The psychiatrist explained the increase in the diagnosis of ASD in adults

The day dedicated to Asperger's syndrome, which was previously considered an independent diagnosis, but today is included in the concept of autism spectrum disorders (ASD) is celebrated on February 18. Igor Potapov, a psychiatrist at the Medical diagnostic department of Sechenov University No. 3, told Izvestia why medicine abandoned the previous classification, what is the reason for the increase in the detection of ASD in adults and where the boundary between a personality trait and a condition requiring help lies.

According to him, the rejection of the term "Asperger's syndrome" is associated with the transition from rigid diagnostic categories to a spectral approach. Clinical practice has shown that symptoms are distributed in a mosaic, and clear boundaries between previous diagnoses were conditional. The concept of ASD allows us to take into account the individual profile of manifestations, rather than "fit" a person into a narrow framework. This has expanded diagnostic capabilities and given more people access to support.

"Every person has their own peculiarities — in communication, in ways of processing information, in sensory sensitivity. The key criterion is not the presence of traits as such, but the degree to which they affect functioning and subjective distress. The diagnosis appears where these features persistently disrupt adaptation: they lead to severe distress, limit education, work, and social contacts," the specialist noted.

In recent years, ASD has been increasingly diagnosed in adults. Potapov emphasizes that this does not indicate a sharp increase in prevalence. It's about increasing awareness and improving diagnosis. Many patients had previously been treated for concomitant conditions for years — depression, anxiety disorders, or attention deficit hyperactivity disorder—while the features of the spectrum remained unrecognized.

Diagnosis in adults remains clinical and behavioral, since there are no laboratory methods that can reliably confirm ASD. The specialist evaluates the medical history, development and current functioning. At the same time, compensatory mechanisms are often found, especially in women. Masking — conscious or unconscious "masking" of behavioral features — can outwardly create the impression of successful adaptation, but is accompanied by chronic internal stress and an increased risk of anxiety and depression.

The expert pays special attention to the widespread romanticization of autism in popular culture. According to him, some people do have a pronounced ability for systematization or attention to detail, but this is not a universal characteristic. Idealization distorts reality in the same way as stigmatization, because it devalues real difficulties, including sensory overload and exhaustion.

Potapov stated that the quality of life of people with ASD is determined not only by the peculiarities of neurodevelopment, but also by the environment. Under conditions of predictability and clear rules, a person can demonstrate stable functioning. In a chaotic and overloaded environment, the workload increases, which increases stress.

"RAS is not a stigma or a superpower. This is a state of neurodevelopment that does not make a person worse off and does not automatically endow him with special advantages. It is important to avoid extremes — both stigmatization and romanticization — and to take into account a person's individual profile in education, work and daily life," concluded the psychiatrist.

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On February 2, clinical psychologist Lidia Inshina told how parents can understand the reasons for their child's isolation. According to her, this behavior is most often not a rebellion, but acts as a defensive strategy in conditions that the psyche considers unsafe. The task of parents is not to "break" this closeness, but to understand its causes and create conditions under which the child himself will make contact.

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