Asperger Syndrome, Autism, Violence and Guns - A Literature Review

Asperger Syndrome, Autism, Violence and Guns - A Literature Review

Like many parents, my thoughts tonight are with the families of Newtown Connecticut. What can I add to the public discussion?

I searched the terms Asperger and violence in the NLM.  I found these TWELVE published peer-reviewed articles. 

Clearly, the association has been incompletely studied.  But, in Autism Spectrum disorder, psychotic and substance abuse disorders are highly associated with violent behavior. 

As the authors say, early recognition and care is important for minimizing this behavior.

And, for any family with a child or teenager with a co-morbid psychiatric disorder, the SAFEST thing is to REMOVE guns, ammunition and any other weapon from the home. 

 At all times, follow basic safety principles.

JR

Safety & Prevention

-+

Gun Safety: Keeping Children Safe

More than 44 million Americans own firearms. Of the 192 million firearms owned in the United States, 65 million are handguns. Research shows guns in homes are a serious risk to families.  

• A gun kept in the home is 43 times more likely to kill someone known to the family than to kill someone in self-defense.  
• A gun kept in the home triples the risk of homicide.  
• The risk of suicide is 5 times more likely if a gun is kept in the home.  

Advice to parents  

The best way to keep your children safe from injury or death from guns is to NEVER have a gun in the home.  

• Do not purchase a gun, especially a handgun.  
• Remove all guns present in the home.  
• Talk to your children about the dangers of guns, and tell them to stay away from guns.  
• Find out if there are guns in the homes where your children play. If so, talk to the adults in the house about the dangers of guns to their families.  

For those who know of the dangers of guns but still keep a gun in the home.

• Always keep the gun unloaded and locked up.  
• Lock and store the bullets in a separate place.  
• Make sure to hide the keys to the locked boxes.  
  
  

Here is the literature search.....

Last Updated

 

6/5/2012

Source

 

TIPP—The Injury Prevention Program (Copyright © 1994 American Academy of Pediatrics, Updated 9/2005)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

AAP website

JR

This message contains search results from the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM). Do not reply directly to this message

Sent on: Sat Dec 15 03:00:59 2012

12 selected items

PubMed Results

Items 1 -12 of 12    (Display the 12 citations in PubMed)

1.	J Interpers Violence. 2009 Aug;24(8):1358-70. doi: 10.1177/0886260508322195. Epub 2008 Aug 13. Risk factors for violent offending in autism spectrum disorder: a national study of hospitalized individuals. Långström N, Grann M, Ruchkin V, Sjöstedt G, Fazel S. Centre for Violence Prevention, Karolinska Institutet, Stockholm, Sweden. niklas.langstrom@ki.se Abstract 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.
	PMID: 18701743 [PubMed - indexed for MEDLINE]
	Related citations
	MeSH Terms Adult Child Development Disorders, Pervasive/epidemiology* Child, Preschool Comorbidity Female Humans Interpersonal Relations Longitudinal Studies Male Patient Discharge/statistics & numerical data* Prevalence Psychotic Disorders/epidemiology* Risk Factors Socioeconomic Factors Substance-Related Disorders/epidemiology* Substance-Related Disorders/psychology Sweden/epidemiology Violence/psychology Violence/statistics & numerical data* Young Adult

2.	J Autism Dev Disord. 2008 Nov;38(10):1848-52. doi: 10.1007/s10803-008-0580-8. Epub 2008 May 1. Violent crime in Asperger syndrome: the role of psychiatric comorbidity. Newman SS, Ghaziuddin M. University of Oregon, Eugene, OR, USA. Abstract Although several studies have suggested an association between violent crime and Asperger syndrome (AS), few have examined the underlying reasons. The aim of this review is to determine to what extent psychiatric factors contribute to offending behavior in this population. Online databases were used to identify relevant articles which were then cross-referenced with keyword searches for "violence," "crime," "murder," "assault," "rape," and "sex offenses." Most of the 17 publications which met the inclusion criteria were single case reports. Of the 37 cases described in these publications, 11 cases (29.7%) cases had a definite psychiatric disorder and 20 cases (54%) had a probable psychiatric disorder at the time of committing the crime. These findings underscore the role of psychiatric disorders in the occurrence of violent crime in persons with Asperger syndrome and highlight the need for their early diagnosis and treatment.
	PMID: 18449633 [PubMed - indexed for MEDLINE]
	Related citations
	MeSH Terms Antisocial Personality Disorder/diagnosis Antisocial Personality Disorder/epidemiology Asperger Syndrome/diagnosis Asperger Syndrome/epidemiology Asperger Syndrome/psychology* Comorbidity Crime/psychology Crime/statistics & numerical data Databases as Topic Humans Mental Disorders/diagnosis Mental Disorders/epidemiology Mental Disorders/psychology Prisoners Sex Offenses/psychology Sex Offenses/statistics & numerical data Violence/psychology

