Clinical Correlates of Personality in ASD

Background:  Addressing the heterogeneity of autism spectrum disorders (ASD’s) has challenged clinicians and researchers alike. Identifying subtypes according to language-, behavioral- or cognitive characteristics seems fruitful, however introduces the risk of over-simplifying the condition and loosing ‘the individual’ out of sight. We propose that especially in the framework of clinical intervention, subtyping autistics according to  personality may be more useful. Although historical accounts and recent research suggest that people with ASD show specific personality traits, as yet not much is known about the clinical correlates of personality in the ASD population.

Objectives:  The current research tries to elucidate whether persons with ASD score differently on the ‘big five’ personality traits in comparison to the norm population. In succession it will be evaluated whether personality traits or - profiles of persons with ASD are associated with observed variance in the expression of autism symptoms, related cognitive styles and general psychological wellbeing.

Methods:  A group of 99 high functioning adolescents and young adults diagnosed with ASD was screened on (1) therapist-rated and self-reported autism symptomatology using respectively the Autisme Beoordelings Lijst (ABL, autism evaluation list) and Autism Spectrum Quotient (AQ), (2) personality using the NEO-Five Factor Inventory (NEO-FFI),  (3) cognitive style (several measures targeting theory of mind, central coherence and cognitive shifting) and (4) psychological wellbeing using the symptom checklist (SCL-90). Latent class analysis was applied to delineate whether autistics could be subgrouped according to personality profile.

Results:  The scores on the five personality traits of persons with ASD’s differ from norm scores, i.e. in general autistics are characterized by high average neuroticism, and low average extraversion, openness, agreeableness  & conscientiousness. Applying latent class analysis yielded two personality classes, indicating that about 43% of the subjects (class 1) shows a relatively average personality profile whereas the other 57% (class 2) is characterized by quite pronounced deviations from normscores in the above mentioned directions. Further analyses showed that personality traits & class are related to self-reported autism symptoms and  psychological wellbeing: persons in class 2 report more problems than those in class 1, suggesting they represent a more ‘vulnerable’ group within the ASD population. Personality seems however unrelated to therapist-rated autism symptoms and the three cognitive styles.

Conclusions: The results provide preliminary evidence for the association between personality & experienced suffering from autism symptoms and psychological distress. Longitudinal research is needed to determine the prognostic value of personality regarding general development and treatment success in individuals with ASD.