Autism X external factors/personality differences

External factors and life experiences

Personality differences/disorders

Schizoid personality disorder (SPD)

Post traumatic stress disorder (PTSD)

Emotionally unstable personality disorder (EUPD)

Trauma

Attachment disorder

Avoidant personalilty disorder (AvPD)

Antisocial personality disorder (ASPD)

Disclaimer

Overlap

What can EUPD look like?

What can autism look like?

• Emotional upset triggered by changes, cognitive overload and sensory overload.
• Sensory sensitivities.
• Potentially struggling with maintaining friendships or developing one intense friendship at a time.
• Engaging in repetitive behaviour and routines.
• Having special and/or specific interests.

• Shame.
• Mood fluctuations.
• Impacted self-esteem.
• A diffuse sense of self.
• Relationship difficulty.
• Increased risk of victimisation, suicidality and self-harm.
• Difficulty regulating intense emotions.
• Tendency to systematise and categorise.
• Increased rates of eating disorders and substance abuse.
• Difficulty with impulse control.
• Rejection sensitivity.
• Sense of emptiness.
• Paranoia.

• Emotional upset triggered by attachment injuries.
• A pervasive pattern of instability in relationships, self-image and mood.
• Having intense relationships that are often marked by idealisation and devaluation dynamics.
• Fear of abandonment.

+info

Overlap

What can SPD look like?

What can autism look like?

• Sensory sensitivities.
• Engaging in repetitive behaviour and rituals.
• Being a visual/high-context thinker
• Strictly adhering to routines and structure.
• Having special or specific interests

• Not outwardly showing emotions.
• Experiences social difficulties and withdrawal.
• Difficulty with eye contact.
• Motivation difficulties.
• Easily overwhelmed with the positive emotions of others.
• High need for alone time.
• Genetic and neurological similarities.
• Feeling more like an "observer" than a participant.
• Higher likelihood of being asexual/aromantic.
• Rigid cognitive patterns.

• Self-isolating.
• Detaching and feeling indifferent to relationships.
• Being driven by internal validation (not external).
• Having a limited range of emotions.
• Experiencing challenges with displaying empathy.
• Social anhedonia.

+info

Overlap

What can AvPD look like?

What can autism look like?

• Displaying repetitive behaviour and rituals.
• Sensory sensitivities.
• Being a visual/high-context thinker.

• Having specific or special interests.
• Having a preference for their own company.

• Rigidity and routines.
• Social comparison.
• Social differences and withdrawal.
• Having difficulty with eye contact.
• Using fantasy as a form of escape.
• Having a high co-occurrence of anxiety disorders, agoraphobia, panic, OCD and PTSD.
• Struggling to feel a sense of self.
• Studying and analysing social interactions.
• Experiencing difficulty with unknown situations.
• Experiencing difficulty with change.
• Sensitivity to rejection or criticism.

• Feeling "out of depth" in social situations.
• Self-isolating.
• Wanting to socialise but having fear and anxiety interfere.
• Having a strong need to be liked by everyone.
• Low self-esteem.
• Feeling fear of being embarrassed.

+info

Overlap

What can ASPD look like?

What can autism look like?

• Experiencing difficulty in interpersonal relationships because they have trouble “reading other people”.
• Struggling to take the perspective of another.
• Becoming frustrated because they don’t understand the behaviour of another person.
• Saying what they mean and meaning what they say.

• Difficulty in interpersonal relationships.
• Struggling to connect with others.
• Difficulty sharing.
• Aggression.
• Communication challenges.

• Experiencing continuous difficulty in their interpersonal relationships.
• Displaying a limited capacity for empathy.
• Struggling to feel with and connect with another person.
• Becoming angry and aggressive when others disagree, fail to meet their expectations, or don’t affirm their sense of self.
• A tendency to be dishonest.

• Acting without thinking of the consequences.

+info

Overlap

What can trauma look like?

What can autism look like?

• Atypical sensory profile (including stimming behaviour).
• Specific passions and special interests.
• Austically social (still social, but not in the “usual” way).
• Communication challenges.

• Struggling with feeling overwhelmed.
• Emotional dysregulation.
• Self-soothing behaviours.
• Seeking predictability and control.
• Displaying restricted or avoidant behaviours.
• Hypervigilance around environmental triggers.
• Obsessive thoughts and behaviours.
• Concentration and attention difficulties.
• Dissociating.
• Derealisation.

• Something that happens to you.
• Adverse experiences.

• Having flashbacks.
• Self-hate and blame.
• A persistent negative emotional state.
• Having a limited capacity to experience positive emotions.

+info

Overlap

What can PTSD look like?

What can autism look like?

