A recent study in one of England’s high-security psychiatric hospitals estimated that approximately 2% of the hospital’s male population had Asperger’s (AS), now called high functioning autism. This significantly exceeds the 0.36% prevalence estimated for the general population. This over-representation of AS was subsequently confirmed in two other English high-secure units.
Asperger’s and criminal offenses:
Asperger’s and criminal offenses:
- Both alcohol and drug abuse, as well as drug offenses have been reported in this population, although drug abuse is comparatively rare.
- Epidemiological studies indicate that people with AS do commit sexual offences, but there is evidence that the rates of sexual offending in general – and of child sex offences in particular – are lower among offenders on the autism spectrum.
- Violence in a community sample was more common among those with AS, and there is evidence that offenders on the autism spectrum are more likely to have previous convictions for assault. Similar rates of violent offending by people on the spectrum have been reported in high-secure units in England.
- There is growing evidence that people with AS are more likely to commit fire-setting offenses than people without the disorder.
A number of factors may mediate offending in people with AS:
- aggressive behavior
- circumscribed interests
- comorbid psychiatric conditions (e.g., bipolar affective disorder, depression, antisocial personality disorder, attention-deficit hyperactivity disorder, conduct disorder, and schizophrenia)
- hyperactivity/impulsivity
- inattention
- late diagnosis
- neuropsychological impairment
- poor educational achievement
- social exclusion
- substance abuse
- truancy
Another study revealed that offenders on the autism spectrum spend more time (11.26 years on average) in high-secure settings than offenders with other psychiatric disorders. The relatively longer stay may be responsible for the over-representation of people with AS in English high-secure units.
People on the autism spectrum held in secure units are more vulnerable to exploitation, bullying and intimidation by virtue of their “odd” behavior and social naivety. The risks arising from these factors are compounded by their inability to articulate their frustrations appropriately. People on the spectrum who behave in an exemplary manner in a particular environment may re-offend if they are transferred to a less appropriate setting or an unfamiliar one with a new set of rules and routines. Among this group of offenders, a lack of comprehension of the consequences of their criminal behavior, as well as their egocentric justification of their acts, further increase the risk of re-offending following transfer to less secure conditions or discharge into community placements.
The majority of AS offenders held in high-secure units are (a) detained under the mental health category of mental impairment, (b) transferred as sentenced prisoners, (c) transferred prior to sentencing, and (d) have committed sexual offenses. In most cases, the index offenses have taken place in the context of substance abuse.
In summary, research suggests that offenders with AS are more likely to commit (a) offenses of a sexual nature, (b) fraud, (c) fire-setting offenses, and (d) drug offenses, but less likely to commit violent offenses.
Further research of a clinical nature within the AS offender population is greatly needed. More specifically, the prevalence of AS among those detained in medium and low-secure psychiatric facilities is needed to create services for the vast majority of offenders with the disorder who find themselves detained for longer than necessary due to the lack of knowledge of methods of rehabilitation.
People on the autism spectrum held in secure units are more vulnerable to exploitation, bullying and intimidation by virtue of their “odd” behavior and social naivety. The risks arising from these factors are compounded by their inability to articulate their frustrations appropriately. People on the spectrum who behave in an exemplary manner in a particular environment may re-offend if they are transferred to a less appropriate setting or an unfamiliar one with a new set of rules and routines. Among this group of offenders, a lack of comprehension of the consequences of their criminal behavior, as well as their egocentric justification of their acts, further increase the risk of re-offending following transfer to less secure conditions or discharge into community placements.
The majority of AS offenders held in high-secure units are (a) detained under the mental health category of mental impairment, (b) transferred as sentenced prisoners, (c) transferred prior to sentencing, and (d) have committed sexual offenses. In most cases, the index offenses have taken place in the context of substance abuse.
In summary, research suggests that offenders with AS are more likely to commit (a) offenses of a sexual nature, (b) fraud, (c) fire-setting offenses, and (d) drug offenses, but less likely to commit violent offenses.
Further research of a clinical nature within the AS offender population is greatly needed. More specifically, the prevalence of AS among those detained in medium and low-secure psychiatric facilities is needed to create services for the vast majority of offenders with the disorder who find themselves detained for longer than necessary due to the lack of knowledge of methods of rehabilitation.
