Prevalence of Personality Disorders Co-Morbid with ASD's

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What is the Percentage of People on the Autism Spectrum with a Personality Disorder?
Greater than 50% 8%  8%  [ 1 ]
25 to 50% 31%  31%  [ 4 ]
15 to 24% 23%  23%  [ 3 ]
5 to 14% 15%  15%  [ 2 ]
Less than 5 % 0%  0%  [ 0 ]
Other, Please Comment. 23%  23%  [ 3 ]
Total votes : 13

aghogday
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17 Dec 2012, 7:56 pm

There is a lot of speculation in the media as to what type of personality disorder the individual involved in the recent incident might be diagnosed with, but no official information on that issue as far as I know. And, varying reports on the potential that the individual was diagnosed with Asperger's syndrome.

However, for some that have been speculating on Anti-Aocial Personality disorder for this individual, while there might be that potential in that unique individual, the study below identifies it was not a personality disorder found among individuals diagnosed with Asperger's syndrome.

Personality disorders are linked strongly with Asperger's syndrome in the study linked below, but Anti-Social Personality Disorder was not identified at all in the sample of individuals studied with Asperger's Syndrome. And, among all ASD's, only identified in 4 individuals diagnosed with PDDNOS.

The highest association among all groups studied was Obsessive Personality disorder among those diagnosed with Asperger's syndrome at 40%, with the second highest identified as Avoidant Personality disorder among those with Asperger's syndrome at 29%. All other personality disorders were measured in the 20% range and below in all ASD's studied.

Out of 62 individuals studied with Asperger's syndrome 68% had one personality disorder and 40% had two personality disorders co-morbid with Asperger's syndrome. 40% were reported obsessive, 29% avoidant, 21% schizoid, 19% paranoid, and 16% schizotypal, among others identified in the second link below that provides a table to illustrate the results.

Out of 50 individuals studied with PDD NOS, 60% had one personality disorder and 32% had two personality disorders co-morbid with PDDNOS, with a breakdown of the personality disorders illustrated in the table.

Out of 5 individuals studied with Autistic Disorder 20% had one personality disorder, 0% had two personality disorders; one individual was identified with obsessive personality disorder with no other personality disorders identified in this very small sample of individuals with autistic disorder.

The study is worth checking out as it has some other interesting information.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705351/

http://www.ncbi.nlm.nih.gov/pmc/article ... /table/T4/

At least from this study, it appears that it would be unusual to find a person diagnosed with Asperger's syndrome with co-morbid anti-social personality disorder, but not unusual at all to find a person diagnosed with Asperger's or PDD NOS with a co-morbid personality disorder of some kind, or potentially two.



Verdandi
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17 Dec 2012, 8:09 pm

The study linked is not of sufficient size to determine percentages for PDs among the autistic population. It may be higher than it is for the general population though, and the research I've seen (with a higher tendency toward Cluster A and C PDs) seems to support that.

This is the second study I've seen that found no instances of histrionic PD, however. That's kind of interesting to me.

The rumor that Adam Lanza had AS is probably just that.



aghogday
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17 Dec 2012, 8:31 pm

Verdandi wrote:
The study linked is not of sufficient size to determine percentages for PDs among the autistic population. It may be higher than it is for the general population though, and the research I've seen (with a higher tendency toward Cluster A and C PDs) seems to support that.

This is the second study I've seen that found no instances of histrionic PD, however. That's kind of interesting to me.

The rumor that Adam Lanza had AS is probably just that.


The report that Lanza had Asperger's syndrome by a Law Enforcement Officer (off the record) has not been officially substantiated. Since the young man committed suicide, and this is not going to go to court where that information might be part of the public record, I don't think that information could be released officially other than by word of mouth by a relative, because of privacy laws. What do you think?



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17 Dec 2012, 8:34 pm

I think Autistic people are going to appear "Personality Disordered" no matter what. We don't have a Neurotypical expression of ourselves.


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Verdandi
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17 Dec 2012, 9:00 pm

aghogday wrote:
Verdandi wrote:
The study linked is not of sufficient size to determine percentages for PDs among the autistic population. It may be higher than it is for the general population though, and the research I've seen (with a higher tendency toward Cluster A and C PDs) seems to support that.

This is the second study I've seen that found no instances of histrionic PD, however. That's kind of interesting to me.

The rumor that Adam Lanza had AS is probably just that.


