Temperament, Character, and Personality Disorders in Adults with Autism Spectrum Disorder: a Systematic Literature Review and Meta-analysis

Abstract

This article offers a systematic review of studies of personality and the dimensions of temperament and character, personality pathology, and personality disorders (PDs) in adults with autism spectrum disorder (ASD). Fifteen studies met the inclusion criteria for the review, from which seven studies were meta-analyzed. Results indicate that ASD is significantly and systematically associated with an introvert, rigid, passive-dependent temperament with low novelty seeking, high harm avoidance, low reward dependence and high persistence, and with an immature and poorly developed character with low self-directedness, low cooperativeness, and high self-transcendence. The review further finds a positive correlation between ASD (severity) and neuroticism and a negative correlation between ASD (severity) and extraversion, openness to experience, agreeableness, and conscientiousness. It also finds a positive correlation with paranoid, schizoid, schizotypal, avoidant, and obsessive-compulsive PDs. However, the far from perfect associations indicate there is considerable variation between people with ASD in their personality and personality pathology. In order to obtain a comprehensive picture of an individual with ASD and to implement the most effective intervention plans for and therapeutic relationship with adults with ASD, temperament, character, and comorbid personality pathology and PDs should be considered.

Changes in temperament over time in young children with autism spectrum disorder and other developmental delays: a follow‐up comparison study

“…However, future research also needs to further examine the relation between temperament areas and certain outcomes (e.g. emotion regulation, mental health, ASD symptomatology and learning/developmental outcomes) to help better understand how a child's temperament relates to their overall developmental trajectory and adjustment, as temperament differences are also observed in ASD later in life (Schwartz et al 2009;De Pauw et al 2011;Sizoo et al 2015;Vuijk et al 2018).…”

“…In addition to these core deficits, some children with ASD have a number of clinically relevant associated features, including a difficult temperament or behavioural style (Hepburn and Stone ; Vuijk et al . ). Learning about temperament in ASD could help us to understand individual differences in symptom presentation and potentially lead to important insights about individualising interventions.…”

“…Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by socialcommunication deficits and repetitive behaviours and interests (American Psychiatric Association 2013). In addition to these core deficits, some children with ASD have a number of clinically relevant associated features, including a difficult temperament or behavioural style (Hepburn and Stone 2006;Vuijk et al 2018). Learning about temperament in ASD could help us to understand individual differences in symptom presentation and potentially lead to important insights about individualising interventions.…”

Temperament and character in men with autism spectrum disorder: A reanalysis of scores on the Temperament and Character Inventory by individual case matching

“…This study, with a strong design of individual case matching, confirms and strengthens the findings of previous studies employing general group matching [ [22] , [23] , [24] , 31 ], all showing clear differences in temperament and character of the ASD male group compared to the male norm group. For meta-analytic results of these TCI studies [ [22] , [23] , [24] , 31 ] we refer to Vuijk et al [ 32 ].…”

Profile analysis of the Personality Assessment Inventory‐Adolescent (PAI‐A) for individuals with autism spectrum disorder

“…The literature on assessing comorbid conditions in adolescents with ASD is expanding, and several themes are arising that warrant caution when selecting measures to use with this population (Kerns et al, 2016; Vuijk et al, 2018). One particularly important theme is understanding how individuals with ASD perform on measures designed to identify psychiatric disorders so clinicians and school psychologists can accurately discriminate between a true comorbidity and typical scale elevations due to the characteristics of ASD.…”