What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world. NINDS and several other NIH Institutes and Centers support research on autism spectrum disorder.
Nearly 20 years ago the NIH formed the Autism Coordinating Committee to enhance the quality, pace, and coordination of efforts at the NIH to find a cure for autism. The NIH/ACC has been instrumental in promoting research to understand and advance ASD. The NIH/ACC also participates in the broader Federal Interagency Autism Coordinating Committee , composed of representatives from various U.S. Department of Health and Human Services agencies, the Department of Education, and other governmental organizations, as well as public members, including individuals with ASD and representatives of patient advocacy organizations. One responsibility of the IACC is to develop a strategic plan for ASD research, which guides research programs supported by NIH and other participating organizations.
Do Individuals With Autism Have Unique Personalities
Children and adults with ASD are described as reluctant to make changes to their routines, as anxiety-prone, and as socially aloof or averse , with their tending to treat social communications with no greater and often less priority than they do asocial stimuli . Even when an interest in social interaction exists, individuals with ASD may lack the requisite skills to make a social encounter successful . The debilitating interpersonal impairments experienced by individuals with ASD are assumed to result from a neurocognitive impairment in the basic motivation and ability to understand people’s thoughts, feelings, and behaviors perhaps even their own . Given the unique characteristics of individuals with ASD, it may be expected that their personality profile that is, the distinct set of traits characterizing their typical patterns of thinking, feeling, and behaving would be quite different from the modal personality profile of TD individuals.
Consistent with our predictions, the two published studies on Big Five traits in ASD one conducted in Belgium with parents reporting on their 6-14 year-old children and the other conducted with adult outpatients screened for Asperger’s syndrome in Japan found lower Extraversion, Agreeableness, Conscientiousness, and higher Neuroticism, in ASD versus TD individuals. De Pauw et al. also found lower levels of Openness in ASD relative to TD individuals, whereas Kanai et al. found no group differences.
What It’s Like To Live With Both Autism Spectrum Disorder And Borderline Personality Disorder
Many are diagnosed with autism spectrum disorder or borderline personality disorder and are later told they have been misdiagnosed and are diagnosed with the other. Yet some are diagnosed with both.
People with BPD feel emotions incredibly strongly and feel compassion deeply, while those with ASD typically feel the opposite.
So what is it like to live with both?
Honestly? It is hell. There is no sugar coating it. It is a daily struggle. These are the ways these conditions affect me personally.
1. Social interactions.
I struggle to socialize, I struggle to make friends and I overshare information acquaintances dont need to know about me. However, when I do make friends, the struggle doesnt stop there. My ASD makes my senses heightened and so the slightest noise or look is picked up on immediately. If someone looks at me a certain way, it triggers off a wave of emotions They hate me, what did I do wrong? These emotions and thoughts then intensify and I start to catastrophize. It doesnt help that both these disorders make me think in black and white. Someone is either good or bad. They either love me or despise me. This has made friendships and relationships almost impossible.
5. Future plans.
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How Is Asd Diagnosed
ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps.
Autism spectrum disorder is diagnosed by clinicians based on symptoms, signs, and testing according to the Diagnostic and Statistical Manual of Mental Disorders-V, a guide created by the American Psychiatric Association used to diagnose mental disorders. Children should be screened for developmental delays during periodic checkups and specifically for autism at 18- and 24-month well-child visits.
Very early indicators that require evaluation by an expert include:
- no babbling or pointing by age 1
- no single words by age 16 months or two-word phrases by age 2
- no response to name
- excessive lining up of toys or objects
- no smiling or social responsiveness
Later indicators include:
- impaired ability to make friends with peers
- impaired ability to initiate or sustain a conversation with others
- absence or impairment of imaginative and social play
- repetitive or unusual use of language
- abnormally intense or focused interest
- preoccupation with certain objects or subjects
- inflexible adherence to specific routines or rituals
Why Children Are Misdiagnosed
Autism is not always a child’s first diagnosis, particularly if he or she is verbal and of average intelligence. Not infrequently, children who wind up with an autism diagnosis receive a range of other diagnoses firstincluding, in some cases, other types of mental disorders.
There is a simple reason for these misdiagnoses: a child who is bright and verbal may not be evaluated for autism. As a result, the child’s symptoms are viewed not as a set of related challenges, but as individual issues that could potentially be signs of another mental illness. There are a number of behaviors in autism and other mental illnesses that may share characteristics and lead to an erroneous diagnosis.
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Functional Magnetic Resonance Imaging
Two individuals from the ASD group, 1 from the SPD group and 1 from the CM group did not participate in the imaging component due to fear of the scanner environment. Two individuals were excluded due to technical issues such that meaningful data were not recorded. Finally, one individual with ASD was excluded due to imaging artifacts. Supplementary table s2 contains the details of those included in the scanning study.
