By Esther Jou
One of the more radical changes to the autism classification within the DSM-5 was the elimination of the category “Asperger’s Disorder” and inclusion of those who would have met that criteria under the name “autism spectrum disorder”. Some families of individuals with Asperger’s and those diagnosed with Asperger’s opposed this change for fear that being a member of the ‘autism’ group would force them to live with a more stigmatized label and subjugate them to further social and academic pressures. In order to address whether this was the case, researchers designed studies to understand the public perception of the word “autism” vs. “Asperger’s”. Coincidentally, two studies were published this week which examined the impact of clinical labels on stigma and treatment attitudes. Does an autism spectrum disorder label conjure a more unpleasant disposition when compared to an Asperger’s Disorder label? These studies also asked whether there was a difference in peer responses to overt ASD behaviors if a clinical label was disclosed.
The first report, authored by Ohan et al., examined the responses of 465 adults who were presented with a vignette of a 9 year old who displayed symptoms characteristic of someone who would have received a diagnosis of Asperger’s Disorder. Participants were then asked to rate levels of discomfort, compassion, and irritation towards the child based on a definition of stigma that included: negative beliefs (stereotypes), emotions (prejudice), and behaviours (discrimination). Statistical analyses showed stigma ratings were not dependent on the clinical label – Asperger’s or ASD. Post hoc tests also revealed participants were less likely to seek out medical treatment for the vignette child if they were unaware of any label due to the assumption that treatment would be ineffective for an undiagnosed condition.
Another study conducted in the UK, authored by Brosnan and Mills, analyzed the responses of 120 college students to two male vignettes, both exhibiting behavior characteristic of an individual with Asperger’s Disorder. Participants were informed that one of them had a clinical disorder (AS, ASD, or schizophrenia) while in the control scenario, they were told that the individual was a typical university student above average intelligence. More positive responses were found towards the clinical disorder vignette and like the first study, the type of clinical label used did not influence the student’s response.
Due to stigma surrounding mental disorders, the name of the clinical diagnosis itself can be powerful enough to deter an individual from seeking or completing treatment. Yet these studies indicate a changing attitude towards mental health, one that encourages people to be more open about an ASD diagnosis. However, it is also important to note that both studies set out to collect data from societies that were more willing to accept, even celebrate, differences and thus dedicate research and education to raising awareness about mental health problems. What happens if we take a look at the responses of cultures who have not accepted the term “autism” let alone the concept of mental health? How can we build on those existing foundations to foster inclusion for the autism community?
- Ohan JL, Ellefson S, Corrigan PW. Brief Report: The Impact of Changing from DSM-IV ‘Asperger’s’ to DSM-5 ‘Autistic Spectrum Disorder’ Diagnostic Labels on Stigma and Treatment Attitudes. Journal of autism and developmental disorders. June 5 2015; doi: 10.1007/s10803-015-2485-7
- Brosnan M, Mills E. The effect of diagnostic labels on the affective responses of college students towards peers with ‘Asperger’s Syndrome’ and ‘Autism Spectrum Disorder’. Autism. June 8, 2015; doi: 10.1177/1362361315586721