The relationship between Autism Spectrum Disorders (ASD) and Narcissistic Personality Disorder (NPD), considering the dimensions of narcissistic grandiosity and vulnerability, represents an important differential diagnosis and potential ground of comorbidity, since both conditions show high grades of pervasiveness, a life-long course, ego-syntonic traits, and difficulties in building up and sustaining interpersonal relationships Although the co-diagnosis rates, according to the categorical criteria in use, are limited (0%-6.4%), it is common to encounter diagnostic doubts in clinical practice. Here we investigated the dimensions of narcissistic vulnerability and grandiosity in a sample of 87 adults diagnosed with ASD without intellectual disabilities through the administration of the Pathological Narcissism Inventory-52 Items (PNI-52). The mean scores of our sample were compared with the normative distribution available in the literature, and we found that individuals with ASD scored significantly higher than neurotypical controls at the Total Score and at the Vulnerable Narcissism subscale, but not at the Grandiose Narcissism subscales. Demographic features did not influence these results. Vulnerable narcissism was significantly associated with the "Ritvo Autism and Asperger Diagnostic Scale - Revised" subscale Social Relatedness. These findings could potentially be indicative of a greater comorbidity rate between the two disorders with respect to the one reported to date, possibly because DSM-5 criteria are mainly focused on the grandiose dimension. Potential explanatory links between ASD phenomenology and vulnerable narcissism, such as the personality dimension of neuroticism, are discussed, together with the possible role of narcissistic vulnerability in mediating internalizing symptoms (e.g., anxiety, depression) in individuals with ASD.

It is now recognised that autism spectrum disorder (ASD) and personality disorders (PDs) have a variety of factors in common. However, the exact nature of the relationship between ASD and the PDs remains unclear. The overlapping symptom profiles of ASD and PDs can lead to diagnostic uncertainty - features of ASD and PD can be misattributed and easily lead to misdiagnosis of ASD patients. Since differentiating between ASD and PD is such a complex task, it has been argued that there is a need for additional understanding and markers for facilitating diagnostic procedures. There is an urgent need to explore, first, how clinicians make diagnostic decisions and, second, how to effectively deal with the challenges and difficulties they face when making decisions. Also, where there are clear overlaps, how do clinicians choose how to attribute labels in order to understand the person.

More empirical research is needed to disentangle the phenotypes of autism spectrum disorder (ASD) and cluster C personality symptomatology (CCPD), as both show similarities in their clinical presentation. We explored personality and psychopathology dimensions as conceptualized in contemporary dimensional taxonomies (i.e., hierarchical taxonomy of psychopathology; HiTOP) in adults with ASD without intellectual disability operationalized by the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF).

Applying secondary analytic processes using clinical data, we cross-examined the MMPI-2-RF profiles of adults with ASD (n = 28) compared to adults with Cluster C personality disorders (CCPD; n = 28) and a control group (n = 28) by conducting nonparametric tests and assessing effect sizes.

The profiles of the ASD and CCPD groups evidenced to be similar, and both average clinical profiles diverged from the average control group profiles by elevated levels of demoralization, internalizing, and somatization symptomatology. There were small differences between the average profiles of adults with ASD and adults with CCPD. Additional research using dimensional measures of psychopathology could elucidate the dimensional phenotypes of ASD and CCPD.

Based on the results in this study, the MMPI-2-RF may not meaningfully discriminate between the two clinical presentations, with the exception of various externalizing scales.

Differential diagnosis, comorbidities and overlaps with other psychiatric disorders are common among adults with autism spectrum disorder (ASD), but clinical assessments often omit screening for personality disorders (PD), which are especially common in individuals with high-functioning ASD where there is less need for support.

To summarize the research findings on PD in adults with ASD and without intellectual disability, focusing on comorbidity and differential diagnosis.

PubMed searches were performed using the key words "Asperger's Syndrome", "Autism", "Personality", "Personality disorder" and "comorbidity" in order to identify relevant articles published in English. Grey literature was identified through searching Google Scholar. The literature reviews and reference sections of selected papers were also examined for additional potential studies. The search was restricted to studies published up to April 2020. This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method.

The search found 22 studies carried out on ASD adults without intellectual disability that met the inclusion criteria: 16 evaluated personality profiles or PD in ASD (comorbidity), five compared ASD and PD (differential diagnosis) and one performed both tasks. There were significant differences in the methodological approaches, including the ASD diagnostic instruments and personality measures. Cluster A and cluster C PD are the most frequent co-occurring PD, but overlapping features should be considered. Data on differential diagnosis were only found with cluster A and cluster B PD.