Task Performance and Within Group Analyses.
Details of in-scanner performance in the task and the within group analyses are in the supplementary material . Within the whole study group combined, greater activations were found in the social compared to the gender condition in many regions previously associated with social brain function: inferior frontal gyri, medial prefrontal cortex, left anterior temporal lobe, left superior temporal sulcus, occipital gyri, and the cerebellum. No regions showed greater activation in the gender vs the social condition.
ASD, SPD, CM vs Controls.
There were no significant group × condition interactions in the ASD, SPD or CM vs control comparisons. However, in the ASD vs control comparison, 2 trends towards significant group × condition interactions were observed, with the ASD group showing less increase in activation than the controls during the social condition compared to the gender condition in the posterior cerebellum bilaterally , P = .05 and , P = .07 table s7 and figure s6 in supplementary material).
ASD vs SPD.
Autism Misdiagnosis: Borderline Personality Disorder
Autism is often “off the diagnostic radar,” particularly for professionals serving adults. As a result, certain symptom clusters get labeled with a diagnosis while the big picture diagnosis is missing.
In the case of borderline personality disorder, the criteria include several things likely to be present for autism spectrum disorder including difficulty with a sense of stable identity, problems making and maintaining long term relationships, concerns about abandonment , self-harm behaviors , and strong fluctuations in mood .
If you are familiar with autism characteristics, you know that many of these are frequently present in autism spectrum disorder. The ASD idividual will have difficulty with stable relationships and a sense of identity, emotional and behavioral regulation , and behaviors that may cause harm or injury .
How do we avoid misdiagnoses?
1. Put Autism in the Differential
One giant leap forward would be for autism to end up in the differential. What does this mean? When a professional considers diagnoses, s/he will usually have a list of possible diagnoses and then narrow them down. We are at the point in our international culture where autism is RARELY on the differential at all.
2. Stereotyped Behaviors and Neurologic Abilities in Social Skills
3. Different Recommendations
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What Are Some Common Signs Of Asd
Even as infants, children with ASD may seem different, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.
The severity of ASD can vary greatly and is based on the degree to which social communication, insistence of sameness of activities and surroundings, and repetitive patterns of behavior affect the daily functioning of the individual.
Social impairment and communication difficultiesMany people with ASD find social interactions difficult. The mutual give-and-take nature of typical communication and interaction is often particularly challenging. Children with ASD may fail to respond to their names, avoid eye contact with other people, and only interact with others to achieve specific goals. Often children with ASD do not understand how to play or engage with other children and may prefer to be alone. People with ASD may find it difficult to understand other peoples feelings or talk about their own feelings.
Losing Control Of Emotions
Children with autism often lose control of their emotions and experience meltdowns . In autism, meltdowns are almost always the result of either sensory assaults, anxiety, frustration, or a combination of all three.
In a child who has not been diagnosed with autism, however, the symptoms may look like oppositional defiant disorder which is considered a behavioral disorder.
Children with higher-functioning autism may also receive a range of inappropriate diagnoses before receiving their autism diagnosis. Some of the most common include ADHD, hyperlexia, learning disabilities, and speech delays.
It’s important to note that some children with very high functioning autism may not be diagnosed until they are well into their teens or even adulthood. When that happens, it can be tricky. Developmental disabilities usually appear in childhood, and it may be necessary to dig into an individual’s past to unearth signs that disabilities existed prior to adulthood.
If childhood information isn’t readily available, it may be impossible to provide an autism spectrum diagnosis even if it is the most appropriate diagnosis based on symptoms and behavior.
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Support Groups For Loved Ones Of People On The Autism Spectrum Or With Npd
It is possible that narcissistic and autistic traits are related genetically, so they may be passed down through families. Some anecdotal evidence from clinicians notes that children with autism rarely have parents with autism, but one parent may display more narcissistic traits. However, there is currently very little research on potential overlap between autism and narcissism. The links are anecdotal.
Children with autism benefit from being diagnosed by a pediatrician as early as possible and then getting prompt and intensive help from a behavior therapist. People with narcissistic personality disorder also benefit from behavioral therapy, but their diagnosis will come much later in life.
Support groups for family and friends of people either with autism or narcissistic personality disorder can help you understand your loved ones condition and cope with stress. Here are some support group or therapy search options:
- The Substance Abuse and Mental Health Services Administration offers a help page, so you can find mental health, behavioral, and other types of therapy near your city. Therapists may specialize in helping family members of those with autism or NPD.
- Autism Speaks offers a resource page listing support groups for parents, siblings, and friends who have a loved one with autism.
