City University London

Why are we doing this research?

People with lived experience and clinicians say that autism may be missed or misdiagnosed in some people diagnosed with personality disorder – particularly in people identifying as female.

This can cause serious harm through people being misunderstood, feeling unheard, and being offered inappropriate and inadequate support.

What will we do?

• We will first conduct in-depth interviews and assessments with women meeting diagnostic criteria for a personality disorder and autistic women (female gender identity and/or identified female at birth) to explore their perspectives on:
  • (1) similarities and differences in lived emotional, behavioural, cognitive, identity and interpersonal experiences
  • (2) limitations of current assessment tools in evaluating and distinguishing autistic traits in women diagnosed with a personality disorder
  • (3) facilitators and barriers to seeking and gaining a diagnosis of autism

• We will use our findings to generate hypotheses about the best ways to assess and differentiate autism and personality disorder, and will test these in a third study.

How will we help improve care?

We will generate a set of key ‘dos and don’ts’ that clinicians can use when considering autism as an alternative or additional explanation for the experiences of a person currently diagnosed with a personality disorder.

We will identify a set of distinguishing features that clinicians can use to differentiate autism from personality disorder in women, as well as identifying shared features that are not useful for making this distinction.

We hope our findings will help clinicians better recognise, understand and support people diagnosed with a personality disorder who may be autistic, and support people experiencing personality disorder and/or autism to better understand and communicate their experiences.

Where is the project up to?

The project is in its final stages and will publish findings over 2025-2026.

The I-RAP website has useful quick facts about personality disorder and autism, with a wealth of background information on the project and where you can follow the findings as they emerge.

About City University London

City University London is a global higher education institution committed to academic excellence, with a focus on business and the professions.

Within City, the School of Health Sciences is actively engaged in internationally recognised research that has a direct impact on the provision of healthcare services today and in the future. 

Its aim is to build on research excellence that informs and improves learning, practice and policy on real-world issues in the health services sector.