ASD and NPD comorbid?

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I have read that narcissistic personality disorder (NPD) and autism spectrum disorder (ASD) are sometimes confused for one another. In common are an apparent lack of empathy, lack of close reciprocal relationships, a preoccupation with the self, and what seem like tantrums (narcissistic rage for NPD, meltdowns for ASD).

Just recently it occurred to me to wonder what it would look like if a person has both conditions, and how often does that occur. I offer as an exhibit a particular narcissistic relative of mine. I was thinking how enraged she gets by another person not being "ready" to go out or to be picked up for a ride, on time. But then it dawned on me that her reaction is very similar to my (aspie) daughter's when I was barely a minute or two late to give her a ride somewhere, panicky and emotional.

Have you seen these two things occur in the same person? How do you account for it?

I bet like the ones you hear about in those negative stories online about being married or in a relationship with an aspie. ASPartners for example.

I think narcissist rage is directed at another person or situation and with ASD it is frustration directed inward. This is what I have witnessed but not in the same person.
The difference may be subtle but it's noticeable.

I think a person I know online has NPD and ASD. Haven't seen someone in real life with both though. I do believe both can occur in an individual though.

Personality disorders are commonly formed in individuals who have suffered abuse and/or trauma at a young age. Autistic individuals are very susceptible to abuse and other traumatic experiences, and these can lead to the development of poor self-esteem and obviously a lot of other problems.

Those with NPD tend to be very insecure with themselves so they have this grandiose exterior and grandiose behaviours to feed their need to be admired/loved. Their behaviours are basically maladaptive coping mechanisms developed to help their extremely low self-esteem; grandiosity compensates for that.

I don't have NPD but I have Borderline PD, from the same Cluster B of PDs so it has some similarities. From how I interpret it, I think NPD rage will be something like: You have to meet my expectations because I am special and I am unique. (maybe: if you don't, you don't care about me and that is unacceptable.) I want to be on time, and I do not want to be waiting for you (I am important!! I am not 'below' you!!). If we are late, you will make us look bad. You will make me look bad. I have to be perfect.

Perfectionism is probably the big thing NPD and ASD have in common. But I think that perfectionism in NPD is more egocentric, that Narcissistic individuals themselves need to be perfect. On the other hand, autistic individuals need perfection in their situation and environment, they need things to be predictable and operating as planned (i.e. if you are late, the schedule is messed up and I am uncomfortable with that). Imperfections can cause both NPD and ASD individuals to react in extremes; NPDs being upset that they are not important, and ASDs being upset and anxious about the new, unfamiliar situation that has been created.

A "lack of empathy" is another thing they have in common, but it's kinda complicated. It refers more to cognitive empathy, or being aware of others' feelings/needs/perspectives.. stuff like that.. But this common symptom is what makes ASD and NPD confused with one another, because both can be (or seem to be) self-centered..

.. Especially when you look at other characteristics like ASD individuals being unable to read social cues so they seem pretentious, poor Theory of Mind skills that make them seem 'self-absorbed'.. Special interests and long monologues about them too, which can also seem very self-absorbed (even when they're not trying to be!! !! They're just trying to share something that makes them happy!! !) NPD's 'self-centeredness' is reflected in their need for admiration and self-importance because that gives them self-worth; they need to be special and unique.

Like with ASD, Narcissistic lack of empathy is also mostly unintended. Most of them don't willingly disregard other's feelings, they just have difficulties grasping them. While for ASD it is present from birth, NPD's lack of empathy is mainly caused by abuse and trauma, which tend to mess up their ability to empathise and regulate their emotions. (source)

Anyway, in conclusion, ASD and NPD can look similar (especially with their extreme behaviours) but deep down they have their own characteristics that explain why they present the ways they do. Both are very misunderstood, stigmatised and often misdiagnosed. But also, I can certainly see that someone can meet criteria for both.

That was a very insightful analysis, but this relative, who everyone agrees has striking entitlement issues, really doesn't have any particular history of abuse or trauma. Instead, she was sort of the golden child, who grew up getting praise for doing everything right. Her biggest trauma was that subsequent children stole some of the limelight. I think we have to be careful about calling the births of siblings trauma - it's a normal family development.

On the surface, both contradict each other.

If a person did, indeed, evince both disorders simultaneously, this person would be most unpleasant, indeed.

Yup. She is. She harshes my mellow (and everybody else's).