3.	Nihon Rinsho. 2007 Mar;65(3):539-44. [Asperger syndrome in adolescence: The problem and appropriate treatment]. [Article in Japanese] Nagao K. National Hospital Organization Sakakibara Hospital Abstract I have described the corresponding method for bullying, independence and interpersonal relationships of company/opposite sex, thinking disorders caused by suffering damage or victimization and withdrawal and violence in the family among the problems in and in response to Asperger syndrome in adolescent cases. Psychotherapy is used for bullying and interpersonal relationship problems. Cognitive therapy and protective correspondence are more effective in bullying than the exposure method. It seems to be more effective to teach and instruct the corresponding principle as well as supportive response because interpersonal relationships are likely to involve failures. Pharmacological therapy was valid in feelings of paranoia and violence. Since the disorder has been recently conceptualized in pervasive developmental disorder, the scope of the subject has increased whereas Asperger syndrome used to be diagnosed in compliance with its classic examples. Therefore, it needs to clarify diagnostic examples based on new concepts, accumulate subject examples and verify the corresponding method with evidence.
	PMID: 17354573 [PubMed - indexed for MEDLINE]
	Related citations
	Publication Types Case Reports English Abstract Review MeSH Terms Adolescent Adult Antipsychotic Agents/administration & dosage Asperger Syndrome/psychology* Asperger Syndrome/therapy* Cognitive Therapy Delusions Domestic Violence Humans Interpersonal Relations Male Obsessive Behavior Risperidone/administration & dosage Substances Antipsychotic Agents Risperidone

4.	J Am Acad Psychiatry Law. 2001;29(4):420-6. Juvenile and young adult mentally disordered offenders: the role of child neuropsychiatric disorders. Siponmaa L, Kristiansson M, Jonson C, Nydén A, Gillberg C. Department of Forensic Psychiatry, Karolinska Institute, Huddinge, Sweden. leila.siponmaa@rmv.se Abstract A retrospective study of the prevalence of child neuropsychiatric disorders was done involving pervasive developmental disorder (PDD), attention-deficit/hyperactivity disorder (ADHD), and Tourette syndrome in young offenders (15-22 years, n = 126) consecutively referred for presentencing forensic psychiatric investigation (FPI) in Stockholm, Sweden. Most offenders were referred for FPI because of serious offenses. Case report sheets were prepared, and retrospective neuropsychiatric DSM IV diagnoses were made by the first two authors. For best-estimated diagnoses, the case report sheets were then submitted to the fifth author, a child neuropsychiatrist with expertise in this area. Fifteen percent of the subjects had a definite diagnosis of ADHD, and another 15 percent had PDD, including 12 percent PDD not otherwise specified (NOS) and 3 percent Asperger syndrome. Autistic disorder was not found in any case. Tourette syndrome occurred in two percent of the cases. The rate of PDD is particularly striking. Neuropsychiatric diagnoses had been determined in the FPI in only a few cases. The contribution of constitutional problems to later criminal development may have been underestimated.
	PMID: 11785613 [PubMed - indexed for MEDLINE]
	Related citations
	MeSH Terms Adolescent Adult Asperger Syndrome/epidemiology Asperger Syndrome/psychology Attention Deficit Disorder with Hyperactivity/epidemiology* Attention Deficit Disorder with Hyperactivity/psychology Child Child Development Disorders, Pervasive/epidemiology* Child Development Disorders, Pervasive/psychology Crime/legislation & jurisprudence Crime/psychology* Crime/statistics & numerical data Female Forensic Psychiatry* Humans Juvenile Delinquency/legislation & jurisprudence Juvenile Delinquency/psychology* Juvenile Delinquency/statistics & numerical data Male Neuropsychological Tests Prevalence Retrospective Studies Sweden/epidemiology Tourette Syndrome/epidemiology* Tourette Syndrome/psychology Violence/psychology Violence/statistics & numerical data

