Emotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), whose aetiology has been attributed to biosocial factors. In autism spectrum condition (ASC), although ED is prevalent and is associated with decreased well-being (e.g. self-harm, suicidality), it has been understudied, especially in adults. It is therefore crucial to further understand ED in autistic adults to improve its treatment. Our study investigates ED, its behavioural correlates (e.g. self-harm, suicidality) and biosocial predictors in autistic adults relative to BPD and nonclinical controls (NC). A total of 724 participants (ASC = 154; BPD = 111; NC = 459) completed 11 self-reported questionnaires assessing ED, ASC and BPD traits, co-occurring disorders, alexithymia, emotional vulnerability and invalidating experiences (e.g. bullying, autistic camouflaging). The occurrence of ED behavioural correlates (i.e. self-harm, history of suicide attempts, and psychiatric hospitalizations) was collected. In addition, between-groups analyses, linear regressions and machine learning (ML) models were used to identify ED predictors in each group. ED and its behavioural correlates were higher in ASC compared to NC, but milder than in BPD. While gender did not predict ED scores, autistic women had increased risk factors to ED, including sexual abuse and camouflaging. Interestingly, BPD traits, emotional vulnerability and alexithymia strongly predicted ED scores across the groups. Using ML models, sensory sensitivity and autistic camouflaging were associated with ED in ASC, and ADHD symptoms with ED in BPD. ASC and BPD diagnoses were self-reported, which did not allow us to check their accuracy. Additionally, we did not explore the transactional and the moderating/mediating relationships between the different variables. Moreover, our research is cross-sectional and cannot draw conclusions regarding the direction and causality of relationships between ED and other clinical dimensions. ED and its behavioural correlates are heightened in BPD compared to ASC and nonclinical controls. In the ASC group, there were no gender differences in ED, despite the heightened exposure of autistic women to ED risk factors. BPD traits, emotional vulnerability, and alexithymia are core to ED regardless of diagnosis. Although less central, sensory sensitivity and autistic camouflaging seem to be specific predictors of ED in autistic adults.

中文翻译：

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与边缘性人格障碍和非临床对照相比，自闭症成人情绪失调的生物社会相关性和预测因素

情绪失调（ED）是边缘性人格障碍（BPD）的核心症状，其病因可归因于生物社会因素。在自闭症谱系疾病 (ASC) 中，虽然 ED 很普遍，并且与幸福感下降（例如自残、自杀）有关，但人们对此的研究还不够，尤其是在成年人中。因此，进一步了解成人自闭症患者的 ED 以改善其治疗至关重要。我们的研究调查了自闭症成人相对于 BPD 和非临床对照 (NC) 的 ED、其行为相关性（例如自残、自杀）和生物社会预测因素。共有 724 名参与者（ASC = 154；BPD = 111；NC = 459）完成了 11 份自我报告的问卷，评估 ED、ASC 和 BPD 特征、并发疾病、述情障碍、情绪脆弱性和无效经历（例如欺凌、自闭症伪装） ）。收集与 ED 行为相关的发生情况（即自残、自杀未遂史和精神病住院治疗）。此外，还使用组间分析、线性回归和机器学习 (ML) 模型来确定每组中的 ED 预测因子。与 NC 相比，ASC 中的 ED 及其行为相关性更高，但比 BPD 中的轻度。虽然性别不能预测 ED 分数，但患有自闭症的女性会增加 ED 的风险因素，包括性虐待和伪装。有趣的是，BPD 特征、情绪脆弱性和述情障碍强烈预测各组的 ED 分数。使用 ML 模型，感觉敏感性和自闭症伪装与 ASC 中的 ED 相关，而 BPD 中的 ADHD 症状与 ED 相关。 ASC 和 BPD 诊断是自我报告的，这不允许我们检查其准确性。此外，我们没有探索不同变量之间的交易关系和调节/中介关系。此外，我们的研究是横向的，无法得出有关 ED 与其他临床维度之间关系的方向和因果关系的结论。与 ASC 和非临床对照相比，BPD 患者的 ED 及其行为相关性更高。在 ASC 组中，尽管自闭症女性更多地接触 ED 危险因素，但 ED 没有性别差异。无论诊断如何，BPD 特征、情绪脆弱和述情障碍都是 ED 的核心。尽管感觉敏感性和自闭症伪装不太重要，但似乎是成人自闭症患者 ED 的特定预测因子。