Autism Spectrum Disorder and Personality Disorders

Autism Spectrum Disorder (ASD) is a disorder characterized by deficits in social communication and social interaction as well as repetitive behavior and restricted interests.

The 10 Personality Disorders:

Cluster A (odd, eccentric)
Paranoid Personality Disorder: pervasive pattern of distrust and hostility
Schizoid Personality Disorder: a tendency to be unresponsive to social dimensions, a loner
Schizotypal Personality Disorder: odd thinking, magical beliefs

Cluster B (erratic, dramatic)
Antisocial Personality Disorder: criminality, irresponsibility, and impulsivity
Borderline Personality Disorder: fear of abandonment, relationship difficulties
Narcissistic Personality Disorder: grandiose sense of self-importance, arrogance, sense of entitlement
Histrionic Personality Disorder: attention seeking and provocative

Cluster C (anxious, fearful)
Avoidant Personality Disorder: not engaging in social situations out of fear of humiliation and rejection
Dependent Personality Disorder: over relying on somebody for support
Obsessive-Compulsive Personality Disorder: perfectionism, rigid adherence to rules

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Strunz, S., Westphal, L., Ritter, K., Heuser, I., Dziobek, I., & Roepke, S. (2015). Personality Pathology of Adults with Autism Spectrum Disorder without Accompanying Intellectual Impairment in Comparison to Adults with Personality Disorders. Journal of Autism and Developmental Disorders, 45(12), 4026–4038.

Empathy in Autism Spectrum Disorder
Irene E. Harmsen
Journal of Autism and Developmental Disorders

Does Theory of Mind Training Enhance Empathy in Autism?
Annaleena Holopainen, Daniëlle M. J. de Veld, Elske Hoddenbach1, Sander Begeer
Journal of Autism and Developmental Disorders (2019) 49:3965–3972

Dudas, R. B., Lovejoy, C., Cassidy, S., Allison, C., Smith, P., & Baron-Cohen, S. (2017). The overlap between autistic spectrum conditions and borderline personality disorder. PLoS ONE, 12(9), 1–13.

Strunz, S., Westphal, L., Ritter, K., Heuser, I., Dziobek, I., & Roepke, S. (2015). Personality Pathology of Adults With Autism Spectrum Disorder Without Accompanying Intellectual Impairment in Comparison to Adults With Personality Disorders. Journal of Autism and Developmental Disorders, 45(12), 4026–4038.

[mirimiriela]

Do you ever notice how some disorders are described almost entirely as an outsider looking in, while the descriptions for other disorders are far more focused on how the patient might experience the world?

[Desertphile]

Regarding paranoia, one General Practitioner, who did not know I am autistic, suggested that I might be paranoid. I told her I have every right to be paranoid, because I grew up being beaten, brutalized, stalked and battered, persecuted, and humiliated because I was weak, always sick, and defenseless. I have every right to be paranoid: hundreds of people went out of their way to harm me, and almost all were complete strangers to me.

[reu]

I’m an autistic woman and I was diagnosed at 27 years old. Prior to that I was misdiagnosed as BPD, and this is common in autistic women. What were really autistic meltdowns were mis-identifier as emotional outbursts. My difficulty in managing relationships and low tolerance for stress was because of being autistic.

[AliciaGuitar]

I am autistic and was misdiagnosed as schizophrenic. The medications and hospitalizations just made things much worse. Finally after years of psychiatric abuse I got a psychiatrist who finally admitted I was misdiagnosed and took me off the meds ...but not before experiencing permanent dystonic reaction to the meds I was forced to take. I am still wondering how I lived through it.

[theharmonyofknowledge]

Dr. Grande, it might be a good idea to make a video about the most common misconceptions of ASD

[Dizzydollie]

I’m glad you made a video about this. I have ASD and was diagnosed at age 20 but prior to that, I was misdiagnosed (like many females are with ASD.) one therapist thought my lack of eye contact meant I was hallucinating. Another was ready to diagnose me as Borderline due almost entirely to my eating habits and lack of friends. I was happy to find out I don’t actually have a personality disorder, but one of my earliest videos was comparing schizoid and ASD’s overlap. Anyway, awesome video!

[srkcjjb-pq]

One phenomenon that I've noticed lately is a folk use of the word autistic to basically mean narcissistic or NPD. People are simplistically putting "lack of empathy" and "high functioning" together to come up with this very damaging misnomer. I've noticed that when I was young, selfish people were called "egotists", then socio or psychopathic (and regularly confused with psychotic), and now it's narcissistic and autistic. This video makes it clear that they are not, so thank you Dr Grande!

