Footnote 1 Within this revision, SPCD ended up grouping together subjects who would have had a DSM-IV autism-related diagnosis but who do not meet a DSM-5 diagnosis of ASD (Brukner-Wertman et al., 2016 Flax et al., 2019 Regier et al., 2013 Swineford et al., 2014). The new category of Autism Spectrum Disorder (ASD) thus replaced the DSM-IV macro-category of PDDs and its disorders altogether. The transition from DSM-IV to DSM-5 involved some sort of simplification of the diagnostic criteria for autism-related disorders (Solomon, 2017b) and led to the elimination of a variety of developmental disorders, including Asperger’s Disorder, Childhood Disintegrative Disorder, and Rett’s Disorder. Other reasons behind the introduction of SPCD probably connect to major changes that were made, for partially independent reasons, to the category of Autistic Disorder and to the macro-category of Pervasive Developmental Disorders (PDDs). Among them, one reason was to pick out individuals affected with language and communication difficulties that do not fall within the range of the typical Specific Language Impairments (SLI)-indeed, individuals with SPCD may have normal phonological processing, vocabulary, and higher-order grammatical and semantic skills (Adams & Bishop, 1989 Bishop & Rosenbloom, 1987 Ketelaars & Embrechts, 2017 Leyfer et al., 2008 Rapin & Allen, 1983). Within the transition from DSM-IV to DSM-5, there were various reasons for introducing a new disorder like SPCD into the Manual. Typical symptoms of SPCD are deficits in using communication for social purposes, impairment of the ability to change communication to match the context, and difficulties in following the conversational rules (American Psychiatric Association, 2013, p. This disorder, which has been included in the macro-category of Communication Disorders (CDs), is characterized by a primary difficulty with pragmatic abilities broadly conceived. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-5 (American Psychiatric Association, 2013) has introduced the Social (Pragmatic) Communication Disorder (SPCD) as a new category of the psychiatry nosography. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. In the second part, we focus on the validity and reliability of SPCD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. This opens up the possibility that individuals with very similar symptoms can be diagnosed differently (with either ASD or SPCD) and receive different clinical treatments and social support. For instance, the symptomatology of SPCD is notably close to that of (some forms of) Autism Spectrum Disorder (ASD). Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons-including bridging a nosological gap in the macro-category of Communication Disorders-in the last few years researchers have identified major issues in such revision. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included the Social (Pragmatic) Communication Disorder (SPCD) as a new mental disorder characterized by deficits in pragmatic abilities.
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