Shining a Light on a Hidden Population: Social Functioning and Mental Health in Women Reporting Autistic Traits But Lacking Diagnosis.

This study looked at women who likely have autism but haven't been diagnosed. Researchers compared them to women who have been diagnosed with autism. They found that undiagnosed autistic women showed better social skills and empathy, but were more often diagnosed with Borderline Personality Disorder instead. The study suggests that autism in women can look different than in men, making it harder to recognize and leading to missed or wrong diagnoses.

This study examined social functioning and mental health differences between diagnosed autistic women and undiagnosed women with high autistic traits (scoring ≥32 on the Autism Quotient). Using two nationwide online surveys, researchers found that probably autistic women showed higher empathy and general social functioning compared to diagnosed autistic women, and were more likely to have received Borderline Personality Disorder diagnoses. The study also found that autistic women typically received more mental health diagnoses before their autism diagnosis than autistic men. These findings support Female Phenotype Theory, suggesting autistic women may present with less obvious social impairments, potentially leading to delayed or missed autism diagnoses and frequent misdiagnosis with other mental health conditions.

Clinicians should be aware that autism in women may present with less obvious social impairments. History of Borderline Personality Disorder diagnosis should prompt consideration of autism assessment. Multiple prior mental health diagnoses in women may indicate unrecognized autism requiring comprehensive evaluation.

Study relies on self-report measures and online surveys. Sample size not reported. Cross-sectional design limits causal inferences. Selection bias possible as participants were recruited online. No validation of autism diagnoses or control for other factors that might influence social functioning differences.

Female Phenotype Theory (FPT) suggests that autistic women often present with less obvious social impairments than autistic men. We examined the possibility of an exaggerated female phenotype among undiagnosed but probably autistic women. In two nationwide online surveys, we compared self-reported social functioning and mental health between diagnosed autistic women and women without diagnosis who scored ≥ 32 on the Autism Quotient. Compared to diagnosed autistic women, probably autistic women had higher empathy and general social functioning, and were more likely to have received a diagnosis of Borderline Personality Disorder.

Autistic women had typically received more mental health diagnoses prior to their ASC diagnosis than autistic men. These findings shed light on the history of misdiagnosis experienced by many autistic women.