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Poke
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29 Sep 2009, 6:35 pm

Is it possible that "narcissistic personality disorder" and "borderline personality disorder" could simply be sub-clinical autism/Asperger's?



Aoi
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29 Sep 2009, 7:09 pm

Possible but quite unlikely. People with NPD or BPD do not typically have difficulties in nonverbal communication, theory of mind, or other aspects of socialization that typify ASDs.

I recently asked a psychiatrist about this comorbidity issue. He said that he's not seen a case of comorbid autism and a PD in his clinical experience, and believed based on the diagnostic criteria for BPD (which I asked specifically about) that it wouldn't be possible, since the criteria for one would rule out the other.

Also not found in PDs is the sensory issues common in ASDs. Similarly, stimming, the need to be alone to recharge/regenerate after socializing, and special interests are common in ASDs but rare in PDs.

But misdiagnosis is possible. Women with HFA/AS are sometimes initially diagnosed with BPD, since BPD is at times used as a "garbage can diagnosis", one given to patients who cannot be readily diagnosed or are difficult to work with (again, according to this psychiatrist).



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29 Sep 2009, 7:14 pm

NO! ASDs can lead to Borderline Personality Disorder as a result of family abuse. The key here is the abuse that leads to Personality Disorders.

Famous sufferers of Narcissistic Personality Disorder: Hitler, Stalin, Saddam, Obama.

Famous sufferers of Borderline Personality Disorder: John Lennon, Marilyn Monroe, Charlie Parker


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29 Sep 2009, 8:30 pm

Yeah, I'm not gonna get into that political debate...

Anyway, yes, a PD and an ASD can definitely co-exist. Autism isn't a pre-written personality and doesn't dictate personality factors to a huge degree; so any extreme, troublesome personality traits can indeed exist in autistic people. I'm going to guess we are more likely than NTs to be Avoidant, Schizoid, Schizotypal, or Paranoid, and less likely to be Borderline or Histrionic. Narcissistic and Antisocial are probably about equal. I haven't actually done any research; but the way autism skews to the introverted and undramatic--in general, definitely not in all cases--would seem to suggest that those traits that are exaggerated versions of inwardly focused traits would be more common, and outwardly focused traits, less so.

I was misdiagnosed Borderline myself, on the strength of a single symptom--my tendency towards self-injurious behavior when under extreme stress. That is the only thing I truly share with the borderline group, though I've spent some time talking to them on an online forum. It seems that they suffer just as much as autistics, maybe more, from being stereotyped; and while they do tend towards drama and get swallowed up easily in their own feelings, they also tend to be very socially perceptive and empathetic. It seems to me that psychiatrists who write off Borderlines don't think very far past the annoying-patient stereotype; because from what I picked up there's no reason to write them off, as they often will mature out of the worst of it, as they learn more about life. There's no good reason they can't learn those things earlier, but many therapists are apparently leery of even trying to teach them. It's as bad as neglecting to teach an autistic child how to understand and control meltdowns...


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29 Sep 2009, 8:54 pm

WoodenNickel wrote:
Famous sufferers of Narcissistic Personality Disorder: Hitler, Stalin, Saddam, Obama.


Who says that Obama is narcissistic? I haven't heard that one yet!

BTW, I have a few family members who present with both AS and BPD.


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29 Sep 2009, 9:28 pm

I think it's very possible to meet the diagnostic criteria for both an autism spectrum disorder and a personality disorder. It's much less frequent that both conditions actually exist in their own right in one person-- many of them are simply effects of the other disorder.
It's quite natural for somebody with AS to be afraid of abandonment. Many cannot manage on their own, and have been abandoned in the past. However, is it pathological for somebody with trouble understanding people and forming relationships to have a fear of abandonment? I don't see how. Borderlines form these instant "relationships" and then have a horrible fear of the "new best friend" they met three days ago abandoning them. That's a completely different phenomenon. Then take the fact that given the borderline "instant relationship" thing, I doubt that I'm the only person with AS who ever ended up with a borderline "friend" who ended up being a very negative influence as a social role model. But if you don't know how to form friendships to begin with, and suddenly you find yourself with a borderline friend, it's difficult to sort out what's going on. And then the BPD friend suddenly changes, and someone with AS tends to stay the same.. Borderlines tend to constantly be "recovering" or "turning over a new leaf" and suddenly thinking that it's pathetic to have any problems. Then it's like they're a totally different person, and all those things they said you had in common.. they've "gotten over." :?
Then a therapist gets annoyed that you're difficult to connect with and --poof!-- a borderline diagnosis appears!
This is the problem with diagnosis by behavior-- the same behavior can have opposite causes. If you try to treat a behavior when the cause is the polar opposite of what the treatment is designed to help, it's going to backfire.

