Multiple-complex Developmental Disorder
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Multiple-complex Developmental Disorder (McDD) represents a distinct group within the autism spectrum based on symptomatology.
Ever since autism was first recognized, its continuity with schizophrenia has been a matter of debate. In fact, until the late 1970s, children with autism were often labeled as having "childhood schizophrenia." In the last thirty years, however, the term "childhood schizophrenia" has been displaced. Diagnostic criteria for autism have been established that rely solely on social, communicative and sensorimotor symptoms, without reference to the thought disorders typical of schizophrenia.
Nevertheless, there are some children who display the severe, early-appearing social and communicative deficits characteristic of autism who ALSO display some of the emotional instability and disordered thought processes that resemble schizophrenic symptoms. Cohen, et al. (1986) coined the term Multiplex Developmental Disorder (MDD) to describe these children, although they are often given a diagnosis of PDD-NOS by clinicians who may be unfamiliar with this terminology. Unlike schizophrenia, MDD symptoms emerge in childhood, sometimes in the first years of life, and persist throughout development.
Multiplex develepmental disorder is dignosed to people who are both on the autism and schizophrenia spectrums. They may have anywhere from intense, to no emotions, and anywhere from low to high intelligence. There is a high co-morbidy rate with learning disorders, AD/HD, obsessive-compulsive disorder, depression, bipoler disorder, social anxiety disorder, Tourette syndrome, personality disorders, epilepsy, and phobias.
McDD is a developmental disorder with symptoms that are to be divided in three groups.
1. Regulation of emotion. (Affective symptoms)
- Intense generalized anxiety, diffuse tension, or irritability.
- Unusual fears and phobias that are peculiar in content or in intensity.
- Recurrent panic episodes, and dissociation.
- Racing thoughts.
- Impulsitivity.
- Depression.
- Poor sleeping patterns.
- Impaired regulation of feelings.
- Significant and wide emotional variability with or without environmental precipitants.
2. Consistent impairments in social behavior and development. (Autistic symptoms)
- Difficulty initiating or maintaining peer relationships.
- Restricted, repetitive and stereotyped behaviors and interests.
- Difficulty expressing self.
- Literal concrete thinking.
- Social disinterest, detachment, avoidance, or withdrawal in the face of evident competence (at times) of social engagement.
- Sensory intergration disorder.
- Compulsive behavior.
- Learning disorders.
- Difficulty making decisions.
- Poor moter skills.
- Poor judgement.
- Disturbed attachments displaying ambivalence.
- Limitations in the capacity of empathy or to read or understand others’ affects accurately.
3. Impaired cognitive processing (Psychotic Symptoms)
- Thought disorder including irrationality, thought insertion, magical thinking, neologisms or nonsense words repeated over and over, desultory thinking, blatantly illogical bizarre ideas.
- Confusion between reality and fantasy life.
- Difficulty paying attention.
- Episodes lasting from minutes to days of behavioral disorganization or regression.
- Perplexity and easy confusability (trouble with understanding ongoing social processes and keeping one's thoughts "straight").
- Delusions, including fantasies of personal omnipotence, paranoid preoccupations, overengagement with fantasy figures, grandiose fantasies of special powers, and referential ideation.
- Hallucinations.
- Negative symptoms (i.e., affective flattening, anhedonia, alogia, or avolition).
- Unorganized affect such as uncontrollable laughter, or inappropriate facial expressions.
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