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Multiple-complex Developmental Disorder (McDD) represents a distinct group within the autistic spectrum based on symptomatology.

McDD is a developmental disorder with symptoms that are to be divided in three groups.

1. Regulation of affective state (anxiety, panic and aggression).

  • Intense generalized anxiety, diffuse tension, or irritability.
  • Unusual fears and phobias that are peculiar in content or in intensity.
  • Recurrent panic episodes, terror, or flooding with anxiety.
  • Episodes lasting from minutes to days of behavioral disorganization or regression with the emergence of markedly immature, primitive, and/or self-injurious behaviors.
  • Significant and wide emotional variability with or without environmental precipitants.
  • High frequency of idiosyncratic anxiety reactions such as sustained periods of uncontrollable giggling, giddiness, laughter, or “silly” affect that is inappropriate in the context of the situation.

2. Consistent impairments in social behavior and sensitivity.

  • Social disinterest, detachment, avoidance, or withdrawal in the face of evident competence (at times) of social engagement, particularly with adults. *More often attachments may appear friendly and cooperative but very superficial, based primarily on receiving material needs.
  • Inability to initiate or maintain peer relationships.
  • Disturbed attachments displaying high degrees of ambivalence to adults, particularly to parents/caregivers, as manifested by clinging, overly controlling, needy behavior, and/shifting or aggressive, oppositional behavior toward parents, teachers, or therapists are common.
  • Profound limitations in the capacity of empathy or to read or understand others’ affects accurately.

3. Impaired cognitive processing (thinking disorder)

  • Thought problems that are well out of proportion with mental age, including irrationality, sudden intrusions on normal thought process, magical thinking, neologisms or nonsense words repeated over and over, desultory thinking, blatantly illogical bizarre ideas.
  • Confusion between reality and fantasy life.
  • 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.

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