The report that Lanza had Asperger's syndrome by a Law Enforcement Officer (off the record) has not been officially substantiated. Since the young man committed suicide, and this is not going to go to court where that information might be part of the public record, I don't think that information could be released officially other than by word of mouth by a relative, because of privacy laws. What do you think?


I think that I read this article the other day:

http://www.newsmax.com/RonaldKessler/Ro ... /id/324146

Which indicates that several rumors were spread via twitter that did not come from the Connecticut State Police.



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17 Dec 2012, 10:38 pm

Personality disorders is not teoretical expected to be higher in autism spectrum disorders than for the normal population; the environment has the responsibility in case of that development. But since autism spectrum disorders may pose challenges in the environment the environments responsibility may fail and have a negative impact on the person with autism spectrum disorder and increase the risk of a personality disorder. This means that autism spectrum disorders and personality disorders can not be seen as connected, but the meeting between autism spectrum disorders and the environment may lead to a personality disorder.

In short word do I believe that parents (and school etc.) who bring up their kids; autistic or not, in a good and loving way prevent the development of a personality disorder. With the range of attitudes toward autism spectrum disorders this may often be a hard task and the risk may be heighten as a result of this.



aghogday
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17 Dec 2012, 11:04 pm

Verdandi wrote:
aghogday wrote:
Verdandi wrote:
The study linked is not of sufficient size to determine percentages for PDs among the autistic population. It may be higher than it is for the general population though, and the research I've seen (with a higher tendency toward Cluster A and C PDs) seems to support that.

This is the second study I've seen that found no instances of histrionic PD, however. That's kind of interesting to me.

The rumor that Adam Lanza had AS is probably just that.


The report that Lanza had Asperger's syndrome by a Law Enforcement Officer (off the record) has not been officially substantiated. Since the young man committed suicide, and this is not going to go to court where that information might be part of the public record, I don't think that information could be released officially other than by word of mouth by a relative, because of privacy laws. What do you think?


I think that I read this article the other day:

http://www.newsmax.com/RonaldKessler/Ro ... /id/324146

Which indicates that several rumors were spread via twitter that did not come from the Connecticut State Police.


I don't think that was the article you intended to link.

The unnamed law enforcement officer link is still linked in Wiki, so I am interested in seeing the link you have. I also found a link from the Wiki article quoted below from 60 minutes show yesterday.

On that show one of the mother's friends was interviewed, and stated on the show with certainty that the mother told him that her son Adam's medical condition was Asperger's, that he was disabled, and on medication. I would take that statement over an unnamed source. I really don't see why the family's friend would have any reason to lie in the interview below. The brother from the start provided a potential association with Autism but did not name a specific disorder.

I heard bits and pieces of this story before, but it seems more credible coming directly from the individual on a 60 minutes TV interview, than from second hand reports in news articles. If it is incorrect, the father will have no problem debunking that from Lanza's medical records. I read that the Adam Lanza's uncle did not want to comment on Lanza's medical records, so unless the statement below is rebuked by the Father this may be the last documented report by a named individual on the subject.

I also see here in this report, and recently in other reports that the media is doing a better job than they did with Holmes, to distance the condition of Asperger's from a general association with violence.

http://www.cbsnews.com/8301-18560_162-5 ... ?pageNum=3

Quote:
Family friends told us that he was being home schooled by his mother Nancy Lanza. Nancy Lanza told her friends Mark and Louise Tambascio that Adam was brilliant but disabled.

Scott Pelley: Did Nancy Lanza ever tell you specifically what her son's medical condition was? And she put a name to it?

Mark Tambascio: Asperger's.

Scott Pelley: That's what she said?

Mark and Louise Tambascio: Yeah. Yes.

Scott Pelley: That it was Asperger's syndrome?

Mark Tambascio: Absolutely. There's no question.

Scott Pelley: And for her it was a full time job taking care of him?

Mark Tambascio: Absolutely. Oh my goodness, yes.

Asperger syndrome is a disorder within the spectrum of autism. It's characterized by social impairment, communication difficulty and repetitive patterns of behavior. An Asperger's support group told us today that patients are more prone to be victims of violence than the perpetrators of violence. And we don't know whether Asperger's played any role in the shootings, but friends told us that the condition did dominate the Lanza's lives.

Louise Tambascio: I mean, I know he was on medication and everything, but she home schooled him at home cause he couldn't deal with the school classes sometimes. So she just home schooled Adam at home. And that that was her life.



Dillogic
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17 Dec 2012, 11:25 pm

Verdandi wrote:
The study linked is not of sufficient size to determine percentages for PDs... .


