is narrower than Asperger syndrome as defined by Wing or Gillberg and would exclude some of the original cases described by Hans Asperger. As the vast majority of persons with Asperger disorder/syn-drome do have speech and language abnormalities it was hoped that future text revisions of DSM–IV might correct this anomaly. Indeed, the recent DSM– IV–TR guides that the occurrence of " no clinically significant delays in language does not imply that individuals with Asperger Disorder have no problems with communication " (American Psychi-atric Association, 2000, p. 80). Examples given include unusual verbosity or subtle abnormalities of social communication (such as turn-taking in con-versation). We feel that DSM–IV–TR draws attention to the issue, but underestimates the language difficulty involved. This paper examines the differ-ential diagnosis of Asperger syndrome (Wing, 1981) and disorder (American Psychiatric Association, 1994), beginning with the more common and finish with the less common causes of diagnostic confusion. Differential diagnosis Other pervasive developmental disorders (PDD) Autism/autism spectrum disorders (DSM–IV) Autism shares the same DSM criteria for abnormal social interaction and behaviour as Asperger disorder, but requires additional impairments in communication (Box 3). Delay or impairment in social interaction, communication or behaviour must arise before age 3 years. In DSM–IV, if both autism and Asperger disorder diagnoses can be made, the autism diagnosis takes precedence. Unlike Asperger disorder (which excludes individuals with delays in cognitive abilities or other skills), autism can occur at all levels of ability: the majority (70%) of cases have associated learning disabilities and almost half have an IQ below 50. In a prevalence study of autism, Wing & Gould (1979) identified a large number of children who failed to meet the diagnostic criteria for classic autism, but had a triad of impairments involving social interaction, communication and imagination, with additional repetitive stereotyped activities. This triad of symptoms, termed the 'autistic spectrum', was recognised at all levels of intelligence and is included in DSM–IV as 'pervasive developmental Box 2 DSM–IV criteria for the diagnosis of Asperger disorder

Clinical characteristics of adults with Asperger's Syndrome assessed with self-report questionnaires

Research in Autism Spectrum Disorders, 2011

and the International Classification of Diseases (ICD-10; World Health Organization, 1993), Asperger's Syndrome (AS) is a subtype of autism spectrum disorders (ASD) or pervasive developmental disorders and is defined as a syndrome in which the individuals meet the criteria for autism but have no history of cognitive or language delay. Language delay is defined as not using single words by the age of 2 years or phrase speech by the age of 3 years. An epidemiologic study estimated that the population prevalence of AS is 0.7% (Ehlers & Gillberg, 1993). Adults with AS sometimes show an intense preoccupation and elaborate internal life around a particular area of interest. They also show repetitive maladaptive behaviors, stereotyped

Strategies for assessing Asperger's syndrome: A critical review of data based methods

Research in Autism Spectrum Disorders, 2008

Asperger's syndrome has gained tremendous recognition and popularity in the last 20 years. However, controversy around the nature of the disorder, whether it is distinct from high functioning autism, and whether it can be reliably and validly diagnosed has continued throughout this period unabated. Fortunately, there has been a strong tradition of developing systematic data based methods of differential diagnosis in the autism spectrum disorders. The bulk of the effort has been in autism, but there has been moderate, yet consistent efforts to develop data based methods to diagnose Asperger's syndrome as well. The present paper provides an up to date critical review of the existing literature on the topic. Strengths, weaknesses of the research, and avenues for future efforts are discussed. #

The adult Asperger assessment (AAA): A diagnostic method

2005

At the present time there are a large number of adults who have suspected Asperger syndrome (AS). In this paper we describe a new instrument, the Adult Asperger Assessment (AAA), developed in our clinic for adults with AS. The need for a new instrument relevant to the diagnosis of AS in adulthood arises because existing instruments are designed for use with children. Properties of the AAA include (1) being electronic, data-based, and computerscorable; (2) linking with two screening instruments [the Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ)]; and (3) employing a more stringent set of diagnostic criteria than DSM-IV, in order to avoid false positives. The AAA is described, and its use with a series of n = 42 clinic-patients is reported. Thirty-seven of these (88%) met DSM-IV criteria, but only 34 of these (80%) met AAA criteria. The AAA is therefore more conservative than DSM-IV.

Aspergers Disorder: High Functioning Austism, Distinct Disorder or Social Construct

First described in a German paper in 1944, Hans Asperger’s account of an autistic psychopathy was only translated and brought to America in 1981. Despite the apparent similarities to the description of autism (based on the 1943 writings of Leo Kanner) given in the Diagnostic and Statistical Manual of Mental Disorders (DSM) III, Asperger’s disorder was included in the DSM IV as a distinct and separate disorder (Sanders, 2009). Although much research has been generated since its inclusion, Asperger’s disorder remains an area of great controversy. While some have argued that it is a disorder in its own right (Kaland, 2011), others have maintained that it is merely a manifestation of high functioning autism (Sanders, 2009). Another argument is that Asperger’s is not a mental disorder at all but is instead social construction (Allred, 2009). At present, Asperger’s disorder is being recommended for removal from the DSM V (American Psychiatric Association [APA], 2011).