Is There a Risk of Overdiagnosis Due to DSM-5 Criteria?

PostedNovember 17, 2025

UpdatedNovember 17, 2025

ByMy Patient Advice

Author: Lucia Alvarez, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Yes, there is concern among some clinicians and researchers that the DSM-5’s broader definitions could contribute to autism overdiagnosis in certain cases. These DSM-5 concerns stem from the consolidation of previous subtypes into a single autism spectrum disorder category and the expansion of recognised traits. While this can improve access to support for those with subtle presentations, it also raises questions about diagnostic accuracy, especially if assessments are not conducted with thorough clinical judgement.

A 2021 review published in Autism Research highlighted that while increased recognition of autism can improve support access, broad diagnostic criteria may inflate prevalence figures if not applied with caution. The authors stressed the importance of combining structured assessments with professional judgement to ensure reliability.

Factors That May Contribute to Autism Overdiagnosis

To better understand the issue, here are some common influences on autism overdiagnosis:

Broad criteria

The DSM-5 includes a wider range of behaviours and developmental profiles than earlier editions, which can encompass individuals with mild or borderline traits.

Symptom overlap

Features of other conditions, such as ADHD, anxiety, or language disorders, can sometimes be mistaken for autistic traits.

Variable assessment quality

Differences in assessor training, tool selection, and interpretation can impact accuracy.

Pressure for support

In some cases, families or schools may push for a diagnosis to access resources, even when symptoms fall short of clear clinical thresholds.

Balancing Inclusion with Accuracy

When addressing autism overdiagnosis, it is essential to balance inclusivity with diagnostic precision. Using multiple assessment tools, gathering detailed developmental histories, and applying clinical expertise help maintain accuracy while ensuring those in genuine need are identified.

For personalised advice and guidance on autism assessments, visit providers like Autism Detect for personal consultations.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Autism Diagnostic Criteria (DSM-5, ICD-11).

Lucia Alvarez, MSc

Author

Lucia Alvarez is a clinical psychologist with a Master’s in Clinical Psychology and extensive experience providing evidence-based therapy and psychological assessment to children, adolescents, and adults. Skilled in CBT, DBT, and other therapeutic interventions, she has worked in hospital, community, and residential care settings. Her expertise includes grief counseling, anxiety management, and resilience-building, with a strong focus on creating safe, supportive environments to improve mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.