They had 66 with AS. That seems to be a good sample size for that particular label. The same with PDD-NOS. (Most studies I read have similar or less numbers.)

The Autistic Disorder one is lacking though.



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17 Dec 2012, 11:41 pm

Everyone has some sort of personality disorder?

The ones aspies have are [much like NT's too] generally the product of the harassment, and isolation that modern cultures imposes on us
Essentially many personality disorders are not authentic to the persons genes, but a product of the parenting they received, society and environment

I have developed some avoidance and paranoia, but these I believe are due to society being full of idiots and bullies

I used to say: treat a man like a dog, and he begins to behave like one.



aghogday
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18 Dec 2012, 12:10 am

Dillogic wrote:
Verdandi wrote:
The study linked is not of sufficient size to determine percentages for PDs... .


They had 66 with AS. That seems to be a good sample size for that particular label. The same with PDD-NOS. (Most studies I read have similar or less numbers.)

The Autistic Disorder one is lacking though.


It was an unusual study as one usually doesn't see the majority of individuals diagnosed with Asperger's syndrome, and one usually doesn't see the 2 to 1 ratio for males and females. There were 5 with Autistic Disorder, 62 with Asperger's syndrome, and 50 with PDD NOS, listed in the table in the second link.

If the US CDC statistics are anywhere close to correct with the approximately 1 in 1000 CDC statistic for Asperger's the number in the sample in the study is close to what one might expect to find diagnosed in a city of 60K individuals.

The CDC statistic for PDD NOS is approximately 1 in 180 so one might expect to find that number diagnosed in a city of 8K. And with Autistic Disorder a village of 800.

That is an extremely limited number for Autistic Disorder, but never the less considering the prevalence in the other two disorders shown in the study it is interesting that out of 5 people only 1 person was assessed with obsessive personality disorder.

Limited research has been done on individuals with ASD's as a full spectrum for depression, and the little research that exists shows very little assessed depression for autistic disorder as opposed to more substantial assessed depression in "milder" cases, but a difficulty with assessment cited was the communication of the depression for those with more "severe" language impairments. I suppose that might be part of the issue in this study, as well, in assessing complex personality disorders in autistic disorder for those assessed with more severe communication impairments.

I read the study again and while it doesn't say that people with severe communication difficulties were excluded from the study, it provides the information quoted below:

Quote:
Cases with known medical causes of autism, including genetic syndromes, or injuries of relevance for the mental disorders assessed, were excluded by history, physical examination, and in dubious cases by karyotype, Fragile × PCR and southern blot, and FISH analyses (15q11-q13, 22q11 and 22q13 deletion syndromes). No patient was in need of language interpretation for communication.



Interesting too, was this was an adult study, and it was done in Sweden, Gilberg's native country, where the Gillberg criteria for Asperger's is often used. I don't think there has ever been a study done comparable to this one, in the US. I understand the attitudes about autism spectrum disorders, particularly Asperger's syndrome are much different there than some other countries, with government supported services provided specific to Asperger's syndrome, even support groups.

It's interesting how much country and culture seem to play a role in autism research. I noticed that when looking at results in research from the different countries in the differentiation of diagnosis of Asperger's opposed to Autistic Disorder.



justkillingtime
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18 Dec 2012, 1:07 am

Thank you for this really interesting post!


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Verdandi
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18 Dec 2012, 1:33 am

aghogday wrote:
I don't think that was the article you intended to link.


It's this article:

http://www.nydailynews.com/news/nationa ... -1.1221554



aghogday
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18 Dec 2012, 2:05 am

justkillingtime wrote:
Thank you for this really interesting post!


You are welcome, I find it particularly interesting now considering the recent events in the news. Another Personality Disorder often discussed in online Autism Communities is Narcissistic Personality Disorder

At least in the table from the study I linked in the first post above, Narcissistic Personality Disorder is pretty uncommon among individuals actually assessed with Asperger's as only 1 out of 62 individuals with Asperger's was assessed with it, and 2 were assessed out of 50 people with PDD NOS.

While these two symptoms listed after this paragraph were described in Wiki for narcissistic personality disorder, they are also clinical features seen in some with ASD's, as a result of difficulties with social-emotional reciprocity, impairments in non-verbal communication, and the experience of being bullied and ridiculed in life, for not meeting the social expectations of others.

