Albantakis Laura, Weindel Leonie, Brandi Marie-Luise, Zillekens Imme C, Henco Lara, Thaler Hanna, Schliephake Lena, Schilbach Leonhard
Max Planck Institute of Psychiatry, Munich, Germany.
International Max Planck Research School for Translational Psychiatry, Munich, Germany.
Autism. 2025 Jun 1;29(10):13623613251338650. doi: 10.1177/13623613251338650.
Alexithymia and autism are variably characterized by social cognitive and perceptual deficits, which can lead to profound social interaction difficulties. Such difficulties are also the hallmark of personality disorders (PDs), but the potential link between alexithymia, autism, and PDs remains unclear. Here, we investigated whether autistic and/or alexithymic traits are associated with specific PD dimensions as measured by the Assessment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (-IV) Personality Disorders Questionnaire (ADP-IV). We included individuals with a formal autism diagnosis (AP, = 89), individuals with a psychiatric diagnosis other than autism (NAP, = 51), and neurotypical participants (NPs, = 84). We applied linear regression analyses with autistic and alexithymic traits as predictors and PD dimensions as outcome variables, while controlling for age, depressive, and socially anxious symptoms. While autistic traits predicted the obsessive-compulsive PD dimension, alexithymic traits predicted the borderline PD dimension. Autistic and alexithymic traits were both significant predictors of the schizoid PD dimension. Taken together, our results point toward overlaps between autistic traits and specific PD dimensions that are well recognized as differential diagnoses of autism, while alexithymia was differentially linked to the borderline PD dimension.Lay abstractAutistic people have trouble identifying their own emotions and others' emotions. They also struggle to describe their emotions. People with alexithymia have similar difficulties. This can make it hard for autistic and alexithymic people to react appropriately to situations. Some may avoid places, while others may start overthinking. This can lead to patterns of behavior and thinking that limit us in our daily lives. If these patterns become a part of our personality, we may develop a personality disorder (PD). In our study, we looked at whether autistic and alexithymic people have certain PD dimensions. We included autistic participants, non-autistic participants with social-interactive difficulties, and non-autistic participants without social-interactive difficulties. We found that autistic features were linked to obsessive-compulsive PD dimension. Alexithymic features were linked to borderline PD dimension. Autistic and alexithymic features were linked to schizoid PD dimension. Our results point toward overlaps between autistic traits and PD dimensions that are well recognized as differential diagnoses of autism. The exception was borderline PD dimension, which was linked to alexithymic traits.
述情障碍和自闭症的特征表现为社会认知和感知缺陷，程度各异，这些缺陷会导致严重的社交互动困难。此类困难也是人格障碍（PD）的标志，但述情障碍、自闭症和人格障碍之间的潜在联系仍不明确。在此，我们研究了自闭症和/或述情障碍特质是否与《精神疾病诊断与统计手册》第四版（-IV）人格障碍问卷（ADP-IV）所测量的特定人格障碍维度相关。我们纳入了被正式诊断为自闭症的个体（AP，n = 89）、患有除自闭症之外精神疾病诊断的个体（NAP，n = 51）以及神经典型参与者（NP，n = 84）。我们进行了线性回归分析，将自闭症和述情障碍特质作为预测因子，人格障碍维度作为结果变量，同时控制年龄、抑郁和社交焦虑症状。结果显示，自闭症特质可预测强迫型人格障碍维度，述情障碍特质可预测边缘型人格障碍维度。自闭症和述情障碍特质均是分裂样人格障碍维度的显著预测因子。综合来看，我们的研究结果表明自闭症特质与特定人格障碍维度之间存在重叠，而这些维度被公认为是自闭症的鉴别诊断标准，同时述情障碍与边缘型人格障碍维度存在差异关联。
自闭症患者在识别自身情绪和他人情绪方面存在困难。他们也难以描述自己的情绪。述情障碍患者也有类似的困难。这可能使自闭症和述情障碍患者难以对各种情况做出适当反应。有些人可能会避开某些地方，而另一些人可能会开始过度思考。这可能导致行为和思维模式在日常生活中限制我们。如果这些模式成为我们人格的一部分，我们可能会发展出人格障碍（PD）。在我们的研究中，我们研究了自闭症和述情障碍患者是否具有某些人格障碍维度。我们纳入了自闭症参与者、有社交互动困难的非自闭症参与者以及没有社交互动困难的非自闭症参与者。我们发现自闭症特征与强迫型人格障碍维度相关。述情障碍特征与边缘型人格障碍维度相关。自闭症和述情障碍特征与分裂样人格障碍维度相关。我们的研究结果表明自闭症特质与人格障碍维度之间存在重叠，而这些维度被公认为是自闭症的鉴别诊断标准。例外的是边缘型人格障碍维度，它与述情障碍特征相关。