References—
1. Allen D, Evans C, Hider A, et al (2007) Offending behaviour in adults with Asperger syndrome. Journal of Autism and Developmental Disorders; 38: 748–58.
2. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). APA.
3. Attwood T (2007) The Complete Guide to Asperger’s Syndrome. Jessica Kingsley Publishers.
4. Baron-Cohen S, Wheelwright S, Robinson J, et al (2005) The Adult Asperger Assessment (AAA): a diagnostic method. Journal of Autism and Developmental Disorders; 35: 807–19.
5. Barry-Walsh JB, Mullen PE (2004) Forensic aspects of Asperger’s syndrome. .Journal of Forensic Psychiatry and Psychology; 15: 96–107.
6. Blair J, Mitchell D, Blair K (2005) The Psychopath: Emotion and the Brain. Blackwell Publishing.
7. Crocombe J, Mills R, Wing L, et al (2006) Autism Spectrum Disorders in the High Security Hospitals of the United Kingdom. A Summary of Two Studies.
8. Elvish J (2007) The exploration of autistic spectrum disorder characteristics in individuals within a secure service for people with learning disabilities. Thesis for Doctorate in Clinical Psychology. The Tizard Centre, University of Kent.
9. Farrington DP (2007) Childhood risk factors and risk-focused prevention. In The Oxford Handbook of Criminology (4th edn) (eds M Maguire, R Morgan, R Reiner): 602–40. Oxford University Press.
10. Frith U (ed) (1991) Asperger and his syndrome. In Autism and Asperger Syndrome: 1–36. Cambridge University Press.
11. Golan O, Baron-Cohen S (2006) Systemizing empathy: teaching adults with Asperger’s syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Development and Psychopathology; 18: 591–617.
12. Hare DJ, Gould J, Mills R, et al (1999) A preliminary study of individuals with autistic spectrum disorders in three special hospitals in England. National Autistic Society.
13. Hawes V (2003) Developmental disorders in prisoners volunteering for DSPD assessment. In Proceedings of the 2nd International Conference on the Care and Treatment of Offenders with a Learning Disability (eds C Dale, L Storey): in Presentations on ‘Working with offenders’.
14. Klin A, McPartland J, Volkmar FR (2005) Asperger’s syndrome. In Handbook of Autism and Pervasive Developmental Disorders (eds FR Volkmar, A Klin, R Paul, et al): 88–125. Wiley.
15. Lord C, Risi S, Lambrecht L, et al (2000) The Autism Diagnostic Observation Schedule–Generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders; 30: 205–23.
16. Lord C, Rutter M, LeCouteur A (1994) The Autism Diagnostic Schedule–Revised: a revised version of a diagnostic interview for caregiver of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders;24: 659–85.
17. McDougle CJ, Naylor ST, Cohen DJ, et al (1996) A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Archives of General Psychiatry; 53: 1001–8.
18. Mouridsen SE, Rich B, Isager T, et al (2008) Pervasive developmental disorders and criminal behaviour: a case control study. International Journal of Offender Therapy and Comparative Criminology ; 52: 196–205.
19. Murphy D (2003) Admission and cognitive details of male patients diagnosed with Asperger’s Syndrome detained in a Special Hospital: comparison with a schizophrenia and personality disorder sample. Journal of Forensic Psychiatry and Psychology; 14: 506–24.
20. Murphy D (2007) Hare Psychopathy Checklist Revised profiles of male patients with Asperger’s syndrome detained in high security psychiatric care. Journal of Forensic Psychiatry and Psychology; 18: 20–126.
21. Myers F (2004) On the Borderline? People with Learning Disabilities and/or Autistic Spectrum Disorders in Secure, Forensic and Other Specialist Settings. Scottish Development Centre for Mental Health (http://www.scotland.gov.uk/Resource/Doc/47251/0023734.pdf).
22. Research Units on Pediatric Psychopharmacology (2002) Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine;347: 314–21.
23. Research Units on Pediatric Psychopharmacology (2005) Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Archives of General Psychiatry; 62: 1266–74.