• Dissociation.
• Intimacy difficulty.
• Increased risk of victimisation.
• Negative beliefs of self and world.
• Difficulty managing emotions.
• Heightened sensitivities to sensory input.
• High rates of substance abuse, depression, self-harm and suicidality.
• Hypervigilance, an overactive nervous system.
• Impulse control difficulties.
• Sleep issues.
• Stimming.

• Displaying repetitive behaviours and self-soothing through the use of routines.
• Experiencing difficulty intuitively reading neurotypical social cues.
• Sensory sensitivities.
• Special interests.

• The presence of a traumatic event.
• The presence of adverse childhood experiences, like abuse.
• Displaying avoidance behaviours.
• Experiencing intrusive memories and flashbacks.
• Hypervigilance.
• Having nightmares.

+info

Overlap

What can attachment disorder look like?

What can autism look like?

• Engaging in repetitive behaviours.
• Echolalia.
• Repeating words or phrases for pleasure.
• Preferring familiarity.
• Preferring parallel or solitary play.
• Adhering strictly to the rules as they interpret them.
• Saying what they mean and meaning what they say.

• Engaging in repetitive behaviours.
• Inflexibility.
• Atypical play.
• Challenges with social interaction.
• Communication difficulties.
• Emotional dysregulation.
• Executive function difficulties.
• Sensory integration difficulties.
• Stimming.
• Potentially seeming calmer when alone.

When trying to differentiate between autism and attachment difficulties, referring to The Coventry Grid is a good place to start.

• The presence of a traumatic event, adverse experience or dysfunctional relationship.
• Showing limited positive emotions.
• Displaying irritability, fear or sadness when they come into contact with their caregivers.
• Difficulty calming down.
• Rarely seeking out comfort from caregivers.
• Showing extreme responses to stress.
• Showing psychomotor restlessness.
• Avoiding or indiscriminately seeking affection.
• Using repetitive language for reassurance.
• Creating scripts for stressful situations.

+info

Coventry grid

Emotionally unstable personality disorder - also referred to as borderline personality disorder - is a common misdiagnosis for autistic people. Challenging matters, both diagnoses co-occur at high rates and an autistic person is more vulnerable to developing emotionally unstable personality disorder.

Given the high rate of co-occurrence, it's more likely that missed diagnosis happens (vs. misdiagnosis). A missed diagnosis happens when a person’s PTSD is accurately diagnosed while their underlying neurotype (autism) remains missed.

Antisocial personality disorder (ASPD) is a particularly challenging type of personality disorder characterised by impulsive, irresponsible and often criminal behaviour. Someone with antisocial personality disorder will typically act without thought of the consequences, be reckless and have limited consideration for other people's feelings.

Typically, attachment disorder is caused by childhood distress, such as separation from parents or changing caregivers. While attachment disorder and autism may share some behavioural similarities, there are distinct characteristics that can help parents differentiate between the two: a. Social behaviour: People with attachment disorder typically show difficulties in forming close emotional bonds, but they can still engage in reciprocal social interactions. In contrast, autistic people may struggle with understanding and initiating social interactions. b. Response to caregivers: Children with attachment disorder may exhibit a lack of emotional responsiveness to caregivers but can still form attachments, albeit insecure ones. Autistic children might seem disinterested or disconnected from caregivers but are still emotionally responsive. c. Communication patterns: Autistic individuals may experience significant challenges in language development and communication, while those with attachment disorder may have age-appropriate communication skills despite their emotional challenges. d. Repetitive behaviours: While both conditions can involve repetitive behaviours, these behaviours serve different purposes. In attachment disorder, they may be as a result of anxiety or fear, while in autism, they are often self-stimulatory and comforting.

Simply put, trauma is something that's experienced due to an event or difficult relationship. Autism is something a person is born with. Autistic people are at increased risk of experiencing adverse life events, like bullying, victimisation and maltreatment. Co-occurring mental health issues are also common among autistic people, all of which can make them more vulnerable to trauma.

Disclaimer

The categories these conditions have been grouped under are to convey the information effectively. We acknowledge and respect that individuals may view their condition(s) differently from how they're grouped here. The information provided in this resource represents common patterns or trends. However, these are generalisations and will not resonate with everyone's individual experiences.

We encourage you to see this resource as an introduction to the many conditions, delays, and syndromes that overlap with autism - not an exhaustive list.

There is a lot of overlap between AvPD and high-masking autism. They share similar personality traits (low extraversion and high neuroticism), similar temperamental traits (difficulty with unexpected changes and change in general) and similar behavioural traits (inhibition and caution).

Schizoid personality disorder (SPD) is characterised by a detachment and indifference to social relationships, interactions and engagements. People with SPD go to great lengths to avoid social interactions - arranging their whole lives in such a way as to reduce contact. While an autistic person may meet the criteria for SPD, if their symptoms are explained by their autism they should not be doubly diagnosed per DSM-5 criteria.