Towards clearer formulation of adult Autism Spectrum Disorder : exploring comorbidity and measurement

• Main Author: Ladha, Ruhina
• Other Authors: Saville, Christopher
• Published: Bangor University 2018
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.767435

This thesis comprises three papers, aiming to explore the overlap between Autism Spectrum Disorder (ASD) and Borderline Personality Disorder (BPD) and explore the development of a new measure of camouflaging behaviour. The first paper consists of a literature review examining the connections and comparisons to be made between ASD and BPD. In total, 11 studies met the inclusion criteria and consisted of case studies and quasi-experimental studies. In line with prior research, shared features were noted between the conditions - emotional recognition and regulation difficulties, interpersonal issues and self-injurious behaviour. Rates of comorbidity were found to vary. Condition specific profiles were also explored and the importance of recognising comorbid individuals as a high risk group was identified. Research and clinical implications are discussed. The second paper describes an empirical research study investigating the development of an original measure of camouflaging behaviour. 247 participants, recruited online, completed questionnaires pertaining to autistic traits and traits of social anxiety, and a proposed measure of camouflaging behaviour - the Conscious Social Strategies Questionnaire (CSSQ). Exploratory factor analysis revealed a four factor measure comprising masking strategies, avoidance strategies, an absence of strategies and compensatory strategies. Significant gender differences were also found. Strengths and limitations of the study are explored. The final discussion paper suggests developing current clinical guidance, regarding assessment and intervention of ASD and BPD to prevent misdiagnosis and promote the consideration of comorbid diagnoses. In addition, detailed suggestions for future research and theory development are discussed, including qualitative approaches to exploring ASD and its overlap with mental health conditions. Further studies to validate the CSSQ are also explored. To conclude the paper, my personal reflections on completing this thesis are discussed.