ASD in high-functioning adults is associated with a distinct personality profile even if variability exists. Further studies are needed to explore the complex relationship between ASD and PD.

To examine the personality profiles of adults with autism spectrum disorder (ASD) using a standard personality assessment and to investigate the association between personality, ASD-related face memory deficit (FMD), and theory of mind (ToM). In a broader context, to examine whether there are distinct clinical phenotypes in the ASD population that have implications for personality development and treatment.

Fifty-five adults with ASD and 22 neurotypical (NT) adults underwent a battery of neuropsychological tests, including measures of personality, face memory, and ToM. We compared ASD and NT groups in terms of their Personality Assessment Inventory (PAI) profiles. Additional analyses focused on the association between specific PAI scales and FMD. Performance on the Eyes Test was compared across groups and was examined in relation to FMD.

Adults with ASD demonstrated significant elevations on several PAI scales compared with NT adults. The presence of FMD was associated with differing PAI profiles among the ASD adults. The ASD adults with FMD scored significantly higher on scales that are sensitive to positive impression management and treatment rejection and significantly lower on scales that are sensitive to borderline personality, anxiety, depression, schizophrenia, and stress. There was a significant association between performance on the Eyes Test and FMD in the ASD group.

Adults with ASD have a unique personality profile. Further, ASD adults with FMD have reduced insight into their difficulties with emotional processing and may not be as sensitive as ASD adults without FMD to the emotions of others.

Autism spectrum disorders (ASD) are difficult to detect in old age. This study examined if ASD symptoms in older adults (age > 60) can be detected with the Dutch informant personality questionnaire, (Hetero-Anamnestische Persoonlijkheidsvragenlijst, HAP) in a mental health setting. Patients with ASD (N = 40) were compared to patients with a different psychiatric diagnosis (N = 43; personality disorders excluded). The ASD group had significant higher scores on the scales 'Socially avoidant behavior', 'Rigid behavior' and 'Unpredictable and impulsive behavior'. These scales were able to discriminate between individuals with or without ASD. The HAP can thus be used as a screening instrument for ASD symptoms in elderly patients. Further research is needed to clarify what items have the best predictive validity for ASD symptoms.

This study tested the spectrum hypothesis, which posits that children and adolescents with high functioning autism (HFA) differ quantitatively but not qualitatively from typically developing peers on self-reported temperament. Temperament refers to early-appearing, relatively stable behavioral and emotional tendencies, which relate to maladaptive behaviors across clinical populations. Quantitatively, participants with HFA (N = 104, aged 10-16) self-reported less surgency and more negative affect but did not differ from comparison participants (N = 94, aged 10-16) on effortful control or affiliation. Qualitatively, groups demonstrated comparable reliability of self-reported temperament and associations between temperament and parent-reported behavior problems. These findings support the spectrum hypothesis, highlighting the utility of self-report temperament measures for understanding individual differences in comorbid behavior problems among children and adolescents with HFA.

Researchers and clinical practitioners have found that hoarding appears in many autism patients and that most of these patients show high anxiety and depression. There is no consensus on the relationship between autistic traits and hoarding, and little research concerning the role of negative emotions. This study investigated the relationship between autistic traits and hoarding in a large non-clinical Chinese sample. Participants were 3,229 university students (M age = 20.5 yr., SD = 1.6; 1,839 men) who were recruited in classroom. They completed measures of hoarding, autistic symptomology, anxiety, and depression: specifically the Saving Inventory-Revised, the Autism-Spectrum Quotient, the Zung Self-Rating Anxiety Scale, and The Center for Epidemiological Studies Depression Scale. Mediating effects of anxiety and depression in the correlation between autistic traits and hoarding were also explored. There was a weak but significant correlation between autistic traits and hoarding. Significant mediating effects of anxiety and depression were observed. Hoarding in people with high autistic traits could be influenced by anxiety and depression.

Although daily hassles and coping are associated with behavior and emotional problems in non-clinical populations, few studies have investigated these relationships in individuals with high-functioning autism/Asperger's Disorder (HFASD). This study examined the relationships between daily hassles, coping and behavior and emotional problems in adolescents with HFASD. Thirty-one adolescents with HFASD completed questionnaires assessing their coping and behavior and emotional problems, and completed an Ecological Momentary Assessment run via a mobile phone application on their coping and daily hassles. Parents completed questionnaires of the adolescents' daily hassles, coping, and behavior and emotional problems. The disengagement coping style was associated with significantly higher levels of behavior and emotional problems regardless of respondent or methodology, suggesting it may be a valuable target for intervention.

