I-RAP
Improving Recognition and Understanding of Autism and Personality Disorder
What Did We Do
1. Highlights
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We wanted to evaluate the similarities and differences in how autistic people and people meeting diagnostic criteria for borderline personality disorder:
1.
experience and regulate their emotions.
2.
interact and relate with other people.
3.
experience their identity and self-concept.
4.
may react to sensory input e.g. sounds, smells.
5.
may use repetitive movements.
6.
may have strict preferences for sticking to familiar ways of doing things.
7.
may have been affected by past traumatic experiences.
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We investigated this by asking:
1.
51 women/AFAB people (assigned female at birth) diagnosed with and meeting diagnostic criteria for borderline personality disorder who were very unlikely to be autistic.
2.
51 women/AFAB people with an autism diagnosis who were very unlikely to meet diagnostic criteria for borderline personality disorder.
3.
32 women/AFAB people with an autism diagnosis and a diagnosis of borderline personality disorder.
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To:
1.
complete online questionnaires assessing each of these areas.
2. Why did we do this study?
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One possible reason that autism is sometimes misdiagnosed as “personality disorder” is because sometimes, an autistic person’s behaviour and experiences can look similar to the diagnostic criteria for borderline personality disorder. To understand this better, we wanted to compare potential similarities and differences between autistic people, and people meeting diagnostic criteria for borderline personality disorder, in five areas:.
1.
Emotions
2.
Behaviours
3.
Cognition
4.
Identity
5.
Interpersonal interactions
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We chose these areas to investigate based on previous research and insights from our lived experience researchers and the people who took part in our first two studies.
3. Who took part?
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Everyone who took part in this study was a woman or assigned female at birth (AFAB). By assigned female at birth, we mean a person's gender was assigned by medical professionals as female when they were born, even if the person then later realised they had a non-female or non-cis gender identity.
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Previous research which has shown a lot of similarities between the two diagnoses has been flawed, because they have assumed that people with a borderline personality disorder diagnosis do not have undiagnosed autism. To try to rule this out, we compared three groups of people:
1.
51 people meeting diagnostic criteria for borderline personality disorder (had a clinical diagnosis and scored over the threshold on a borderline personality disorder questionnaire), who were very unlikely to be autistic (because they did not have an autism diagnosis, did not believe themselves to be autistic and did not score over the threshold on autism screening questionnaires).
2.
51 people with an autism diagnosis who were very unlikely to meet diagnostic criteria for borderline personality disorder (because they had never had a personality disorder diagnosis, did not believe themselves to have a personality disorder and did not score over the threshold on a borderline personality disorder questionnaire).
3.
32 people with an autism diagnosis and a diagnosis of borderline personality disorder (who also scored over the threshold on a borderline personality disorder questionnaire).
4. What information did we gather?
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Participants completed some questionnaires online to assess different aspects of:
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how they experience and regulate their emotions
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how they interact and relate with other people
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their identity and self-concept
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their sensory processing (how they react to information coming from their senses e.g. sounds, smells)
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their use of repetitive movements (“stimming”)
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They also completed more detailed questionnaires about autistic and personality disorder traits, and if they were comfortable and willing, they shared information about past traumatic experiences and how these had affected them.
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their preferences for sticking to familiar ways of doing things.
5. How will we use this information?
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We will use statistical methods to compare anonymised scores on each questionnaire between the three groups of people who took part. We will use this information to better understand similarities and differences between autism and borderline personality disorder, to better understand how autism can be misdiagnosed as borderline personality disorder, and to make recommendations for differential diagnosis and avoiding misdiagnosis.
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