For many years I thought that I had BPD, and I think I technically meet the criteria. It's the clinical picture that's off.

BPD may really be easier to treat-- it does tend to fade with age and maturity. Of course, borderlines are always changing.

:oops: sorry for the rant..



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29 Sep 2009, 11:23 pm

Schizoid PD is pretty much subclinical AS/HFA.



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30 Sep 2009, 1:12 am

No, I disagree; I think they're two different things, in fact, the schizoid "not taking pleasure in much of anything" directly opposes the ASD tendency towards intense special interests. Schizoid PD is a sort of extreme introversion; and while it definitely shares a lack of socializing with those who have an ASD, the big difference is that with schizoid PD, you don't want to socialize; with an ASD, it's tiring, overwhelming, or very difficult. Asexuality is common in both groups but much more common in the schizoid group; flat affect is common in both but again much more common with schizoid PD... I'll agree that if you could diagnose them both in one person (they don't let them do that because the schizoid PD diagnosis is meant to pin on otherwise-neurotypical folks), then you would probably have a higher percent of schizoid among the ASD group than the typical group; but they aren't the same thing. A lack of interest in other people combined with a lack of expressed emotion doesn't really connect to the level of social skills, and is quite opposed to the intense activities/interests of autism.


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30 Sep 2009, 2:09 am

To phrase it better, it's a form of subclinical AS/HFA, i.e., one manifestation of it. The type of person with AS/HFA who doesn't want to socialize, even though they have the ability to at least try to in an odd manner (and it's not as overwhelming as the clinical forms of AS/HFA for them); the solitude in early life of minor AS could create this picture. However, definitions of Schizoid PD do vary between researchers and clinicians.

Lorna Wing wrote* that AS can be seen as a form of [childhood onset] Schizoid PD in her definitive paper, but that classifying it under Schizoid PD wouldn't actually be of any help.

*

Quote:
Schizoid personality

The lack of empathy, single-mindedness, odd communication, social isolation and over-sensitivity of people with Asperger syndrome are features that are also included in the definitions of schizoid personality (see review by Wolff & Chick, 1980). Kretschmer (1925) outlined some case histories of so-called schizoid adults, one or two of which were strongly reminiscent of this condition, although he did not provide sufficient detail to ensure the diagnosis. For example, one young man had no friends at school, was odd and awkward in social interaction, always had difficulty with speech, never took part in rough games, was oversensitive, and very unhappy when away from home. He thought out fantastic technical inventions and, together with his sister, invented a detailed imaginary world.

There is no question that Asperger syndrome can be regarded as a form of schizoid personality. The question is whether this grouping is of any value. This will be discussed below in the section on classification.



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30 Sep 2009, 4:45 am

Callista wrote:
No, I disagree; I think they're two different things, in fact, the schizoid "not taking pleasure in much of anything" directly opposes the ASD tendency towards intense special interests.


At first look, seems very similar: in practice, what is exactly the big diference between "don't have interest in almost everything, with the exeption of a few activities" and "have an interest in some restricted activities so strong that leads to the exclusion of everything else"?



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30 Sep 2009, 5:27 am

I am diagnosed aspergers but i think hfa can also be involved. The doctor showed no interest. Diagnosis is done and it's time for the next client, that kind of attitude.



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30 Sep 2009, 5:31 am

Welcome to WP!