5.	Compr Psychiatry. 2005 Mar-Apr;46(2):111-6. The childhood-onset neuropsychiatric background to adulthood psychopathic traits and personality disorders. Soderstrom H, Nilsson T, Sjodin AK, Carlstedt A, Forsman A. Department of Forensic Psychiatry, 422 04 Hisings Backa, Sweden. henrik.soderstrom@rmv.se Abstract Childhood conduct disorder (CD) and adult psychopathic traits according to the Psychopathy Checklist Revised (PCL-R) were the closest psychiatric covariates to repeated violent crimes and aggression among offenders under forensic psychiatric investigation in Sweden. As psychopathy is not included in the present psychiatric diagnostic systems, we compared total and factor PCL-R scores to Axis I disorders, including childhood-onset neuropsychiatric disorders, and to Axis II personality disorders, to establish the convergence of psychopathic traits with other psychiatric diagnoses, and to identify possible unique features. Psychopathic traits were positively correlated with bipolar mood disorder and negatively with unipolar depression. The total PCL-R scores as well as the Factor 2 (unemotionality) and Factor 3 (behavioral dyscontrol) scores were significantly correlated with attention-deficit/hyperactivity disorder, Asperger's syndrome/high-functioning autistic traits, CD, substance abuse, and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Cluster B personality disorders. The interpersonal Factor 1 showed none of these correlations and may capture features that are specific to psychopathy, distinguishing core psychopathy from other diagnostic definitions.
	PMID: 15723027 [PubMed - indexed for MEDLINE]
	Related citations
	Publication Types Research Support, Non-U.S. Gov't MeSH Terms Adolescent Adult Aged Aggression/psychology Antisocial Personality Disorder/diagnosis Antisocial Personality Disorder/epidemiology* Antisocial Personality Disorder/psychology Asperger Syndrome/diagnosis Asperger Syndrome/epidemiology* Asperger Syndrome/psychology Attention Deficit Disorder with Hyperactivity/diagnosis Attention Deficit Disorder with Hyperactivity/epidemiology* Attention Deficit Disorder with Hyperactivity/psychology Autistic Disorder/diagnosis Autistic Disorder/epidemiology* Autistic Disorder/psychology Bipolar Disorder/diagnosis Bipolar Disorder/epidemiology* Bipolar Disorder/psychology Child Child Behavior Disorders/diagnosis Child Behavior Disorders/epidemiology* Child Behavior Disorders/psychology Comorbidity Cross-Sectional Studies Depressive Disorder/diagnosis Depressive Disorder/epidemiology Depressive Disorder/psychology Female Humans Male Middle Aged Personality Disorders/diagnosis Personality Disorders/epidemiology* Personality Disorders/psychology Prisoners/psychology Prisoners/statistics & numerical data Risk Factors Sex Offenses/psychology Sex Offenses/statistics & numerical data Statistics as Topic Substance-Related Disorders/diagnosis Substance-Related Disorders/epidemiology Substance-Related Disorders/psychology Violence/psychology Violence/statistics & numerical data

6.	J Autism Dev Disord. 2005 Jun;35(3):313-21. Characteristics of children with autistic spectrum disorders served in comprehensive community-based mental health settings. Mandell DS, Walrath CM, Manteuffel B, Sgro G, Pinto-Martin J. Center for Mental Health Policy and Services Research, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.mandelld@mail.med.upenn.edu Abstract This study describes the characteristics of children with autistic spectrum disorders (ASD) receiving treatment in community mental health settings. Data from a national community mental health initiative was used to identify children who had received a primary diagnosis of ASD. These children were compared with children with other diagnoses on socio-demographic and psychosocial characteristics, presenting problems and service histories. Regardless of diagnosis, children were most often referred to service because of disruptive behaviors. Children with ASD were less likely to be referred for drug use, truancy or running away, but were more likely to be referred for social interaction difficulties and strange behavior. Many children had family histories of mental illness, substance abuse and domestic violence. Implications of these findings are discussed in detail.
	PMID: 16119472 [PubMed - indexed for MEDLINE]
	Related citations
	MeSH Terms Asperger Syndrome/epidemiology* Autistic Disorder/epidemiology* Child Child Abuse/statistics & numerical data Community Mental Health Services/utilization* Comprehensive Health Care/utilization* Demography Female Humans Male Referral and Consultation/statistics & numerical data

7.	J Am Acad Psychiatry Law. 2005;33(3):390-3. Asperger's disorder and murder. Schwartz-Watts DM. University of South Carolina School of Medicine, 15 Medical Park, Suite 102, Columbia, SC, USA. donnasw@gw.mp.sc.edu Comment in Asperger's disorder and murder. [J Am Acad Psychiatry Law. 2006] Asperger's disorder and murder.Silva JA, Haskins BG. J Am Acad Psychiatry Law. 2006; 34(1):133-4. Abstract Little is known about the prevalence of violence and autistic spectrum disorders. This article reviews findings of current research on Asperger's disorder and violence. Criteria for diagnosing Asperger's disorder are given. Three cases are presented in which defendants with diagnosed Asperger's disorder were charged with murder. Specific symptoms in this disorder are discussed as they relate to issues of diminished capacity and criminal responsibility.
	PMID: 16186206 [PubMed - indexed for MEDLINE]
	Related citations
	Publication Types Case Reports Comparative Study MeSH Terms Adult Asperger Syndrome/diagnosis* Asperger Syndrome/psychology* Capital Punishment/legislation & jurisprudence Child Child Development Disorders, Pervasive/diagnosis Child Development Disorders, Pervasive/psychology Criminal Law/legislation & jurisprudence Expert Testimony/standards* Forensic Psychiatry*/standards Homicide/legislation & jurisprudence* Humans Insanity Defense Male Mental Competency/legislation & jurisprudence Mental Competency/standards United States Violence/legislation & jurisprudence Violence/psychology

