Few Differences in the Externalizing and Criminal History of Young Violent Offenders With and Without Autism Spectrum Disorders

Autism Spectrum Disorders in forensic psychiatric investigations-patterns of comorbidity and criminality

Background

There are contradictory research findings regarding whether individuals with Autism Spectrum Disorders (ASDs) are more or less likely to commit crimes. The aims of the current study were to: (1) Describe psychiatric and crime-related characteristics of a large group of offenders with ASD who had undergone a Forensic Psychiatric Investigation (FPI). (2) Identify clinical subgroups among this group of offenders. (3) Investigate associations between the identified clinical subgroups and (a) psychiatric comorbidity (b) types of crimes and (c) criminal responsibility.

Methods

The study cohort consists of all subjects (n = 831) who received an ASD-diagnosis at an FPI between 2002 and 2018 in Sweden. Descriptive and clinical, as well as crime related variables were obtained from the FPIs. Non-parametric (Pearson χ2, Fisher's exact and Mann-Whitney U-test) inferential statistics were used for analyses of between-group differences and effect sizes were reported. A Latent Class Analysis was used to identify homogeneous subgroups (or classes) from categorical characteristics.

Results

The cohort consisted of 708 men and 123 women, aged 18 to 74 yrs. Two-thirds (66.7%) of the cohort had at least one other psychiatric diagnosis, the most prevalent was substance use disorder (SUD). A severe mental disorder, equivalent to lack of criminal responsibility, was most often reported among offenders with a comorbid diagnosis of schizophrenia spectrum disorder. The most common type of crime was violent crime. Three person-oriented clinical subgroups were identified; (1) ASD with few other diagnoses; (2) ASD and very high levels of SUDs, plus moderate levels of other externalizing disorders and psychotic psychopathology and (3) ASD and moderate to high levels of personality disorders (other than ASPD) and SUDs.

Conclusion

Our results highlight the importance of all parts of the CJS to be prepared to handle offenders with ASD, often with high levels of additional psychiatric problems. Traditional approaches in treatment or other psychosocial interventions for ASD may need to be adapted to at least three general clinical profiles- one with mainly neurodevelopmental problems, one with a spectrum of externalizing problems and one with complex personality related difficulties.

Offending Trajectories in Violent Offenders: Criminal History and Early Life Risk Factors

The understanding of offending, and thus its possible prevention, is expanded through longitudinal studies on criminal trajectories depicting early life risk factors. This longitudinal study aimed to explore criminal trajectories, criminal histories, and early life risk factors in a cohort of violent offenders. A Swedish nationally representative cohort of male violent offenders (n = 266), clinically assessed while imprisoned aged 18 to 25, was followed through national registers from age 15 to 25-34. Substantial differences in criminal histories between violent offenders and a matched comparison group (n = 10,000) were demonstrated. Five trajectory groups were identified: four persisting and one desisting. Although differences were observed between persisting trajectory groups, a higher prevalence of early life risk factors was generally displayed compared to the desisting, especially in conduct problems and experiences of out-of-home placements. Neurocognitive ability and prevalence of ADHD and autism were similar across trajectories. Severe early life risks highlight the population's need for early interventions.

A Systematic Review of Autistic People and the Criminal Justice System: An Update of King and Murphy (2014)

The purpose of this paper was to determine whether recommendations made by King & Murphy (Journal of Autism and Developmental Disorders 44:2717-2733, 2014) in their review of the evidence on autistic people in contact with the criminal justice system (CJS) have been addressed. Research published since 2013 was systematically examined and synthesised. The quality of 47 papers was assessed using the Mixed Methods Appraisal Tool. Findings suggest a limited amount of good quality research has been conducted that has focused on improving our understanding of autistic people in contact with the CJS since 2013. Methodological limitations make direct comparisons between autistic and non-autistic offenders difficult. Autistic people commit a range of crimes and appear to have unique characteristics that warrant further exploration (i.e., vulnerabilities, motivations for offending).

Sex offending among adolescents and young men with history of psychiatric inpatient care in adolescence

BACKGROUND

Some mental disorders have been associated with increased likelihood of sexual offending in adolescents (and adults), but relevant studies tend to be of established sex offenders.

