In general, I feel that the potential of personality disorder misdiagnosis of neurodivergent patients is a very important topic that doesn't seem get the attention it deserves within the research community. I have been diagnosed as having both paranoid and Schizotypal personality disorder yet most people who actually know me describe me as one of the most rational, level headed people they've ever known. Yet the diagnosis remains and follows me everywhere I go. It was rendered when I was at a low point in my life, experiencing psychosis and thus my speech was less coherent and highly circumstantial. Thus I didn't explain myself very well when I was being interviewed by the clinician who gave me that diagnosis. And though I've long since been in a much better state of mind and able to communicate more clearly, no clinician I have ever seen since has seemingly questioned the validity of my Cluster A personality disorder diagnosis.
I suspect that there is a profile that Autistic people tend to show on the MMPI that includes some false schizotypal traits that are just from how the questions are asked and how Autistic people interpret them differently than the designers of the MMPI intended.
For example, I’m pretty sure my MMPI flagged with schizotypal tendencies partially because of the questions along the lines of “I usually know what people are thinking/feeling before they tell me”. I thought it was about empathy and they were really asking if you thought you could literally read minds. Add to that the questions about what you enjoy make it look like you have anhedonia because they don’t ask about things that bring Autistics joy. And the questions about feeling different to other people assume it’s coming from a place of delusion and not from actually being demonstrably divergent from the norm.
Fortunately, the neuropsych who administered the test knew I was Autistic going in, and didn’t try to say I was actually schizotypal. But I’ve heard several other Autistic people getting misdiagnosed by psychologists not familiar with how Autism tends to show up on the MMPI and similar personality disorder diagnostic tools.
That's all very interesting and makes a lot of sense. It really gives me a lot to think about so thanks for sharing that. I identify as primarily dyspraxic because that's my most recent and seemingly most credible diagnosis in terms of actual neurodivergence. But I also know that DCD/dyspraxia are also highly comorbid with autism and two neuropsychologists I've delt with, really weren't sure exactly where I stood in terms of the autism spectrum. Yet I've been diagnosed as both Schizotypal with traits of paranoid personality disorder. And I do remember taking the MMPI and wondering if I was interpreting some of those questions the way they were intended. Like I said, that give me a bit to look into and think about.
I think my mother was both, undiagnosed , untreated, and the results were harsh for her and everyone near her. She married an abusive, possibly also audhd man and he liked to spite her and his children, controlling with financial and emotional neglect and covert narcissistic games. I was just late diagnosed audhd and also cptsd. It is interesting to reflect back on my parents who are passed now with what I keep learning. I struggle with anger myself bc I was parentifed and neglected in so many ways. But I also see my parents' pain since I am a parent. The difference is that I don't rage and shame my child.
Diagnosed BPD & CPTSD in 2020. Connected with Autism community on X. I know now, it's Autism and it always has been. I actually worked as an Autism sped teacher and wondered why I connect so easily and feel at home in that setting. Internalized ableism kept me thinking I was the problem. I'm gentler with myself, using self compassion 💜🫂
It happens the other way too. My BPD was originally diagnosed as autism. As a person with autism, I was denied mental health support on the grounds that my problems were the result of my own social misconceptions. I was told 'facts' about myself that seemed inaccurate, but because I had an autism diagnosis, I was not considered to have the right cognitive tools to judge whether the 'facts' were accurate or not. BPD for the most part feels much more natural. There is still stigma and judgement (I don't consider myself to have a personality defect, more a difficulty in regulating my emotions), but a lot of the 'facts' stated about me feel a lot more familiar and the treatment and support available is more helpful. It is possible I have autism too - my new therapist thinks I'm certainly neurodivergent in some respect - but you're so right, a wrong diagnosis can be very harmful.
