Caractéristiques cliniques communes et distinctives de l’autisme et du trouble de la personnalité borderline chez les femmes et les personnes assignées de sexe féminin à la naissance : une étude transversale

Titre original en anglais : Overlapping And Differentiating Clinical Features of Autism and Borderline Personality Disorder in Women and People Assigned Female at Birth: A Cross-Sectional Study

Cette publication est incluse dans le projet « Contributions académiques de personnes autistes sur l’autisme ». La publication mentionne deux auteur·ices autistes, sans divulguer leur identité.

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Barnicot, K., Thompson, E., Turner, S., Mandy, W., McCabe, R., Stark, E., & Parker, J. (2026). Overlapping And Differentiating Clinical Features of Autism and Borderline Personality Disorder in Women and People Assigned Female at Birth: A Cross-Sectional Study. Autism, 30(5), 1292-1304. https://doi.org/10.1177/13623613261431309

Publication date: 02/04/2026 Ajout dans AutiHub: 16/09/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
7
Auteur·ices autistes mentionné·es dans la publication
2
  1. Kirsten Barnicot
  2. Elissa Thompson
  3. Sally Turner
  4. Will Mandy
  1. Rose McCabe
  2. Eloise Stark *
  3. Jennie Parker

Résumé

Des recherches antérieures ont suggéré des similitudes phénotypiques potentielles entre l’autisme et le trouble de la personnalité borderline (TPB). Nous avons cherché à identifier les caractéristiques communes et distinctives des deux groupes diagnostiques chez les femmes et les personnes assignées de sexe féminin à la naissance (PAFAB). Des femmes et des PAFAB ayant reçu un diagnostic d’autisme (n = 51) ou de TPB (n = 51), qui présentaient peu de traits ou des traits subcliniques du diagnostic de comparaison, ont rempli une série de questionnaires auto-administrés. La réactivité émotionnelle, la dysrégulation émotionnelle, la perturbation de l’identité, les difficultés à être seul et la sensibilité au rejet étaient significativement plus caractéristiques des participants ayant reçu un diagnostic de TPB, la perturbation de l’identité représentant la différence la plus importante avec les participants autistes (d = −1.36, intervalle de confiance à 95 % [IC] = [−1.79, −0.92]). Les participants autistes obtenaient des scores significativement plus élevés aux mesures du traitement sensoriel, de la cognition et du comportement sociaux, de la préférence pour la similitude et des comportements moteurs répétitifs, le traitement sensoriel représentant la différence la plus importante avec les participants ayant reçu un diagnostic de TPB (d = 1.19, IC à 95 % = [0.76, 1.60]). Les différences entre les groupes en matière de cognition sociale, de camouflage social, de perturbation de l’identité, d’impulsivité et de capacité à faire face au fait d’être seul ont, ensemble, correctement classé 95.1 % des participants (aire sous la courbe [AUC] = 0.98). Cependant, la comparaison avec les scores aux mesures obtenus dans des recherches antérieures suggère des similitudes phénotypiques plus complexes, selon lesquelles les personnes autistes peuvent présenter davantage de caractéristiques alignées sur le TPB que la population générale, et inversement. Résumé grand public L’autisme peut ressembler au trouble de la personnalité borderline (TPB), ce qui peut conduire à un diagnostic erroné. Par exemple, les deux groupes diagnostiques peuvent éprouver des difficultés à réguler leurs émotions. Afin d’améliorer le diagnostic, nous avons voulu comprendre les similitudes et les différences entre l’autisme et le TPB chez les femmes adultes et les personnes assignées de sexe féminin à la naissance (PAFAB). Nous avons demandé à deux groupes de personnes de remplir des questionnaires en ligne : (1) 51 femmes/PAFAB ayant reçu un diagnostic d’autisme, qui ne satisfont pas aux critères diagnostiques du TPB, et (2) 51 femmes/PAFAB ayant reçu un diagnostic de TPB et satisfaisant aux critères diagnostiques du TPB, qui ne sont pas autistes. Les questionnaires demandaient aux participants comment ils vivent leurs émotions, comment ils interagissent avec d’autres personnes et établissent des relations avec elles, comment ils vivent leur identité et leur concept de soi, comment ils réagissent aux stimuli sensoriels, par exemple aux sons et aux odeurs, et comment ils utilisent des mouvements répétitifs, ainsi que leurs préférences pour s’en tenir à des façons familières de faire les choses. Nous avons constaté davantage de différences que prévu entre les personnes autistes et les personnes satisfaisant aux critères diagnostiques du TPB. Par exemple, comparativement aux personnes satisfaisant aux critères diagnostiques du TPB, les personnes autistes ont décrit une plus grande sensibilité aux stimuli sensoriels, davantage de « masquage » lors des interactions sociales et davantage de difficultés à comprendre le comportement social des personnes non autistes. Comparativement aux personnes autistes, les personnes satisfaisant aux critères diagnostiques du TPB ont décrit davantage de difficultés dans la régulation des émotions et dans leur sentiment de soi (« savoir qui je suis »), étaient plus susceptibles de se comporter de manière impulsive et trouvaient plus difficile d’être seules. Les cliniciens, ainsi que les personnes ayant reçu un diagnostic de TPB qui pensent être autistes, peuvent utiliser ces résultats pour mieux comprendre les différences entre les deux diagnostics. Même si nous avons trouvé de nombreuses différences, il reste probable que les personnes autistes présentent davantage de similitudes avec le TPB que les personnes non autistes, et inversement.