[writeonwoman]

When you describe ASD, you are describing my grandson to the letter, although he is a very loving sweetheart. He does not participate with his cousins in meaningful play, unless they are all at the table colouring/drawing, but he loves being in the presence of his peers . He gets quite excited when other children come over, but does not participate in their active play. He has recently been accepted into a pilot program that has one teacher, two aides, and one speech pathologist for four children. He is very advanced in his reading and math skills and is a very good drawer, but has only been speaking in sentences within the past year and more markedly lately more so, saying things like, "Grandma you're back!"💘

[CoralineJonesPinkPalace]

My son is 9yo and has autism. He's non verbal, still in diapers, has zero sense of danger, very special to me and everyone he meets. He's not interested in other kids, but I'm his best friend. He follows me everywhere and it breaks my heart to think of what will happen when I'm not here for him anymore 😢 one day 🙄 love your channel and your professionalism.

[Seemashe]

My son has Aspergers. ASDs have very high levels of anxiety, frustrations and can get very depressed. This is very understandable living in a world where they don’t understand others, the way things are done in a different way to theirs and also vice versa. The root of all their actions and behaviours and clashes with the world is their lack of communication and social skills. Their brains are wired differently from the neurotypicals. What comes naturally to the neurotypicals does not for the ASDs . It is like they speak a different language hence they need to learn another language and also the world needs to learn the basics of their language. It goes both ways. Hence thanks doc for this video increasing the awareness and how it is related to personality disorders.

[mattiassollerman]

I'm diagnosed with Asperger and dysthymia. Had my life played out a bit differently, I might have been diagnosed with schizoid instead. It's difficult even for me to get to grips with the differences.
On one hand, I feel like schizoid describes my problems better, since my main handicap is lack of motivation and 'emotional content'. On the other, Asperger and depression are less alienating concepts to most people nowadays.
I don't envy the doctors who have to make these decisions. Sometimes it comes down to what sort of resources the diagnosis gives access to. Asperger tends to open more doors.

[maddmedic]

I am child psychiatrist, I am very familiar with ASD, especially High Functioning Autism. I see patient from childhood thru to adulthood. In my opinion, a significant % of Schizoid and Schiztypal adults are actually High Functioning Autism. I do appreciate your insights.

[Asporez]

I am autistic, I have been diagnosed late at 31 years old, through my whole life I thought i was such a s**t, I thought I was such a horrible person. Everytime I tried to show my empathy it always ended up awkward and so I wired myself to never show it, I keep it inside and I meltdown when the bucket is full about once every 2 weeks.

[JoseGonzalez-krgg]

Autism is so misunderstood. We don’t “think” that things are affecting us. We are highly sensitive to the environment

[dianamarie]

I like the power points or whatever they are called that you just added. That makes it easier for me to follow.

[isaacseiffoudine]

Daaaamn doctor Grande's using visual components to explain his points now. Literally the one thing that could open the content to lesser informed populations, and showing us how he actually does take time on his video despite what people may think about the lack of movements or of dynamic cuts. Dr Grande keeps learning from what surrounds him. Nothing can stop him now.

[rosiejl]

I was diagnosed with BPD and ASD (along with depression, social anxiety, anorexia nervosa b/p, self harm and alcohol misuse) between 18 and 19 yr old with my first year of uni resulting in a mental health crisis. I think the BPD symptoms was a result of trauma from bullying as a (undiagnosed) autistic girl who was a teachers pet but hated by my peers.
For many girls with ASD we cope by looking at our peers and masking ASD traits which means constantly denying any natural identity to fit in in addition to avoiding overwhelming emotions with harmful coping mechanisms that you see with BPD. There is also a large potential for experiencing trauma as a child from bullying or distress with a need for approval feeding into the instability of relationships and self worth.
Regardless of a diagnosis of bpd I do think that dialectical behavioural therapy could be beneficial for some with ASD as it helps increase awareness and ability to cope with overwhelming emotions, the ability to communicate needs through an assertive way, to reduce vulnerability to stimuli that can trigger meltdowns and challenge black and white thinking.

[spinsterpunk]

Thankyou! Actual information on ASD is sorely lacking online and feeds such ignorance. I was diagnosed at 36 and it changed my life. It's so hard to explain to friends sometimes when they ask me to explain ASD over 'mental illness'

[renep]

I vote your content be included for consideration, in on some sort of required Official University Study Material, and/or referenced for future DSM publications.

[maidenmarian]

I need to come back and go through this very slowly. This is amazingly interesting and this addresses questions I have had for as long as 20+ years. THANK YOU Dr. GRANDE. This is A WONDERFUL VIDEO!