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      Heterogeneity within autism spectrum disorder in forensic mental health: the introduction of typologies

      e-conceptual-paper
      Regi Alexander , Peter E. Langdon ,   Verity Chester , Magali Barnoux , Ignatius Gunaratna , Sudeep Hoare
      Advances in Autism
      Emerald Publishing
      Intellectual disability, Forensic, Autism spectrum disorder, Autism spectrum condition, Mental disorder, Behavioural phenotypes

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          Abstract

          Purpose

          Individuals with diagnoses of autism spectrum disorder (ASD) within criminal justice settings are a highly heterogeneous group. Although studies have examined differences between those with and without ASD in such settings, there has been no examination of differences within the ASD group. The paper aims to discuss these issues.

          Design/methodology/approach

          Drawing on the findings of a service evaluation project, this paper introduces a typology of ASD within forensic mental health and intellectual disability settings.

          Findings

          The eight subtypes that are described draw on clinical variables including psychopathy, psychosis and intensity/frequency of problem behaviours that co-occur with the ASD. The initial assessment of inter-rater reliability on the current version of the typology revealed excellent agreement, multirater Kfree =0.90.

          Practical implications

          The proposed typology could improve understanding of the relationship between ASD and forensic risk, identify the most appropriate interventions and provide prognostic information about length of stay. Further research to refine and validate the typology is ongoing.

          Originality/value

          This paper introduces a novel, typology-based approach which aims to better serve people with ASD within criminal justice settings.

          Related collections

          Most cited references22

          • Record: found
          • Abstract: found
          • Article: not found

          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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            • Abstract: found
            • Article: not found

            Risk factors for violent offending in autism spectrum disorder: a national study of hospitalized individuals.

            Little is known about risk factors for violence among individuals with autism spectrum disorder (ASD). This study uses data from Swedish longitudinal registers for all 422 individuals hospitalized with autistic disorder or Asperger syndrome during 1988-2000 and compares those committing violent or sexual offenses with those who did not. Thirty-one individuals with ASD (7%) were convicted of violent nonsexual crimes and two of sexual offenses. Violent individuals with ASD are more often male and diagnosed with Asperger syndrome rather than autistic disorder. Furthermore, comorbid psychotic and substance use disorders are associated with violent offending. We conclude that violent offending in ASD is related to similar co-occurring psychopathology as previously found among violent individuals without ASD. Although this study does not answer whether ASDs are associated with increased risk of violent offending compared with the general population, careful risk assessment and management may be indicated for some individuals with Asperger syndrome.
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              • Record: found
              • Abstract: found
              • Article: not found

              Pervasive developmental disorders and criminal behaviour: a case control study.

              The prevalence and pattern of criminal behaviour in a population of 313 former child psychiatric in-patients with pervasive developmental disorders were studied. The patients were divided into three subgroups and compared with 933 matched controls from the general population. Age at follow-up was between 25 years and 59 years. An account of convictions in the nationwide Danish Register of Criminality was used as a measure of criminal behaviour. Among 113 cases with childhood autism, .9% had been convicted. In atypical autism (n=86) and Asperger's syndrome (n=114) the percentages were 8.1% and 18.4%, respectively. The corresponding rate of convictions in the comparison groups was 18.9%, 14.7%, and 19.6% respectively. Particular attention is given to arson in Asperger's syndrome (p= .0009).
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                Author and article information

                Contributors
                Journal
                AIA
                10.1108/AIA
                Advances in Autism
                AIA
                Emerald Publishing
                2056-3868
                03 October 2016
                : 2
                Issue : 4 Issue title : Autism and offending behaviour Issue title : Autism and offending behaviour
                : 201-209
                Affiliations
                [1]Partnerships in Care Learning Disability Services, Norfolk, UK
                [2]Tizard Centre, University of Kent , Canterbury, UK
                [3]Broadland Clinic, Hertfordshire Partnership, University NHS Foundation Trust in Norfolk , UK
                [4]Partnerships in Care Ltd, Norfolk, UK
                Author notes
                Regi Alexander can be contacted at: R.Alexander@uea.ac.uk
                Article
                586488 AIA-08-2016-0021.pdf AIA-08-2016-0021
                10.1108/AIA-08-2016-0021
                bb1a705e-9a9b-4d54-8e42-f5cb33a2959d
                © Emerald Group Publishing Limited
                History
                : 02 August 2016
                : 02 August 2016
                : 06 August 2016
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 33, Pages: 10, Words: 4703
                Categories
                e-conceptual-paper, Conceptual paper
                cat-HSC, Health & social care
                cat-LID, Learning & intellectual disabilities
                Custom metadata
                yes
                yes
                JOURNAL
                included

                Health & Social care
                Intellectual disability,Forensic,Autism spectrum disorder,Autism spectrum condition,Mental disorder,Behavioural phenotypes

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