24. Royal College of Psychiatrists (2006) Psychiatric Services for Adolescents and Adults with Asperger Syndrome and Other Autistic-Spectrum Disorders (Council Report CR136). Royal College of Psychiatrists (http://www.rcpsych.ac.uk/files/pdfversion/cr136new.pdf).
25. Schwartz-Watts DM (2005) Asperger’s disorder and murder. Journal of the American Academy of Psychiatry and the Law; 33: 390–3.
26. Scragg P, Shah A (1994) Prevalence of Asperger’s syndrome in a secure hospital.British Journal of Psychiatry; 165: 679–82.
27. Siponmaa L, Kristiansson M, Jonsson C, et al (2001) Juvenile and young adult mentally disordered offenders: the role of child neuropsychiatric disorders. Journal of American Academy of Psychiatry and the Law; 29: 420–6.
28. Soderstrom H, Nilsson T, Sjodin AK, et al (2005) The childhood-onset neuropsychiatric background to adult psychopathic traits and personality disorders. Comprehensive Psychiatry; 46: 111–6.
29. Viding EM (2007) Re: The callous unemotional traits (e-Letter). British Journal of Psychiatry; 29 May (http://bjp.rcpsych.org/cgi/eletters/190/49/s33#3699).
30. Wing L (1981) Asperger’s syndrome: a clinical account. Psychological Medicine;11: 115–29.
31. Wing L (1997) Asperger’s syndrome: management requires diagnosis. Journal of Forensic Psychiatry; 8: 253–7.
32. Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2005) A case–control study of offenders with high-functioning autistic spectrum disorders. Journal of Forensic Psychiatry and Psychology; 16: 747–63.
33. Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2006) High functioning autistic spectrum disorders, offending and other law-breaking: findings from a community sample. Journal of Forensic Psychiatry and Psychology; 17 : 108–20.
34. Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2009) Circumscribed interests among offenders with autistic spectrum disorders: a case–control study. Journal of Forensic Psychiatry and Psychology; in press.
35. Woodbury-Smith MR, Volkmar FR (2008) Asperger Syndrome: a review.European Journal of Child and Adolescent Psychiatry; 56: 1–11.
36. World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO.
1. Allen D, Evans C, Hider A, et al (2007) Offending behaviour in adults with Asperger syndrome. Journal of Autism and Developmental Disorders; 38: 748–58.
2. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). APA.
3. Attwood T (2007) The Complete Guide to Asperger’s Syndrome. Jessica Kingsley Publishers.
4. Baron-Cohen S, Wheelwright S, Robinson J, et al (2005) The Adult Asperger Assessment (AAA): a diagnostic method. Journal of Autism and Developmental Disorders; 35: 807–19.
5. Barry-Walsh JB, Mullen PE (2004) Forensic aspects of Asperger’s syndrome. .Journal of Forensic Psychiatry and Psychology; 15: 96–107.
6. Blair J, Mitchell D, Blair K (2005) The Psychopath: Emotion and the Brain. Blackwell Publishing.
7. Crocombe J, Mills R, Wing L, et al (2006) Autism Spectrum Disorders in the High Security Hospitals of the United Kingdom. A Summary of Two Studies.
8. Elvish J (2007) The exploration of autistic spectrum disorder characteristics in individuals within a secure service for people with learning disabilities. Thesis for Doctorate in Clinical Psychology. The Tizard Centre, University of Kent.
9. Farrington DP (2007) Childhood risk factors and risk-focused prevention. In The Oxford Handbook of Criminology (4th edn) (eds M Maguire, R Morgan, R Reiner): 602–40. Oxford University Press.
10. Frith U (ed) (1991) Asperger and his syndrome. In Autism and Asperger Syndrome: 1–36. Cambridge University Press.
11. Golan O, Baron-Cohen S (2006) Systemizing empathy: teaching adults with Asperger’s syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Development and Psychopathology; 18: 591–617.
12. Hare DJ, Gould J, Mills R, et al (1999) A preliminary study of individuals with autistic spectrum disorders in three special hospitals in England. National Autistic Society.
13. Hawes V (2003) Developmental disorders in prisoners volunteering for DSPD assessment. In Proceedings of the 2nd International Conference on the Care and Treatment of Offenders with a Learning Disability (eds C Dale, L Storey): in Presentations on ‘Working with offenders’.