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30 Sep 2009, 7:20 am

There are two issues here: can PDs coexist with ASD, and can an ASD be misdiagnosed as a PD? Regarding the fomrer, obviously yes. I don't see any reason why meeting the criteria for NPD and BPD would exclude the possiblity of an ASD. Even though the stereotype of NPD and BPD are quite socially aware and use this to manipulate others, and the stereotype of AS is naive and too socially awkward to be able to manipulate anyone, stereotypes are not criteria. In NPD, exploitation of others is only one criteria of 9. In BPD, there is no such explicit criterion. Therefore, if a person meets DSM criteria for both an ASD and BPD/NPD, they can be diagnosed with both.

As for misdiagnosis, this may occur as well, when symptoms are misinterpreted by the clinician. For example, an Aspie's meltdowns may be interpreted as simple impulse control issues, thereby meeting one criterion from BPD (repeated anger outbursts or fights). An Aspie's lack of empathy may be interpreted as unwillingness to empathize rather than inability, therby meeting one criterion from NPD. These are just examples, but the same can be said of most PD criteria. On the othe rhand, this is of cours eno reason to say that if an autistic is diagnosed, that means they can't possibly have a comorbid PD because all their symptoms must be due to autism.



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30 Sep 2009, 11:30 am

I've posted this on another thread, but when I got my MA in psychology, I took an entire quarter course on personality disorders. Autism Spectrum Disorders were never mentioned in my three year program. Most clinicians are not familiar with them. My therapist and psychiatrist that I see now admit they are not familiar with them.

When a person has chronic social difficulties, the average clinician is going to label with a personality disorder. It's because they don't know any better.


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24 May 2024, 8:46 am

I started to understand social cues, but I lack social-emotional reciprocity to a mild degree.

Are there any tips to improve my social-emotional reciprocity?

Is social-emotional reciprocity a social skill as well?

It's just I feel like an alien, even though I understand social cues, I still have mild commutation delay to some extent.

I hope you know what I mean.

I feel a bit Schizoid, but it is actually Autism Spectrum Disorder.



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24 May 2024, 8:51 am

It is possible to have Autism Spectrum Disorder and Antisocial Personality Disorder, as well as are much more likely to be victims than perpetrators, some victims also can become criminals, but that is rare. Some victims become delusional or psychotic and then develop severe personality disorders and unhealthy paraphilias/unhealthy fetishes and make delusional excuses as to why they want to murder their abusers and some of those people commit murder against their abusers.



To say that victims can't become criminals is false and untrue because being abused for a long time can affect your mental health badly resulting in symptoms of personality disorders that may lead to criminal behavior later on in young adulthood.



Research, sources, and references:



​1) https://www.google.com/search?q=The+cau ... s-wiz-serp





2) https://www.mayoclinic.org/diseases-con ... evelopment.





3) https://www.samhsa.gov/mental-health/an ... y-disorder





4) https://my.clevelandclinic.org/health/d ... y-disorder





5) https://jaapl.org/content/49/4/462





6) https://www.google.com/search?q=Autism+ ... s-wiz-serp





7) https://www.purdueglobal.edu/blog/crimi ... ce-system/



But Prof. Sam Vaknin links crime to High-functioning Autism, also known as Autism Spectrum Disorder Level 1: https://youtu.be/7GjuAdqi1nA



Same thing with Wikipedia as well: https://en.wikipedia.org/wiki/High-func ... m#Behavior


I expressed that I might have PTSD and Unspecified Personality Disorder with Schizotypal, Narcissistic, and Antisocial pathology after many negative experiences in the past.



It is important to understand that most people with Autism Spectrum Disorder are much more likely to be victims than perpetrators, however, there are people like me with Autism Spectrum Disorder who have some social intelligence to commit crimes, by learning all kinds of psychology and reading a book on how to read and recognize facial expressions and most body languages. I also learned dark social skills, due to a history of mental health issues related to ODD and CD tendencies, with mania, normal mood, and then depression with delusions as a symptom.

People like me became the Joker, the only difference between my symptoms of personality disorders and Jokerś is that t he commits crimes and I never harmed anyone, as I tend to follow by practicing communards by Judaism.

There is a link between having Neurodevelopmental Disorders and being victimized more than the general population. It causes some of those people to have mental health issues, delusions, and personality disorders that may lead to antisocial tendencies or severe personality disorders.