AIMS

To examine relationships between adolescent mental disorders and subsequent involvement in sex offending and to explore any predictive value of primary diagnoses for subsequent interpersonal offending, whether sexual or violent.

METHODS

We analyse national register-based longitudinal data on males in Finland admitted for their first psychiatric inpatient treatment between the ages of 13-17 in the period 1980-2010 (N = 6749). Cox regression was used for the analysis of multivariate associations.

RESULTS

A subsequent criminal record for sex crime in the 10-year follow up was rare among former child and adolescent psychiatric (CAP) inpatient males (1.5%). Having a subsequent criminal record for non-sex-related violent crime was more common (25%). Time to either sex crimes or non-sex-related violent crimes after a first CAP inpatient treatment was 3-4 years. Whilst the risk of committing non-sex-related violent crimes was elevated in all diagnostic groups compared to those with schizophrenia spectrum disorders, the risk of committing subsequent sex crimes was elevated only in the group with substance use, conduct or personality disorders. Among those with pre-existing criminal history of sex crime, the risk of a subsequent criminal record for sex crime after CAP treatment was increased 11-fold, but the risk for later non-sex-related violent crimes was not increased compared to the rest of the male adolescent CAP population.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

In this first longitudinal study of criminal convictions for sex offending after a period of inpatient psychiatric treatment as an adolescent such convictions were rare, but the difference in post discharge risk of further convictions for sexual offending and non-sexual violent offending raises questions about whether more attention and specific treatment for aberrant sexual behaviours is needed for male adolescents with severe mental disorders.

Policy gaps and opportunities: A systematic review of autism spectrum disorder and criminal justice intersections

Autism spectrum disorder prevalence is rising, and as this population enters adulthood, preliminary research has identified high rates of contact with the criminal justice system. Policy and programmatic reform are crucial given reported negative and violent outcomes for autistic individuals when encountering the criminal justice system. Given the size and scope of the entire criminal justice system, identifying priorities and opportunities for change is critical, and must be rooted in evidence-based findings to maximize impact and scalability. This article provides a systematic review of the literature on autism spectrum disorder and criminal justice system intersections, analyzed through a convergent qualitative synthesis. As the extant literature is diverse and employs a variety of study methods, this review allows for an analysis across study types. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis structure was utilized and captured 89 total articles from six databases. Studies are grouped by the Sequential Intercept Model, which offers a framework for analyzing criminal justice system dimensions, and informs where research at the intersection of autism spectrum disorder and the criminal justice system is most prevalent. Themes were identified at each intercept and described through key study findings to articulate implications and guidance for policy, practice, and future research to promote equitable justice for autistic individuals.

Lay abstract

The number of people with autism spectrum disorder has increased, and as this population ages, research is showing high rates of contact with the criminal justice system among this group. Social and communication differences that autistic individuals experience can act as a risk factor during these interactions, as shown by public reports of negative and violent encounters between autistic individuals and the law enforcement. There is a clear need for evidence-based strategies to reduce high rates of contact and to improve outcomes when an interaction occurs. This article provides a systematic review of research on autism spectrum disorder and criminal justice system to compile this evidence base. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis structure was used to identify 89 articles after searching six databases. The Sequential Intercept Model describes the criminal justice system as different stages, or intercepts, that are connected, and the Sequential Intercept Model serves as an overall framework to organize the included articles. Articles were analyzed to identify research themes at each intercept, which offer guidance for policy and program changes that support equitable justice for autistic individuals.

Case-control study on clinical characteristics of child and adolescent psychiatric outpatients with child-to-parent violence

OBJECTIVES

To the best of our knowledge, no case-control study on child and adolescent psychiatric outpatients has investigated the clinical characteristics of patients with child-to-parent violence (CPV). The current study aimed to evaluate the clinical characteristics of child and adolescent psychiatric patients with CPV.

SETTING AND PARTICIPANTS

This research included child and adolescent psychiatric patients who were aged 10-15 years during their initial consultation. The participants were allocated to one of two groups: children with CPV (CPV group, n=109) and without CPV (non-CPV group, n=713).

