Asperger Syndrome vs. Borderline Personality Disorder

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Verdandi
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04 Dec 2012, 12:14 am

argyle wrote:
So, yes, BPD/NPD/AS can look really similar. And yes, AS can lead to BPD.


Actually, I found a study that indicated that cluster A and C personality disorders are more likely for autistic people with and without ADHD, and that cluster B disorders are more common with ADHD alone.

BPD had the highest prevalence of all four cluster Bs in autistic people, however.

It was a small study, so I wouldn't assume it actually shows accurate percentages, but I think it did point to certain tendencies. I think a statement such as the one you made is overreaching, especially without reference to how many autistic people don't develop PDs at all, or which PDs are more likely to develop in autistic people.



argyle
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04 Dec 2012, 1:49 pm

DBT is typically taught by a combination of a CBT individual therapist and another therapist teaching a class on DBT skills. This arrangement works well for BPD, probably mostly because BPDs tend to paint their therapists black occasionally and stop talking to them and having 2 therapists means that one of them will usually still be painted white. The course also has the advantage of reducing shame by exposing the patient to other people suffering from the same challenges. I suspect that the DBT course alone would be pretty effective for an anxiety-prone AS. (The advantage there is that the DBT course is inherently cheap - because several people attend 1 therapist.)

@Verdandi
Oy, which study (if you can remember...)? (The Impact of ADHD and Autism Spectrum Disorders on Temperament, Character, and Personality Development?) I agree that that statement is overreaching and possibly deceptive. (particularly as clusters A and C are more prevalent) Something along the lines of...
Autism may be a strong risk factor for the development of maladaptive behaviors leading to various personality disorders, including BPD.

That said, I haven't found (and have looked for) a single study checking for AS traits in BPD-diagnosed women. I suspect (absolutely no data, just a reasonable guess) that AS traits have a high incidence in BPD-diagnosed women. This is mostly based on observations in BPDFamily, where I tended to notice that BPD women, as described by their partners, tended to fall into 2 roughly equal subgroups.
(a) Overly emotional, out-of-control, executive dysfunction, often suicidal, poor character.
(b) Violent rageaholics, zero empathy, strangely innocent, extremely honest, and obsessed by the notion that everyone around them was broken in some way.

Dunno. Seems suspicious to me. ...particularly after noticing that some of the women in our AS support group ended up in DBT...and that at least one female Aspie author of Aspie books was misdiagnosed...and that Penelope Trunk is apparently an Aspie with significant personality issues. (blogger) It is easy to see patterns where none exist, but...still suspicious.

--Argyle



Verdandi
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04 Dec 2012, 8:51 pm

I think a lot of autistic women get misdiagnosed with BPD. There are several on this forum.

I didn't mean to say you were being deceptive. Mostly just "incomplete."

I'll look up that study again and link it for you. I found it fairly interesting.



argyle
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05 Dec 2012, 1:37 pm

...yep.
...and I didn't think you'd implied that I was being deceptive - but, in my judgement - my earlier comment wasn't accurate and could tend to lead people to the conclusion that autism was mostly a risk factor for BPD. As far as I understood the paper in parenthesis, autism is a risk factor for practically any personality disorder - more type A and C and that, for type B personality disorders, BPD tends to be the most common. (I wonder about NPD connections also.) This is reasonable as increased stress+black and white thinking is a recipe for poor mental health.

...I'm not sure it is entirely misdiagnosis - it is perfectly possible to install Windows on a defective machine - having a messed up OS and messed up hardware isn't mutually exclusive. With my wife, for example, she fit the diagnostic criteria for BPD - so I'd tend to say she had it. She also has quite noticeable autistic traits. I'm guessing there are two checkboxes - one says (has BPD) and the other says (is AS). You can check any combination.

I suspect that women with less than 2 boxes checked tend to be diagnosed correctly. However, I suspect that women with both boxes checked tend to be lumped into the (has BPD) category. This isn't terrible - as (has BPD) is often fairly treatable. OTOH, this isn't great - as appropriate treatment should change a lot with an additional (has AS) diagnosis.

In particular, I believe that fewer therapists would have thrown my wife out of the office if they'd seen her communication issues as autistic rather than as mind games. And, frankly, my wife would have been more motivated if she'd accepted that many of her communication issues were related to her instead of being a function of how everyone she met was autistic and failing to understand her. Her progress has been noticeably more consistent since she realized she is at least moderately AS.

--Argyle



Verdandi
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05 Dec 2012, 5:06 pm

argyle wrote:
...I'm not sure it is entirely misdiagnosis - it is perfectly possible to install Windows on a defective machine - having a messed up OS and messed up hardware isn't mutually exclusive. With my wife, for example, she fit the diagnostic criteria for BPD - so I'd tend to say she had it. She also has quite noticeable autistic traits. I'm guessing there are two checkboxes - one says (has BPD) and the other says (is AS). You can check any combination.


