I-RAP
Improving Recognition and Understanding of Autism and Personality Disorder
Information about autism and personality disorder
1. Highlights
We do not know the answer to this as limited research has been carried out. What we do know is:
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Studies show high levels of autistic traits in people diagnosed with borderline personality disorder
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Studies show high levels of personality disorder traits in autistic people, and many people diagnosed with autism have a previous diagnosis of personality disorder.
2. Further Information
There have been 3 studies examining autistic traits in people diagnosed with borderline personality disorder:
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In 2 studies, people with a diagnosis of borderline personality disorder scored more highly than the general population on self-report measures of autism [1, 2]. In one study, their scores were as high as autistic people’s scores on the autism questionnaire [2].
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The only study to carry out a full diagnostic assessment, using an interview called the Aspergers Syndrome Diagnostic Interview, estimated that 15% of people with a recorded diagnosis of BPD met the diagnostic threshold for autism [3].
Six studies have looked the other way around, at personality disorder traits or diagnoses in people diagnosed with autism:
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Two studies using diagnostic interviews for personality disorder found high levels of avoidant, obsessive-compulsive and schizoid personality disorder traits amongst autistic adults [4, 5].
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In one survey, 12% of people with diagnosed or self-identified autism had also been diagnosed with a personality disorder and half said they thought this was a misdiagnosis [6].
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In another survey, personality disorder was the most frequently reported perceived misdiagnosis amongst autistic people [7].
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In another study, 20% of people with an autism diagnosis had a prior diagnosis of a personality disorder, and 8% had an ongoing diagnosis of personality disorder [8].
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In another study, an autism diagnostic assessment (the ADOS-4) was used to find people with undiagnosed autism in adult mental health services, and 26% of people with undiagnosed autism had a current diagnosis of borderline personality disorder [9].
3. References
[1] Dell'Osso, L., Cremone, I.M., Carpita, B., Fagiolini, A., Massimetti, G., Bossini, L., Vita, A., Barlati, S., Carmassi, C., Gesi, C. (2018a). Correlates of autistic traits among patients with borderline personality disorder. Comprehensive Psychiatry, 83, 7-11. [2] Dudas, R.B., Lovejoy, C., Cassidy, S., Allison, C., Smith, P., Baron-Cohen, S. (2017) The overlap between autism spectrum conditions and borderline personality disorder. PLoS ONE 12(9): e0184447. [3] Rydén, E., Rydén, G., Hetta, J. (2008). Borderline personality disorder and Autism Spectrum Disorder in females – A cross-sectional study. Clinical Neurosychiatry, 5(1), 22-30. [4] Hofvander, B., Delorme, R., Chaste, P., Nyden, A., Wentz, E., Ståhlberg, O., Herbrecht, E., Stopin, A., Anckarsäter, H., Gillberg, C., Råstam, M., Leboyer, M. (2009). Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry, 9(35). [5] Lugnegård, T., Hallerbäck, M.U., Gillberg, C. (2012). Personality disorders and autism spectrum disorders: what are the connections? Comprehensive Psychiatry, 53, 333-340. [6] Au-Yeung, S.K., Bradley, L., Robertson, A.E., Shaw, R., Baron-Cohen, S., Cassidy, S. (2019). Experience of mental health diagnosis and perceived misdiagnosis in autistic, possibly autistic and non-autistic adults. Autism, 23(6), 1508-1518. [7] Kentrou, V., Livingston, L. A., Grove, R., Hoekstra, R. A., & Begeer, S. (2024). Perceived misdiagnosis of psychiatric conditions in autistic adults. E Clinical Medicine, 71. [8] Kentrou, V., Oostervink, M., Scheeren, A. M., & Begeer, S. (2021). Stability of co-occurring psychiatric diagnoses in autistic men and women. Research in Autism Spectrum Disorders, 82, 101736. [9] Brugha, T., Tyrer, F., Leaver, A., Lewis, S., Seaton, S., Morgan, Z., ... & van Rensburg, K. (2020). Testing adults by questionnaire for social and communication disorders, including autism spectrum disorders, in an adult mental health service population. International Journal of Methods in Psychiatric research, 29(1), e1814.
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