In general, I feel that the potential of personality disorder misdiagnosis of neurodivergent patients is a very important topic that doesn't seem get the attention it deserves within the research community. I have been diagnosed as having both paranoid and Schizotypal personality disorder yet most people who actually know me describe me as one of the most rational, level headed people they've ever known. Yet the diagnosis remains and follows me everywhere I go. It was rendered when I was at a low point in my life, experiencing psychosis and thus my speech was less coherent and highly circumstantial. Thus I didn't explain myself very well when I was being interviewed by the clinician who gave me that diagnosis. And though I've long since been in a much better state of mind and able to communicate more clearly, no clinician I have ever seen since has seemingly questioned the validity of my Cluster A personality disorder diagnosis.
It's deeply frustrating because when we get better they just call it an episode and ignore that we don't meet criteria any longer
I suspect that there is a profile that Autistic people tend to show on the MMPI that includes some false schizotypal traits that are just from how the questions are asked and how Autistic people interpret them differently than the designers of the MMPI intended.
For example, I’m pretty sure my MMPI flagged with schizotypal tendencies partially because of the questions along the lines of “I usually know what people are thinking/feeling before they tell me”. I thought it was about empathy and they were really asking if you thought you could literally read minds. Add to that the questions about what you enjoy make it look like you have anhedonia because they don’t ask about things that bring Autistics joy. And the questions about feeling different to other people assume it’s coming from a place of delusion and not from actually being demonstrably divergent from the norm.
Fortunately, the neuropsych who administered the test knew I was Autistic going in, and didn’t try to say I was actually schizotypal. But I’ve heard several other Autistic people getting misdiagnosed by psychologists not familiar with how Autism tends to show up on the MMPI and similar personality disorder diagnostic tools.
That's all very interesting and makes a lot of sense. It really gives me a lot to think about so thanks for sharing that. I identify as primarily dyspraxic because that's my most recent and seemingly most credible diagnosis in terms of actual neurodivergence. But I also know that DCD/dyspraxia are also highly comorbid with autism and two neuropsychologists I've delt with, really weren't sure exactly where I stood in terms of the autism spectrum. Yet I've been diagnosed as both Schizotypal with traits of paranoid personality disorder. And I do remember taking the MMPI and wondering if I was interpreting some of those questions the way they were intended. Like I said, that give me a bit to look into and think about.
Thanks - really interesting. ’d love to read more about this, have you any suggestions of articles I might read too?
Can I check what sort of articles you're looking for?
Sure - I was thinking academic or research based. Thx.
I think my mother was both, undiagnosed , untreated, and the results were harsh for her and everyone near her. She married an abusive, possibly also audhd man and he liked to spite her and his children, controlling with financial and emotional neglect and covert narcissistic games. I was just late diagnosed audhd and also cptsd. It is interesting to reflect back on my parents who are passed now with what I keep learning. I struggle with anger myself bc I was parentifed and neglected in so many ways. But I also see my parents' pain since I am a parent. The difference is that I don't rage and shame my child.
Diagnosed BPD & CPTSD in 2020. Connected with Autism community on X. I know now, it's Autism and it always has been. I actually worked as an Autism sped teacher and wondered why I connect so easily and feel at home in that setting. Internalized ableism kept me thinking I was the problem. I'm gentler with myself, using self compassion 💜🫂
It happens the other way too. My BPD was originally diagnosed as autism. As a person with autism, I was denied mental health support on the grounds that my problems were the result of my own social misconceptions. I was told 'facts' about myself that seemed inaccurate, but because I had an autism diagnosis, I was not considered to have the right cognitive tools to judge whether the 'facts' were accurate or not. BPD for the most part feels much more natural. There is still stigma and judgement (I don't consider myself to have a personality defect, more a difficulty in regulating my emotions), but a lot of the 'facts' stated about me feel a lot more familiar and the treatment and support available is more helpful. It is possible I have autism too - my new therapist thinks I'm certainly neurodivergent in some respect - but you're so right, a wrong diagnosis can be very harmful.
And sometimes you have both (here ✋)