14. Klin A, McPartland J, Volkmar FR (2005) Asperger’s syndrome. In Handbook of Autism and Pervasive Developmental Disorders (eds FR Volkmar, A Klin, R Paul, et al): 88–125. Wiley.
15. Lord C, Risi S, Lambrecht L, et al (2000) The Autism Diagnostic Observation Schedule–Generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders; 30: 205–23.
16. Lord C, Rutter M, LeCouteur A (1994) The Autism Diagnostic Schedule–Revised: a revised version of a diagnostic interview for caregiver of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders;24: 659–85.
17. McDougle CJ, Naylor ST, Cohen DJ, et al (1996) A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Archives of General Psychiatry; 53: 1001–8.
18. Mouridsen SE, Rich B, Isager T, et al (2008) Pervasive developmental disorders and criminal behaviour: a case control study. International Journal of Offender Therapy and Comparative Criminology ; 52: 196–205.
19. Murphy D (2003) Admission and cognitive details of male patients diagnosed with Asperger’s Syndrome detained in a Special Hospital: comparison with a schizophrenia and personality disorder sample. Journal of Forensic Psychiatry and Psychology; 14: 506–24.
20. Murphy D (2007) Hare Psychopathy Checklist Revised profiles of male patients with Asperger’s syndrome detained in high security psychiatric care. Journal of Forensic Psychiatry and Psychology; 18: 20–126.
21. Myers F (2004) On the Borderline? People with Learning Disabilities and/or Autistic Spectrum Disorders in Secure, Forensic and Other Specialist Settings. Scottish Development Centre for Mental Health (http://www.scotland.gov.uk/Resource/Doc/47251/0023734.pdf).
22. Research Units on Pediatric Psychopharmacology (2002) Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine;347: 314–21.
23. Research Units on Pediatric Psychopharmacology (2005) Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Archives of General Psychiatry; 62: 1266–74.
24. Royal College of Psychiatrists (2006) Psychiatric Services for Adolescents and Adults with Asperger Syndrome and Other Autistic-Spectrum Disorders (Council Report CR136). Royal College of Psychiatrists (http://www.rcpsych.ac.uk/files/pdfversion/cr136new.pdf).
25. Schwartz-Watts DM (2005) Asperger’s disorder and murder. Journal of the American Academy of Psychiatry and the Law; 33: 390–3.
26. Scragg P, Shah A (1994) Prevalence of Asperger’s syndrome in a secure hospital.British Journal of Psychiatry; 165: 679–82.
27. Siponmaa L, Kristiansson M, Jonsson C, et al (2001) Juvenile and young adult mentally disordered offenders: the role of child neuropsychiatric disorders. Journal of American Academy of Psychiatry and the Law; 29: 420–6.
28. Soderstrom H, Nilsson T, Sjodin AK, et al (2005) The childhood-onset neuropsychiatric background to adult psychopathic traits and personality disorders. Comprehensive Psychiatry; 46: 111–6.
29. Viding EM (2007) Re: The callous unemotional traits (e-Letter). British Journal of Psychiatry; 29 May (http://bjp.rcpsych.org/cgi/eletters/190/49/s33#3699).
30. Wing L (1981) Asperger’s syndrome: a clinical account. Psychological Medicine;11: 115–29.
31. Wing L (1997) Asperger’s syndrome: management requires diagnosis. Journal of Forensic Psychiatry; 8: 253–7.
32. Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2005) A case–control study of offenders with high-functioning autistic spectrum disorders. Journal of Forensic Psychiatry and Psychology; 16: 747–63.
33. Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2006) High functioning autistic spectrum disorders, offending and other law-breaking: findings from a community sample. Journal of Forensic Psychiatry and Psychology; 17 : 108–20.
34. Woodbury-Smith MR, Clare ICH, Holland AJ, et al (2009) Circumscribed interests among offenders with autistic spectrum disorders: a case–control study. Journal of Forensic Psychiatry and Psychology; in press.
35. Woodbury-Smith MR, Volkmar FR (2008) Asperger Syndrome: a review.European Journal of Child and Adolescent Psychiatry; 56: 1–11.
36. World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO.
