The mediating effect of trauma and loss spectrum on the relationship between autistic traits and eating disorder symptoms among patients with borderline personality disorder

Background While increasing research is reporting a higher presence of autistic traits (AT) in patients with borderline personality disorder (BPD), both autism spectrum disorder (ASD) and BPD have been associated in literature with a vulnerability to trauma and eating disorders. Aim The present study aimed at evaluating trauma-related symptoms and eating disorder symptoms in BPD patients with or without significant AT. Methods A sample of 73 BPD patients was assessed with the adult autism subthreshold (AdAS) Spectrum, trauma and loss spectrum-self report (TALS-SR), and EDI-2 questionnaires. Results The findings revealed that BPD patients with autistic traits (BPD-AT) scored significantly higher on the eating disorder inventory (EDI-2) and trauma and loss scale (TALS-SR) compared to those without AT. Moreover, while both AdAS Spectrum and TALS-SR scores predicted higher EDI-2 scores, a significant mediating effect of TALS-SR on the relationship between AdAS Spectrum and EDI-2 scores was reported. Conclusion These results suggest that AT may imply more severe clinical correlates in the BPD population, including an enhanced vulnerability toward psychopathological traits frequently reported in BPD patients such as eating disorders and trauma-related symptoms, stressing the need to clarify the complex interactions among these disorders and the factors that may shape specific illness trajectories.