Aside from your wife, you are speaking hypothetically. Several women on this forum have reported being misdiagnosed with BPD before being correctly diagnosed with AS, autism, or PDD-NOS, so I would assume their reports are correct. I also fall into this category, and despite the BPD diagnosis, five other professionals now have disputed it and agreed with my AS diagnosis. Two of them diagnosed me with AS.

Quote:
I suspect that women with less than 2 boxes checked tend to be diagnosed correctly. However, I suspect that women with both boxes checked tend to be lumped into the (has BPD) category. This isn't terrible - as (has BPD) is often fairly treatable. OTOH, this isn't great - as appropriate treatment should change a lot with an additional (has AS) diagnosis.


I suspect given the number of misdiagnoses I've read about that the "diagnosed correctly" is not as common as you might think.



argyle
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06 Dec 2012, 1:24 pm

The paper's I'd read seem to allow for co-morbidity between AS and BPD. OTOH, they seem to indicate that AS+BPD is less than 15% of the female AS population. So, probably less common than I'd guessed. I haven't been able to find any results for autism in the BPD population though.

...I'm perfectly willing to believe that misdiagnosis of women with (has AS) as (has BPD) is common. This might explain why, of the people in my wife's DBT group, she characterizes one as crazy and the other as AS. I'm somewhat dubious, as she also characterized 3 of our therapists, several of our doctors, my entire family (some truth there), and most of her friends (some truth there too...) .... as AS. I'm not saying she's altogether incorrect - she just seems unable to grasp the notion that autistic traits exist on a continuum.

--Argyle



Tali
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11 Feb 2013, 1:47 am

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Tyri0n
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11 Feb 2013, 2:28 am

pwjb wrote:
What are the key differences ? Eye contact ?


They are the exact opposite of one another. I think they can co-exist, however. There is the stereotype of the "emotional aspie."



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11 Feb 2013, 7:56 am

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Tali
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11 Feb 2013, 7:59 am

I apologise I do not know the right etiquette here. I have deleted my post in order to minimise disturbance.



Triple__B
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11 Feb 2013, 10:40 am

It is funny to see this thread. My wife was diagnosed with BPD and I suspect I am an Aspie. We are the epitome of opposites attract, having almost nothing in common. I can't stand to be around people, where she is not relaxed unless she is around lots of friends. I don't see the point in having more than 2 good friends, where she has over 30 that she keeps up with. We have been together almost 13 years now. I hate the mainstream normal life though, and she and I are definitely not normal. This is how I suspect we keep pushing on together.



aspiesavant
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08 Feb 2015, 5:33 pm

The distinction between Autism, Bi-Polar Disorder, Schizophrenia, OCD, ADHD and Borderline Personality Disorder is not clear-cut.

There's a significant overlap in symptoms and genetic correlation between each of these "disorders". Co-morbidity is also very common.

Personally, I lean towards the notion that Autism, Bi-Polar Disorder, Schizophrenia, OCD, ADHD and Borderline Personality Disorder are not individual conditions but as different expressions of the same spectrum.

I would also argue that these are not disorders, but normal variations within human behavior that have been pathologized for no other reason but the rather eccentric and unusual behavior of people within, which makes them more difficult to manipulate and control.



lasirena
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12 Apr 2016, 7:22 pm

I've found this forum very interesting. I have ASD and suspect my sister is BPD (her husband actually brought this up).
A recent conversation with her:
Her: "You know how you have Aspergers, do you have problems with strong smells, like perfume?".
Me: "I have sensory issues and I dislike strong smells but they don't cause significant issue".
Her: "Because they make me start throwing up and have to be taken to the emergency room."

At which point I don't know where to go with the conversation, because my sister creates medical "problems" to manipulate people and/ or get what she wants/ get out of doing things she doesn't want to.
For example: I text her and asked if she could pick me up from a friends house (someone she also used to be friends with but has fallen out with). She said she couldn't because she had a headache that was developing into a migraine and thought it make her too disabled to drive. When I got back to her house 10 min later she did not appear to be in any pain, no further mention of a headache etc.



macandpea
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13 Apr 2016, 4:53 am

I've been diagnosed with both. It took me awhile to get my BPD diagnosis because the psychiatrist I was seeing at the time thought my 'acting out' and emotional disregulation could be explained away by AS. I kept pushing him though because I know plenty of people on the spectrum and they weren't stuck in the kind of self destructive cycles that I was.

Autistic spectrum disorders are innate, we are born with them. Personality disorders are created through life experiences. As a rule any personality disorder won't be diagnosed in a person under 18.

BPD is characterised by destructive behaviour centred around feelings of rejection. As a person with AS I think I had a greater exposure to rejection but you can experience rejection without developing BPD traits, as many people with AS do



kraftiekortie
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13 Apr 2016, 4:54 pm

Whoever said AS could lead to BPD has rocks in his/her head.



lasirena
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13 Apr 2016, 5:15 pm

^ I don't think anyone really implied that. I think causation is a hard thing to determine.
I think it's similar to how Bruno Bettleheim observed that autistic children had similar patterns of behavior to people held prisoner in a nazi concentration camp.
He was correct in thinking those children found the world stressful, wrong in thinking it was caused by "refrigerator mothers".