PSYCHOPATHOLOGY II

Presented by: SHRILAKSHMI P

2281028
St.Agnes PG & Research Centre
Mangalore
 Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)

• Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS) describes children

who display the social, communication, and behavioral impairments associated with PDD but
do not meet criteria for other PDDs, schizophrenia, or other disorders (Volkmar, Shaffer, &
First, 2000).

• PDD-NOS might better be called atypical autism, since the category is often used to diagnose
children who fail to meet criteria for autistic disorder because of their late age of onset, atypical
symptoms, subthreshold symptoms, or a combination of these factors.

• PDD-NOS is the most frequently diagnosed disorder on the autism spectrum, suggesting that
this category as currently defined in DSM may be too broad (Volkmar et al., 2000).
• In addition, children who receive the diagnosis of PDD-NOS often exhibit
various problem behaviors in addition to the core symptoms of autism.
These include aggression, impulsivity and hyperactivity, and anxiety
(Holtmann, Bolte, & Poustka, 2007; Sukhodolsky et al., 2008).

• This category is for cases that are not typical in terms of age of onset or
specific behavior pattern. Pervasive and severe impairment in reciprocal
social interactions occurs, as do communication abnormalities and limited
interests and activities. These children do not, however, meet the full
criteria for autistic disorder.
• In the past several years, genetic studies of Autism Spectrum Disorders (ASDs; Autistic
disorder, Asperger’s disorder, and PDD-NOS) have revealed similarities among them all,
and underscored the connection between PDD-NOS and autism. Clinically, although
individuals with PDD-NOS may display milder symptoms than individuals with autism,
the biological features and genetic risks suggest remarkable similarities.
• PDD-NOS is similar, not identical, to autism. There is reliable evidence that individuals
diagnosed with PDD-NOS have milder deficits and a better prognosis than those diagnosed
with autism (Gillberg, 1991).
• It is less clear whether these differences hold up when one compares those with PDD-NOS
to individuals with autism who are matched on nonverbal IQ and basic grammatical and
syntactical language.
• It is also unknown whether the definitions and demarcations of subtypes of PDD in the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and World Health
Organization International Classification of Diseases (ICD-10) are valid or meaningful.
CLASSIFICATION
• The term PDD first surfaced in DSM-III. Within the group of PDDs,
there were three conditions: infantile autism, childhood onset PDD,
and atypical PDD.
• In DSM-III-R, this was modified once again and PDD was redefined
with only two subtypes: Autistic Disorder and PDD-NOS.
• DSM-IV and ICD-10 created new subgroup diagnoses that previ-
ously were under the umbrella term PDD-NOS in DSM-III-R or ICD-
9.
• The new subgroups with separate designations include Asperger’s
disorder (ICD-10 and DSM-IV-TR), atypical autism (ICD-10),
Childhood Disintegrative Disorder (ICD-10 and DSM-IV-TR), and
Rett’s Disorder (ICD-10 and DSM-IV-TR).
• DSM-IV and ICD-10 use diagnostic terms and guidelines for PDD-
NOS in different ways ICD-10 has a category of PDD-unspecified
(F84.9), but this description is not as broad as DSM-IV PDD-NOS.
• Closer scrutiny of the clinical guidelines and descriptions in ICD
reveal that a more complete analogue to DSM-IV’s PDD-NOS is the
combination PDD-unspecified and atypical autism (F84.1; World
Health Organization [WHO], 1992).
• DSM-IV-TR declares that “atypical autism” is included. Under their
term of PDD-NOS (p. 84). DSM-IV states that individuals in this
category fail to meet age criteria, do not dis- play all the key elements
of autism or the other subtypes of PDD, or that when these other ele-
ments are present, they may not be of suffi- cient severity to meet the
full criteria for autism or the other subtypes of PDD.
• DSM-IV-TR makes clear that PDD-NOS is, foremost, a disorder of
“reciprocal social interaction that is associated with” impairments in
“either verbal or non-verbal communication,” or with repetitive
behaviors, And/or restricted interests.