68% of Individuals with ASD Met the DSM Criteria for at Least One Personality Disorder
During the past two decades, researchers have recognized that autism spectrum disorder (ASD) and personality disorders (PDs), including borderline personality disorder (BPD), share several similarities. A previous study found that 42 of 62 (68%) patients with an ASD diagnosis also fulfilled DSM criteria for at least one PD. However, despite robust investigative research, the relationship between these disorders remains uncertain. A new research article has called attention to the challenges clinicians face when diagnosing ASD or PDs due to overlapping symptoms. These shared symptoms include developing and maintaining relationships, identity problems, intense anger, self-injurious behaviors, and severe problems managing interpersonal relationships. Specifically, the authors report that BPD can mask features of autism or present as a comorbidity, leading to an increased risk of misdiagnosis. To combat this problem, the research team encourages clinicians to consider the overall clinical presentation of the patient’s lifespan before making a diagnosis. For instance, a diagnosis of ASD requires the presence of restricted and repetitive behaviors and interests. Some individuals with PD may exhibit these behaviors due to becoming “institutionalized” by routines in inpatient and secure settings. In these situations, the authors encourage clinicians to determine whether the insistence on routine predated the admission to the secure setting or establish if this behavior has been a persistent feature since early childhood. The article also advocates for considering the developmental trajectory of the patient before diagnosing either disorder. Ultimately, the authors believe that understanding how clinicians approach instances where there are complexities in determining an ASD and/or PD diagnosis and ensuring that professionals have access to appropriate training is crucial in delineating the two disorders.