Quote:
Hypersensitivity to any insults or imagined insults
Inability to view the world from the perspective of other people


I think a third brief characteristic associated with Narcissistic Disorder from Wiki of bragging about one's accomplishments and embellishing in subtle ways is pretty unusual for people with ASD's as a deficit of sharing one's accomplishments with other people is actually one of the impairments listed in the criteria for Autistic Disorder and Asperger's syndrome. I think in general, most people do that anonymously online more than they would in real life. So, a life online may make some people seem more narcissistic than they likely are in real life.

I do think in real life people who continuously attempt to embellish their achievements, find themselves in a bit of a fix sometimes with folks with good rote memories who pay attention to detail that more often might notice when the details of a story about one's life continues to change in subtle ways. It's even easier to notice when someone online is doing this as there is usually a permanent record of words, and one doesn't even have to rely as much on their rote memory for those kind of details.

I think I have only come across one person on the internet that runs an internet site identifying on the spectrum that is constantly talking about their achievements in life and at times obviously embellishing them from statements they have made before. In real life, I only came across a relatively few people that did this, in excess. Unfortunately, one of them was a supervisor.

Basic DSMIV-TR criteria for Narcissistic Personality Disorder quoted from Wiki:

http://en.wikipedia.org/wiki/Narcissist ... y_disorder

Quote:
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
Requires excessive admiration
Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
Is often envious of others or believes others are envious of him or her
Shows arrogant, haughty behavior or attitudes.



aghogday
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18 Dec 2012, 2:21 am

Verdandi wrote:
aghogday wrote:
I don't think that was the article you intended to link.


It's this article:

http://www.nydailynews.com/news/nationa ... -1.1221554


Maybe I missed it, but I didn't see anything in there specifically about the "unnamed" law enforcement official claiming Lanza has Asperger's Syndrome. But, that is not the type of private medical information that any law enforcment official should be giving out publicly named or unamed, during an investigation, and my understanding is that was the official statement from law enforcement when asked about the issue, per the ongoing investigation. That to me, in itself, takes credibility away from the "unnamed" law enforcement official making the anonymous statement, if one really did that.

I'm also not too comfortable with the idea of the "friends"releasing those kind of private details to the media, in an ideal world, but of course that doesn't exist, and they don't get paid not to talk about it as a job requirement, like law enforcement does.



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18 Dec 2012, 8:14 am

One of my pet peeves is people talking about 'personality disorder' as if it's all one thing. There are many different kinds of personality disorders, and they aren't all the same.

They can be divided into three clusters - odd/eccentric, dramatic/erratic and anxious/unhappy.

The odd/eccentric cluster includes Schizoid, Schizotypal and Paranoid. Schizoid is basically extreme introversion, and overlaps a lot with AS. Difference is that Schizoid need not always have repetitive behavior, while AS can be sociable (social subtypes aloof, passive or active-but-odd, schizoid would be aloof). Schizotypal and Paranoid are more related to schizophrenia to autism, but could be more common in AS.

The dramatic/erratic cluster includes Antisocial, Borderline, Narcissistic and Histrionic. Histrionic is being extremely attention-seeking, so it's probably pretty unlikely in AS. Borderline is mood swings and attachment issues (clingy and untrusting) and apparently is more common in people with AS. Antisocial is basically just being a chronic criminal, and criminal behavior is no more common in AS than NTs. Narcissistic is an overly high opinion of yourself, it's probably also no more common in AS than NTs. Incidentally, Antisocial, Narcissistic and Borderline are the only personality disorders that have a clear link to violent behavior.

The anxious/unhappy cluster includes Obsessive Compulsive Personality, Avoidant, and Dependent. Dependent is a person who depends on someone else more than they should given their level of ability. It may be more often misdiagnosed in AS people due to overestimating the person's abilities, but in reality it's probably not much more common. OCPD is being perfectionistic and routine bound, and is pretty common in AS. (In fact, OCPD plus schizoid basically adds up to AS.) Avoidant is avoiding many nondangerous activities out of fear. It could be more common in AS because we tend to be more anxious and have more negative experiences to contribute to fearfulness.

So it really depends on which PD you mean.



Verdandi
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18 Dec 2012, 9:26 am

Dillogic wrote:
Verdandi wrote:
The study linked is not of sufficient size to determine percentages for PDs... .


They had 66 with AS. That seems to be a good sample size for that particular label. The same with PDD-NOS. (Most studies I read have similar or less numbers.)

The Autistic Disorder one is lacking though.


Fair enough. It may be. Two studies seem to have similar results, as well.

(edited as I rechecked the other numbers and they were closer than I recalled)



Last edited by Verdandi on 18 Dec 2012, 9:56 am, edited 1 time in total.