OUTCOME MEASURES

This study analysed data including age, sex, diagnostic classification of the primary diagnosis, antisocial behaviour, suicidal attempt or self-harm and refusal to attend school. Moreover, a history of abuse by parents was investigated. Psychological rating scales such as the Spence Children's Anxiety Scale, Depression Self-Rating Scale for Children, Tokyo Autistic Behavior Scale, Attention-deficit/Hyperactivity Disorder-Rating Scale and Oppositional Defiant Behavior Inventory were used.

RESULTS

Of 822 patients who sought consultation in our department, 109 (13.26%) were included in the CPV group during the first consultation. Compared with the non-CPV group, the CPV group had significantly higher proportions of patients who experienced physical abuse, psychological abuse and who witnessed violence between parents. Meanwhile, the proportion of patients with neurodevelopmental disorders was significantly higher in the CPV group than in the non-CPV group. Regarding developmental characteristics, impulsivity might be correlated with CPV. Moreover, violence and behavioural problems outside of home were associated with CPV.

CONCLUSIONS

In patients with CPV who sought consultation, the findings of the current study should be considered to understand invisible side and to facilitate the use of appropriate treatment approaches. However, a prospective study should be performed to investigate the causality between CPV and clinical characteristics.

Evolution of the Autism Literature and the Influence of Parents: A Scientific Mapping in Web of Science

Parents interventions are relevant to address autism spectrum disorder (ASD). The objective of this study is to analyze the importance and evolution of ASD and its relationship with the parents (ASD-PAR) in the publications indexed in Web of Science. For this, a bibliometric methodology has been used, based on a scientific mapping of the reported documents. We have worked with an analysis unit of 1381 documents. The results show that the beginnings of scientific production date back to 1971. There are two clearly differentiated moments in scientific production. A first moment (1971-2004), where the production volume is low. A second moment (2005-2019), where the volume of production increases considerably. Therefore, it can be said that the subject began to be relevant for the scientific community from 2005 to the present. The keyword match rate between set periods marks a high level of match between periods. It is concluded that the main focus of the research on ASD-PAR is on the stress that is generated in families with children with ASD, in addition to the family problems that the fact that these children also have behavior problems can cause.

Trends in Autism Research in the Field of Education in Web of Science: A Bibliometric Study

Autism spectrum disorder (ASD) is conceived as a neurodevelopmental disorder. The scientific literature welcomes studies that reflect the possible singularities that people with ASD may present both in their daily lives and at an educational level. The main objective of this study is to analyze the scientific production on the term autism in Web of Science, focused on the educational field, in order to identify the research trends in this field of study. The intention is to offer researchers who study autism in the educational field some clear research directions. A bibliometric-type methodology was developed using the scientific mapping technique. For this purpose, a performance analysis and a co-word analysis were carried out. Work was conducted with an analysis unit of 5512 documents. The results show that the volume of production has been irregular from the beginning to the present. The collection of documents on the subject began to be relevant, in terms of the volume of production, from 2007, and this has persisted to the present. It is concluded that there are two lines of research. The first is the line focused on mothers of children with ASD and the second is the line of research focused on young people with ASD. In addition, since 2012, new lines of research have been generated, focused on the diagnosis and inclusion of these students in educational centers.

Documentary Analysis of the Scientific Literature on Autism and Technology in Web of Science

The objective of the study is to track the progression of the scientific literature on autism and the technology applied to this disorder. A bibliometric methodology has been used, based on a co-word analysis. The Web of Science database was chosen to perform the analysis of the literature. A unit of analysis of 1048 publications was configured. SciMAT software was used mainly for document analysis. The results indicate that the first studies appeared in 1992, but it was not until 2009 that the research volume increased considerably. The area of knowledge where these studies were compiled was rehabilitation, which marks the truly therapeutic nature of this type of study. One of the authors with the most studies, as well as the most relevant research, was Sarkar, N. Manuscripts were usually research articles written in English. It could be concluded that research in this field of study focused mainly on interventions carried out through the use of technological resources, with students or young people who present with ASD. This line of research, although not the only one, was the most relevant and the one that had aroused the most interest among the scientific community.