Comorbid autism spectrum disorder and borderline personality disorder: case conceptualization and treatment implications

Abstract

PurposeAutism spectrum disorder (ASD) and borderline personality disorder (BPD) are complex disorders characterized by pervasive symptoms of rigidity, emotion dysregulation and social cognitive difficulties. Comorbid ASD and BPD are recognized emerging clinical problem that may be challenging to treat.Design/methodology/approachThe authors present a case study of a young person in the authors’ assessment clinic diagnosed with BPD and ASD who had received standard dialectical behavior therapy (DBT) with modest effects. The authors provide ASD-informed recommendations for continued DBT treatment.FindingsThe de-identified patient described in this case report met full criteria for ASD and BPD. The patient’s cognitive, behavioral, social and personality functioning are described in detail.Practical implicationsOther practitioners seeking to treat this complex comorbidity may make use of the authors’ treatment recommendations for their patients. The authors underscore the importance of individualized treatment planning and hope the authors’ exemplar will be useful to others.Originality/valueSeveral evidence-based treatments exist for ASD and BPD symptom reduction. However, to the best of the authors’ knowledge, no current treatments exist for comorbid ASD and BPD to target emotion dysregulation in individuals with restricted and repetitive interests and behaviors and disturbances in social and communication domains.