Personality Disorders and ASD

Autism spectrum disorder (ASD) in adolescence and adulthood is frequently difficult to discriminate from personality disorders (PD), a group of conditions that could present with similar symptomatology. For instance, PD belonging to cluster A (i.e., schizoid or schizotypal) share with high-functioning ASD the presence of odd behaviors and social withdrawal, while cluster B PD may present dysregulation in emotional expressivity, as well as self-injurious behaviors (i.e., borderline) and empathic behaviors (i.e., antisocial); finally, cluster C PD may again share a certain level of social avoidance (i.e., avoidant PD) or sameness (i.e., obsessive-compulsive PD). The assessment of PD in the low-functioning part of the spectrum may be even more difficult and few tools are available for their identification. Literature also reports that PD can be present also in comorbidity with ASD. In conclusion, during ASD assessment in adulthood it is always important to consider PD, both for differential diagnosis and for better treatment planning.