Sissel Berge Helverschou

Psychiatric Disorders in People with Autism Spectrum Disorders: Phenomenology and Recognition

The prevalence and incidence rates of psychiatric disorders are higher in people with autism spectrum disorders (ASD) than in the general population (Bradley, Summers, Hayley, & Bryson, 2004; Brereton, Tonge, & Einfeld, 2006; Clarke, Baxter, Perry, & Prasher, 1999; Ghaziuddin & Greden, 1998; Ghaziuddin, 2005; Ghaziuddin, Alessi, & Greden, 1995; Ghaziuddin, Tsai, & Ghaziuddin, 1992; Glenn, Bihm, & Lammers, 2003; Howlin, 1997, 2000; Howlin, Goode, Hutton, & Rutter, 2004; Lainhart, 1999; Leyfer et al., 2006; Matson & Nebel-Schwalm, 2007; Morgan, Roy, & Chance, 2003; Simonoff et al., 2008; Tsakanikos et al., 2006).

Violence and Sexual Offending Behavior in People with Autism Spectrum Disorder who have Undergone a Psychiatric Forensic Examination

The increased awareness of Autism Spectrum Disorders (ASD) over the last few decades as well as the potential association between ASD and offending behaviors has spurred a need for increased research in this area. In order to explore any possible relationship between ASD and violent or sexual crime the present study examines all forensic examination reports over a 10-yr. period in Norway where the charged persons were diagnosed with ASD and charged with either a violent (N = 21) or a sexual (N = 12) offense. Differences between these two groups regarding previous contact with child welfare and confessions to the offense were found. There was also a tendency toward more severe mental health problems and less intellectual problems among the violent offenders than the sexual offenders.

Offending profiles of individuals with autism spectrum disorder: A study of all individuals with autism spectrum disorder examined by the forensic psychiatric service in Norway between 2000 and 2010

This study examined the characteristics of adults with autism spectrum disorder who have undergone a forensic examination and explored any relationships between the diagnosis and the offence. The reports described 41 men and 7 women. The autism spectrum disorder was diagnosed late (mean age: 25.3 years), and 22 of the 48 cases were diagnosed with autism spectrum disorder for the first time by the forensic experts. The education level and employment status were low. Family networks were close, but social networks outside the family were limited. Co-morbid diagnoses were common, and more than half of the group knew their victims. The examined individuals constitute a vulnerable and heterogeneous group, as do offenders within other diagnostic categories. Unlike most others who commit criminal acts, the majority of the individuals with autism spectrum disorder in this study showed no evidence of substance abuse, had a close relationship to their victims and were willing to confess to the accused crime. No clear association between the characteristics of autism spectrum disorder and the criminal act were identified, but in most cases, autism spectrum disorder characteristics, such as idiosyncratic comprehensions and obsessions appeared to be related to the motive for the offence.

Personal experiences of the Criminal Justice System by individuals with autism spectrum disorders

The processes of arrest, investigation, trial and imprisonment are often extremely difficult for individuals with autism spectrum disorders. In this study, nine offenders with autism spectrum disorders were interviewed about the circumstance surrounding the criminal acts, their views of the arrest, the police interrogation, the trial and the defence and their experiences of being in prison and/or life following the offence. The nine individuals described a range of different and often negative experiences with the Criminal Justice System. However, the majority of those given a custodial sentence coped well in prison, probably due to the high levels of structure and firm frameworks in that environment. Explanation factors associated with the offences indicated that autism spectrum disorder characteristics such as misunderstandings, obsessions and idiosyncratic beliefs and/or behaviours were frequently involved, but stress was the most common explanation provided by the participants. The findings suggest limited understanding of autism spectrum disorders within the Criminal Justice System which needs to be significantly improved in order to secure their legal protection.

Assessment of psychosis in ASD/ID: a case study

Purpose Assessment of psychiatric disorders in people with autism spectrum disorder (ASD) and intellectual disabilities (ID) is challenging. The purpose of this paper is to explore the diagnostic decision making and strategies employed in the assessment of a young man with ASD and ID who eventually got the additional diagnosis of schizophrenia. Design/methodology/approach To describe and explore a process not easily converted into quantitative measures, it was chosen to perform a case study of a single case. Findings The combined knowledge of ASD, ID and psychiatric disorder was important in the current assessment. General assessment tools were of some value, but their results had to be interpreted with care. The same was true of a more ASD/ID-specific tool. Using multiple informers may strengthen data from such tools in this population, but does not make it interchangeable with self-report. The case presented demonstrates the possibility of negative symptoms and functional decline overshadowing positive psychotic symptoms in people with ASD/ID, as well as the expression of ASD changing with a functional decline. Originality/value The present study adds to the few previous reports on identification of psychosis in this population, and in addition, may assist clinicians in making more accurate psychiatric assessments of people with ASD/ID.

Psychiatric assessment in Phelan-McDermid Syndrome (22q13 deletion syndrome)

ABSTRACT Background: Phelan-McDermid Syndrome (PHMDS)/22q13.3 deletion syndrome is a rare genetic disorder linked to Autism Spectrum Disorder (ASD) and Intellectual Disability (ID). There are reports of PHMDS co-occurring with psychiatric disorders, but little is known about the assessment of such disorders in PHMDS. Method: A case study focusing on a single assessment was performed to explore whether approaches to psychiatric assessment in ASD/ID may be applicable in PHMDS. Results: Findings indicate that strategies employed in psychiatric assessment in individuals with ASD and ID may be utilised in individuals with PHMDS with little or no adjustment. Conclusions: Developing more systematic approaches to psychiatric assessment in individuals with PHMDS is important, both for further research and in the clinic.