Controversies in autism: is a broader model of social disorders needed?

Abstract

This article examines the most significant, contradictory evidence pertaining to autism. The first section of the article includes reports of recovery from autism, data obtained from studies involving oxytocin, early deprivation, autism in preterm children, late-onset autism, and symptom overlap among ASD, social phobias and personality disorders. In the second section of the article, we offer a model that better incorporates current findings and address controversies that continue to surround ASD. We propose an umbrella term "social inhibition disorders" which integrates autism spectrum disorders and social phobias, as well as schizoid, schizotypal, and obsessive-compulsive personality disorders. It would also include "quasi-autism," which has been found in early deprivation studies, autism in preterm children, and cases of late-onset autism presenting after herpes encephalitis infection. Finally, we discuss suggestions for further research and clinical perspectives.

Figure 1

Social inhibition disorders. This figure presents the conditions included under this suggested umbrella term as well as the relationships between the included conditions, age and vulnerability factors. VF – vulnerability factors, PDD-NOS - Pervasive Developmental Disorder – Not Otherwise Specified, ASD - autism spectrum disorders, PD - personality disorder.