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      Examining the experiences and quality of life of patients with an autism spectrum disorder detained in high secure psychiatric care

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          Abstract

          Purpose

          Although individuals with an autism spectrum disorder (ASD) represent a small proportion of forensic psychiatric patients as a group they present with specific difficulties and needs. There is also evidence that if detained individuals with an ASD experience particular difficulties within custodial environments as a result of a mismatch between the difficulties associated with their ASD and the environmental demands. The purpose of this paper is to explore the experience of individuals with an ASD admitted to a high secure psychiatric care (HSPC) hospital.

          Design/methodology/approach

          Using both a semi-structured interview and a quality of life self-report measure (the Lancashire Quality of Life Profile) the experiences and views of seven patients with an ASD detained in one HSPC hospital were qualitatively explored.

          Findings

          Whilst a diverse range of negative and positive aspects of being within HSPC were identified by patients interviewed, those with prison experience thought HSPC was a less stressful environment with more therapeutic opportunities. As a group, patients with an ASD reported a similar or significantly better quality of life in many domains (global, leisure, financial and living situation) compared to other detained forensic patient groups.

          Practical implications

          Although most patients with an ASD interviewed reported positive experiences, there are a number of practical improvements that could be made within the hospital to reduce experienced stress levels and perhaps improve therapeutic outcomes.

          Originality/value

          Within the context of the Department of Health's autism strategy (2010) and subsequent update think autism (2014), the survey highlights continued ASD awareness training for staff as important. In responding to the risks and needs of individuals with an ASD in HSPC there is further support for the development of an ASD specialist service.

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          Most cited references 21

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          Prevalence of Asperger's syndrome in a secure hospital.

          The hypothesis that Asperger's syndrome (AS) may go unrecognised in forensic populations was examined by ascertaining the prevalence in Broadmoor Special Hospital. The entire male patient population was screened by examination of case notes. Identified cases were subject to the next stage of the study, which involved observation and interviewing of patients, and a semi-structured interview of key staff. A prevalence of 1.5% (0.6% to 3.3%, 95% CI) was found. The addition of equivocal cases increased the prevalence to 2.3%. The prevalence of AS in Broadmoor Hospital is greater than that reported for the general population.
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            Asperger's Syndrome in Forensic Settings

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              Offending behaviour in adults with Asperger syndrome.

              Considerable speculation is evident both within the scientific literature and popular media regarding possible links between Asperger syndrome and offending. A survey methodology that utilised quantitative data collection was employed to investigate the prevalence of offending behaviour amongst adults with Asperger Syndrome in a large geographical area of South Wales, UK; qualitative interviews were then conducted with a sub-sample of those identified. A small number of participants meeting the study criteria were identified. For those who had offended, their experience of the criminal justice system was essentially negative. Possible implications of the results were discussed.
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                Author and article information

                Contributors
                Journal
                AIA
                10.1108/AIA
                Advances in Autism
                AIA
                Emerald Publishing
                2056-3868
                03 January 2017
                : 3
                : 1
                : 3-14
                Affiliations
                Department of Psychology, Broadmoor Hospital, Crowthorne, UK
                Author notes
                David Murphy can be contacted at: david.murphy@wlmht.nhs.uk
                Article
                589199 AIA-02-2016-0006.pdf AIA-02-2016-0006
                10.1108/AIA-02-2016-0006
                © Emerald Publishing Limited
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 29, Pages: 12, Words: 7356
                Product
                Categories
                e-viewpoint, Viewpoint
                cat-HSC, Health & social care
                cat-LID, Learning & intellectual disabilities
                Custom metadata
                yes
                yes
                JOURNAL
                included

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