Burden and Treatment Preference of Probable Neuropathic Pain in 13 592 people: A Cross-Sectional and Discrete Choice Experiment in the General Population in Malaysia.

The definition of autism and the criteria for its diagnosis in the various editions of the Diagnostic and Statistical Manual of the American Psychiatric Association have been discussed at length (e.g. Happé & Frith, ). Briefly, autism first appeared as a diagnostic category in 1980 (DSM-III), based on Kanner’s () classic features of autistic aloneness and insistence on sameness but added language impairments. In 1983 (DSM-IIIR), the criteria formed what became known as the triad of impairments: impairment in social interaction; impairment in communication (including language delay); and restricted, repetitive, and stereotyped patterns of behavior, retaining the core social and nonsocial features. In 1994 (DSM-IV), Asperger disorder was added as a new category. This label was applied to individuals with good language and without intellectual impairments. This presented a significant step in the widening of the criteria. In the latest edition, DSM-V (2013/2022), the sole diagnostic category is autism spectrum disorder (ASD), which can be applied at any age and at any level of intelligence. It folds the triad of impairments into a dyad of persistent deficits in social communication and restricted, repetitive patterns of behavior, interests or activities, sticking with the core features but adding some subtle changes. Newly mentioned are hyper- or hypo-reactivity to sensory input. Furthermore, symptoms can now be met currently or by historical report, provided some impairment is present. This represents a further widening of the criteria and a lowering of the diagnostic threshold. It is widely accepted that autism is a neurodevelopmental disorder evident from early childhood with a largely genetic basis. It is also generally agreed that while it exists on a spectrum, at its core, autism is defined by characteristic social and nonsocial impairments. But does this mean that it is a true biological entity? This is still far from agreed (Waterhouse & Mottron, ). Big questions are still to be asked, particularly because there are no objective biomarkers.