Previous research has suggested potential phenotypic similarities between autism and borderline personality disorder (BPD). We aimed to identify overlapping and differentiating characteristics of the two diagnostic groups in women and people assigned female at birth (PAFAB). Women and PAFAB with an autism diagnosis (n = 51) or a BPD diagnosis (n = 51), who had few or subclinical traits of the comparator diagnosis, completed a range of self-report questionnaires. Emotional reactivity, emotional dysregulation, identity disruption, difficulties being alone and rejection sensitivity were significantly more characteristic of BPD-diagnosed participants, with identity disruption representing the biggest difference from autistic participants (d = −1.36, 95% confidence interval [CI] = [−1.79, −0.92]). Autistic participants scored significantly more highly on measures of sensory processing, social cognition and behaviour, preference for sameness and repetitive motor behaviour, with sensory processing representing the biggest difference from BPD-diagnosed participants (d = 1.19, 95% CI = [0.76, 1.60]). Group differences in social cognition, social camouflaging, identity disruption, impulsivity and coping with being alone, together correctly classified 95.1% of participants (area under the curve [AUC] = 0.98). However, comparison with measure scores in previous research suggests more complex phenotypic similarities, whereby autistic individuals may show more BPD-aligned characteristics than the general population and vice versa. Lay Abstract Autism can look similar to borderline personality disorder (BPD), leading to misdiagnosis. For example, both diagnostic groups may experience difficulties in regulating their emotions. To improve diagnosis, we wanted to understand similarities and differences between autism and BPD in adult women and people assigned female at birth (PAFAB). We asked two groups of people to complete online questionnaires: (1) 51 women/PAFAB with an autism diagnosis, who do not meet diagnostic criteria for BPD and (2) 51 women/PAFAB diagnosed with and meeting diagnostic criteria for BPD, who are not autistic. The questionnaires asked participants how they experience their emotions, how they interact and relate with other people, how they experience their identity and self-concept, how they react to sensory input, for example, sounds and smells, and how they use repetitive movements, as well as their preferences for sticking to familiar ways of doing things. We found more differences than we expected between autistic people and people meeting diagnostic criteria for BPD. For example, autistic people described being more sensitive to sensory input, described ‘masking’ more during social interactions and described more challenges in understanding the social behaviour of non-autistic people, compared to people meeting diagnostic criteria for BPD. People meeting diagnostic criteria for BPD described more difficulties with emotion regulation and with their sense of self (‘knowing who I am’), were more likely to behave impulsively and found being on their own more difficult, compared to autistic people. Clinicians, and people with a BPD diagnosis who think they may be autistic, can use these findings to better understand the differences between the two diagnoses. Even though we found lots of differences, it is still likely that autistic people experience more similarities with BPD than non-autistic people do and vice versa.

Bibliographie citée par cette référence

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Vue d’ensemble de la bibliographie citée

Ces indicateurs décrivent la bibliographie citée par cette publication. Un nom d’auteurice est compté chaque fois qu’il apparaît dans une référence citée : une même personne peut donc être comptée plusieurs fois. Les noms qui ne sont pas encore associés à un·e auteurice déjà présent·e dans AutiHub sont traités comme inconnus, pas comme non autistes. Dernier calcul : 19/09/2026 01:01.

Références citées
69
Avec un DOI
62
Sans DOI, à partir du texte brut de la bibliographie
7
3 / 69 (4,3 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
2 / 69 (2,9 %)
Références avec noms d’auteurices détectés
68 / 69 (98,6 %)
Sans nom d’auteurice détecté
1
Sans titre structuré
2
Sans identifiant stable
7
Références avec noms bruts d’auteurices restant à vérifier
1
Références avec problème de récupération des métadonnées externes
0
Ces indicateurs portent sur les références citées affichées sur cette page, après fusion des doublons techniques. Une référence sans DOI peut quand même soutenir les statistiques d’auteurices lorsqu’un titre et des noms d’auteurices sont disponibles.
Noms d’auteurices détectés dans la bibliographie citée
319
À partir du DOI ou de métadonnées externes
319
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
1
108 / 319 (33,9 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 211 / 319 (66,1 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
9 / 319 (2,8 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 9 / 108 (8,3 %). Personnes distinctes identifiées comme autistes : 8 / 291 (2,7 %).
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