- Psychology Today provides a search page to help you find a narcissism support group near you.
Common Conditions Among People With Autism
While many people with autism are misdiagnosed with other types of mental illness, many are also appropriately diagnosed with both autism and mental illness. In fact, mental illness is more common among people with autism than it is among the general population.
The most common co-occurring mental illnesses for people with autism include depression and anxiety.
It’s not completely clear why this may be the case. One theory suggests that there is a genetic link between autism and mental illness. Another theory points to the extreme challenges of living in the modern world with autism. The fact is that for many people with autism, it is anxiety-provoking and depressing to attempt to overcome social, sensory, and/or intellectual challenges that are simply part of who they are.
In addition to mental illness, many children and adults with autism receive additional developmental diagnoses. While it can be argued in many cases that the symptoms are associated with autism, it is sometimes helpful to know that a child is both autistic and, for example, diagnosable with ADHD, learning disabilities, hyperlexia, Savant Syndrome, or another disorder.
A secondary diagnosis, while it may or may not be completely appropriate, can sometimes provide direction for therapy, academic support, and services. Hopefully, in doing so, this could correct any potential misdiagnoses moving forward.
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How Doctors Define Autism
Autism spectrum disorder is indeed categorized as a mental disorderalso called a mental illnessin the Diagnostic and Statistical Manual of Mental Disorders . The DSM-5 also classifies autism as a neurodevelopmental disorder . In other words, although autism is classified as a general mental disorder, it may be better conceptualized by its subcategory: a developmental disorder.
There are many characteristics of autism that overlap with other mental illnesses, so autism is often misdiagnosed as another mental illness. While there can be people who have more than one type of mental illnessincluding developmental disordersthe two may be defined, treated, and managed very differently.
Analysis Of The Full Sample
The mean age of the sample was 39.43 years , and the 4 groups did not differ from each other on age . The BPD group, and to a lesser extent the NC group, showed a female preponderance, whilst the ASC groups were well-balanced. Responders predominantly attended mainstream schools .
The AQ scores
The AQ scores followed a normal distribution in the groups . Each group was significantly different from one another in terms of this measure , resulting in the following pattern: NC < BPD < ASC < ASC+BPD . Post hoc comparison with the Games-Howell test between the NC and BPD groups yielded a significant p value of 0.014 , however, the difference between the BPD and the ASC group was only marginally significant . Patients with both conditions, the ASC+BPD group, scored highly significantly higher than those with ASC . The AQ scores of the two ASC patient groups very clearly separated them from the responders with no diagnosis .
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Seeking The Roots Of Autism And Antisocial Personality In The Brain
Experts have long noted that both autism and antisocial personality disorder are marked by problems with empathy, yet the differences between the two conditions couldnt be starker.
Autistic people are anxious and misread social cues, but they typically care about not hurting others they are also often incapable of manipulation. Those with antisocial personality disorder, however, are masters of bending people to their will and tend to have little fear. They actually enjoy causing people pain.
In recent research, scientists highlighted the brain differences associated with autistic and antisocial traits, finding clear distinctions that remain stable during childrens development. Researchers imaged 323 typically developing youth, starting at an average age of 11. They children were also rated by their parents on levels of autistic and antisocial traits: for example, autistic traits might include has difficulty relating to peers or would rather be alone than with others, and parents would be asked to designate how well these phrases fit their child. Antisocial traits included things like lies easily and skillfully and acts without thinking of the consequences.
Indeed, the authors write: Notably, the regions associated with autistic and antisocial traits were largely anatomically distinct, calling them strikingly different.
The new study was published in the Journal of Neuroscience and conducted by researchers at the National Institute of Mental Health.
Overlaps Between Bpd And Asd
Difficulties related to the social and relational fields are characteristics found in patients with BPD, as well as in patients with ASD. Considering patients with high functioning autism, Hofvander et al. showed that 68% of the sample, composed of adults with ASD, met the criteria for at least one personality disorder. In accordance with this, when checking for possible personality disorders in a group of young adults with Asperger’s syndrome, a study showed a considerable overlap of symptoms between Asperger’s syndrome and some personality disorders . Baron-Cohen et al. emphasizes how the social and communicative difficulties of ASD subjects can be traced back to a deficiency of maturation of the theory of mind , or rather, of the cognitive mechanism responsible for the analysis of one’s own and others’ mental states, as well as highlighting in these subjects important difficulties in terms of empathy. Considering empathy as the ability to understand another’s state of mind and systematization as the ability to perceive the models of change that allow us to understand how things work and predict their future, some authors have developed a theory according to which different brain types are attributed to individuals according to their tendency to be more empathic or systematic.
It has been clarified in the literature that a lack of empathy is a hallmark of ASD .
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