Ecological Momentary Assessment (EMA) may increase accuracy of data compared with retrospective questionnaires by assessing behaviours as they occur, hence decreasing recall biases and increasing ecological validity. This study examined the feasibility and concurrent validity of an EMA tool for adolescents with High-Functioning Autism Spectrum Disorders (HFASD). Thirty-one adolescents with HFASD completed a mobile phone EMA application that assessed stressors and coping for two weeks. Parents and adolescents also completed retrospective measures of the adolescent's coping/stressors. Moderate compliance with the EMA tool was achieved and some concurrent validity was established with the retrospective measure of coping. Concordance was found between the types of stressors reported by parents and adolescents but not the quantity. The results suggest adolescents with HFASD are capable of reporting on their stressors and coping via EMA. EMA has the potential to be a valuable research tool in this population.

As autism spectrum disorders (ASD) have largely been neglected in old-age psychiatry, the objective of the present paper is to describe the diagnostic process in elderly patients.

A systematic review of the literature on ASD in older age was undertaken and illustrated by a case series of three elderly patients first diagnosed with ASD in later life by a tertiary mental health clinic.

The search of the literature only yielded three papers on late-life ASD, while the review of the available diagnostic procedures among adults suggests some relevance for screening instruments (Autism Questionnaire), diagnostic instruments (Module 4, Autism Diagnostic Observation Schedule), and neuropsychological examination to profile impairments. Nonetheless, the case reports clearly showed that taking a thorough history with the patient, corroborated and supplemented by a close relative or caregiver who has known the patient for at least ten years, still remains the most important diagnostic tool.

The three case studies show that in clinical practice ASD can easily be missed in elderly individuals presenting with comorbid psychiatric disorders, potentially causing iatrogenic damage. Although further research on phenotyping and diagnosing ASD in older people is warranted, the most important step at this point is to create a greater awareness of the possibility of ASD in old age among health-care professionals working with people in this age group.

To test the spectrum hypothesis--postulating that clinical and non-clinical samples are primarily differentiated by mean-level differences--, this study evaluates differences in parent-rated temperament, personality and maladjustment among a low-symptom (N = 81), a high-symptom (N = 94) ASD-group, and a comparison group (N = 500). These classic spectrum hypothesis tests are extended by adding tests for similarity in variances, reliabilities and patterns of covariation between relevant variables. Children with ASD exhibit more extreme means, except for dominance. The low- and high-symptom ASD-groups are primarily differentiated by mean sociability and internal distress. Striking similarities in reliability and pattern of covariation of variables suggest that comparable processes link traits to maladaptation in low- and high-symptom children with ASD and in children with and without autism.

The frequency, origin, and interpretative implications of elevation differences on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical and restructured clinical (RC) scales were examined. Two large clinical samples consisting of 1,770 outpatients and 2,438 inpatients were used for this study. Three potential factors (Demoralization, subtle items, and K correction) were explored as to the extent to which they contributed to elevation differences between a clinical scale and its restructured counterpart. Results showed that differences in elevation between clinical and RC scales occurred between 10% and 35% of cases. Demoralization, subtle items, and K correction contributed substantially to elevation differences. Findings indicate that core descriptors of a clinical scale should be emphasized only when its corresponding RC scale is also elevated, whereas for Scales 4, 6, and 8, elevated scores on the RC scales are interpretable even when the corresponding clinical scales are not elevated.

I present a case study of a latency-age boy referred for assessment of a nonverbal learning disability/disorder (NLD) who also had features of Asperger's syndrome (AS). I review NLD terminology, presumed brain-behavior relationship, neuropsychological profile, and diagnosis/classification issues. I discuss the challenge of differentiating NLD from AS in relation to the client's pattern of visual-spatial, communication, social-emotional, and behavioral NLD correlates. I integrate neuropsychological and personality assessment data with interviews, observations, prior testing, and input from teacher and therapist in formulating a diagnostic impression. I discuss Rorschach (Exner, 2003) and neuropsychological consultations in relation to subtle language and interpersonal features of the client's communication style. I provide parent feedback at 18 and 24 months posttesting. I discuss implications relative to a model of school neuropsychological assessment that includes the Rorschach test.