Tamilson Bruce, Eccles Jessica A, Shaw Sebastian C K
Brighton and Sussex Medical School, UK.
Autism. 2025 Feb;29(2):504-517. doi: 10.1177/13623613241276073. Epub 2024 Sep 11.
Autistic people face many barriers to receiving an autism diagnosis. Often, they may be misdiagnosed with borderline personality disorder instead. For our study, we interviewed 10 autistic adults who had previously been diagnosed with borderline personality disorder. This helped us to better understand their experiences. They explained how borderline personality disorder is quite stigmatised and may suggest that people are to blame for their differences in behaviour. They found the treatments they had to try for borderline personality disorder to be harmful. For example, these treatments promoted 'masking'. Previous research showed that masking can be harmful for autistic people, linking it to risk of suicide. This diagnosis also led to healthcare professionals neglecting them and discounting their beliefs. Once they were diagnosed with borderline personality disorder, it was hard to access an autism assessment. When they did receive their autism diagnoses, this was much more positive. This diagnosis was validating. It also improved their mental health, as they were no longer expected to mask - their differences were now accepted. They still felt that autism was stigmatised in society. However, this was very different to the stigma around borderline personality disorder. They felt autism stigma was more about their competence as people, whereas borderline personality disorder stigma was about how they were broken and might be harmful to others. This study is important because it allows their stories to be heard by researchers and healthcare professionals alike. Adding their voices helps to humanise them, promoting positive change in mental health services. More research is now needed.
自闭症患者在获得自闭症诊断方面面临许多障碍。通常,他们可能会被误诊为边缘型人格障碍。在我们的研究中,我们采访了10位曾被诊断为边缘型人格障碍的成年自闭症患者。这有助于我们更好地了解他们的经历。他们解释了边缘型人格障碍是如何受到相当大的污名化的,并且可能暗示人们要为自己行为上的差异负责。他们发现他们为边缘型人格障碍不得不尝试的治疗方法是有害的。例如,这些治疗方法促进了“伪装”。先前的研究表明,伪装对自闭症患者可能有害,并将其与自杀风险联系起来。这种诊断还导致医疗保健专业人员忽视他们并忽视他们的信念。一旦他们被诊断为边缘型人格障碍,就很难获得自闭症评估。当他们最终得到自闭症诊断时,情况要积极得多。这种诊断得到了认可。这也改善了他们的心理健康,因为他们不再需要伪装——他们的差异现在被接受了。他们仍然觉得自闭症在社会上受到污名化。然而,这与围绕边缘型人格障碍的污名非常不同。他们觉得自闭症污名更多地关乎他们作为人的能力,而边缘型人格障碍污名则关乎他们如何“有缺陷”以及可能对他人有害。这项研究很重要,因为它让研究人员和医疗保健专业人员都能听到他们的故事。加入他们的声音有助于使他们更有人情味,促进心理健康服务的积极变革。现在需要更多的研究。