Well, here are the current DSM-V criteria for Narcissistic Personality Disorder (NPD):

Source: https://en.wikipedia.org/wiki/Narcissis ... rder#DSM-5

The underlined part alone may lead to confusion about ASD vs. NPD, but the pathological need for social admiration in NPD (the parts in italics) puts it somewhat at odds with the awkwardness in (and frequently outright aversion from) social situations common to ASD.

I also suspect that the apparent correlation between ASD and NPD may partly be a result of people with NPD (or, if they are children - their parents) deliberately trying to squeeze themselves into an ASD diagnosis because it is less stigmatizing. The same thing may be the case with Antisocial Personality Disorder...

Which may relevant in this case:


I actually read quite a few stories about these husbands on ASPartners, and in many cases they are described as being "expert social manipulators" ... That's not really an AS trait...

If you've seen an instance of a narcissistic injury - where a narcissist is wounded to the core by something he perceives as a slight - and then mounts defenses, whether hostile or self-aggrandizing; and you've seen instances of aspies, often due to histories of being bullied, being unduly traumatized by a perceived slight, such as ostracism; then you might be looking at some similar psychological processes. I do think the aspie is more likely to turn the pain and blame inward.

This is one of a number of reasons it is helpful to work with an aspie child on self-esteem preservation and dealing with bullies. Of course, the nascent narcissist may need help too, but is often left to his own devices because he seems so generally competent.

In both cases you see maladaptive coping behaviors to instances of social conflict.

I stay away from that forum now. Too much negativity and I don't doubt those women are actually being abused or were in abusive relationship with their "aspie." I can sometimes relate to them because I was also in a emotionally abusive relationship some some of their other stories sound like my first ex. But some women there act like nazis about us and act like we need to wear something that indicates we're aspie to warn others and some of them also act like we are out to hunt people down to hurt and rob their emotions and feelings and bring down their self esteem. I feel pity if this is how they view us. That place has gone very hostile towards us. Also some also diagnose every a-hole with AS. I swear they make us sound like narcissist psychopaths and I can understand ASD peoples concerns about that forum.


But as my mom always says, anyone can be an as*hole, anyone can be abusive. There is nothing out there that makes anyone incapable unless they are confined to a wheelchair and can't even move their bodies or talk.

I strongly believe my ex was a narcissist than aspie. So that means I am not insensitive or that I am crazy or too sensitive or intolerant or none accepting. But sadly those women on that forum don't want to hear the wonderful news that their "aspie" may be a narcissist and that their "AS symptoms" is actually narcissism.

"I have good news. Your partner is a narcissist."

Why is that good news? That is horrible, how is being with a narcissist great?"

"You misunderstood, what I mean is your partner isn't an aspie so that means you are not insensitive or intolerant towards him and that you don't need to toughen up or that you are wrong for how you feel and you are not too sensitive, your partner is a narcissist so that means you are the victim, not a bad guy. Now you won't be seen as the bad guy when you talk about your abusive relationship because your partner was a narcissist. Just don't label him as an aspie or you will be seen as the insensitive one and they will see your abuser as the victim but if he is a narcissism you get sympathy and no one will see you as the bad guy, they will see you as the victim."


But my question is what if your abuser actually had AS? But luckily here no one gets mad at anyone for being with an abuser who happens to have AS. Instead we just tell them it has nothing to do with AS. But if they came here complaining how bad aspies are bla bla bla, then we get mad. For years I just didn't mention my ex partner having it when I would talk about how bad he was. I didn't want to deal with any victim blaming and see any abuser apologists. When you have been hurt, that is the last thing you want to hear. Then I remember how excited I felt this year when I discovered he may have been a covert narcissist. Then I decided I will no longer identify him as an aspie. If he was both, don't care.

Well, if you mean have I seen narcissism and ASD occur in the same person, then, YES! Right-off-the-top-of-my-head, there's at least THREE people right here in River City (this site) with BOTH.

Narcissism, IMO, is a behavior (meaning, it's learned), whereas ASD is a disorder, and is NOT learned (although, I've heard there are some fakers, out there in the world). A behavior can be learned by most anyone with an ASD.

I don't think I've ever seen someone who was narcissistic, who wasn't ALSO spoiled-rotten (I've even seen people, in person, who spoiled THEMSELVES, cuz they had such a sucky life [or, FELT they did] and they decided they were gonna MAKE people respect / like / admire them)----and, alot of ASDers are spoiled because they are treated with kid gloves, because they are "special"; so, I think it's QUITE possible to be BOTH.