City Research Online

Abstract

Overlap between the features of autism and borderline personality disorder (BPD) complicates the diagnostic process and underlines the need for research to pinpoint distinct features, especially amongst adult females, who appear most at risk of having an autism diagnosis missed. While emotion dysregulation is a key area of overlap, the triggers of emotional distress and dysregulation (EDD) may differentiate between these conditions. However research is lacking in this area, along with validated measures of EDD triggers for differential diagnosis.

The aim of this research was threefold: (i) to explore perceptions of what triggers EDD amongst people assigned female at birth (PAFAB) with BPD and autism from their own frames of reference; (ii) identify categories of EDD triggers which may differentiate between PAFAB with BPD and autism; (iii) explore the acceptability/usability of the Triggers of Distress Questionnaire (ToDQ), a newly designed 76-item self-report measure.

A mixed-methods design was employed, in which 22 participants assigned to one of three groups according to their pre-existing diagnoses (Autism, Autism+BPD, or BPD) completed the ToDQ and took part in a semi-structured interview. Effect sizes were calculated between Autism and BPD Group ToDQ scores to examine the practical significance of group differences. Qualitative data was analysed with inductive content analysis, and a model of categories relating to the triggering and development of EDD was derived.

Results indicate multiple triggers tend to give rise to distress and various factors affect whether distress manifests as emotional dysregulation. Preliminary quantitative findings suggest some triggers are a greater cause of EDD for autistic PAFAB, while other EDD triggers appear to be more prominent for those with BPD. In the main, interviewees felt the ToDQ managed to capture their key EDD triggers, with questions considered to be neither difficult nor confusing to answer. However a range of interpretations and strategies for completing a sample ToDQ item were apparent, and the task of answering this question appeared complex for those participants responding with a strict but accurate interpretation of the questionnaire.

The implications of the findings for supporting the accurate and timely diagnosis of autism and BPD amongst PAFAB are discussed, along with suggestions for further developing the ToDQ to support this endeavour.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Departments:	School of Health & Psychological Sciences > Psychology School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses Doctoral Theses

Export

Downloads