8.	Isr J Psychiatry Relat Sci. 2006;43(3):166-73. Criminal responsibility in Asperger's syndrome. Katz N, Zemishlany Z. Geha Mental Health Center, Petah Tikva, Israel. nkatz@clalit.org.il Abstract BACKGROUND: Asperger's syndrome (AS) has been of much interest in the last two decades. Most people with AS are law abiding and are not involved in any violence. Over the years, however, there is increasing evidence of violent behavior and criminal acts committed by some people with AS. The characteristics of the link between AS and violation of the law requires identification and definition and the question regarding the criminal responsibility to be attributed to these offenders needs to be clarified. DATA: We present three cases that illustrate how the special characteristics of this syndrome and particularly the inability to assess social situations and appreciate others' point of view constitute the main cause for the violent behavior and the criminal offences. For this specific behavior, the AS patients lack the criminal intent or the intent to cause harm (mens rea), which is essential for criminal responsibility. Thus it is reasonable to consider some AS sufferers not criminally responsible for their actions and unfit to stand trial. This approach has been accepted by the courts. CONCLUSION: It can be inferred that people with AS may not be criminally responsible despite not suffering from a psychotic illness. Free Article
	PMID: 17294982 [PubMed - indexed for MEDLINE]
	Related citations
	Publication Types Case Reports MeSH Terms Adult Asperger Syndrome/diagnosis* Asperger Syndrome/psychology Commitment of Mentally Ill/legislation & jurisprudence Crime/legislation & jurisprudence* Crime/psychology Diagnosis, Differential Domestic Violence/legislation & jurisprudence Empathy Expert Testimony/legislation & jurisprudence Humans Insanity Defense* Interpersonal Relations Male Personal Construct Theory Sexual Harassment/legislation & jurisprudence Social Behavior Violence/legislation & jurisprudence* Violence/psychology

9.	Acta Neurol Belg. 2010 Dec;110(4):334-6. Asperger syndrome, violent thoughts and clinically isolated syndrome. Vanderbruggen N, Van Geit N, Bissay V, Zeeuws D, Santermans L, Baeken C. Department of Psychiatry, UZ Brussel, Brussel, Belgium. nathalie.vanderbruggen@uzbrussel.be Abstract A young man, 23 years old, with a clinically isolated syndrome (CIS), presented violent thoughts during a neurological consultation. He was diagnosed with Asperger Syndrome based on a psychiatric and (neuro)psychological examination. Possible risk factors for acting-out and the implications for treatment, if CIS would evolve to MS, are discussed based on a review of the literature.
	PMID: 21305864 [PubMed - indexed for MEDLINE]
	Related citations
	Publication Types Case Reports MeSH Terms Asperger Syndrome/diagnosis Asperger Syndrome/physiopathology* Asperger Syndrome/psychology* Humans Male Neuropsychological Tests Syndrome Violence/psychology* Young Adult

10.	J Law Med. 2011 Jun;18(4):677-94. Asperger's disorder and the criminal law. Freckelton I. Law Faculty, Department of Psychology, Psychiatry and Psychological Medicine, Monash University. l.Freckelton@vicbar.com.au Abstract Asperger's Disorder has the potential to be relevant to many aspects of the functioning of the criminal justice system. However, its mere presence does not excuse or justify all offending. The inquiry into its potential relevance to criminal offending and sentencing must be both contextual and informed by suitably qualified expert evidence. This column reviews court decisions in respect of offences of physical violence, sexual violence, arson, stalking/harassing and computer offences across a range of jurisdictions to evaluate how courts have latterly incorporated Asperger's Disorder into decisions about criminal responsibility and culpability.
	PMID: 21774264 [PubMed - indexed for MEDLINE]
	Related citations
	Publication Types Legal Cases MeSH Terms Asperger Syndrome/psychology* Crime/legislation & jurisprudence Crime/psychology* Criminal Law* Humans

11.	Am J Psychiatry. 2011 Sep;168(9):890-2. doi: 10.1176/appi.ajp.2011.10091261. A suicidal adult in crisis: an unexpected diagnosis of autism spectrum disorder. Spencer L, Lyketsos CG, Samstad E, Dokey A, Rostov D, Chisolm MS. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA.
	PMID: 21890803 [PubMed - indexed for MEDLINE]
	Related citations
	MeSH Terms Adjustment Disorders/diagnosis Adjustment Disorders/psychology Adult Asperger Syndrome/diagnosis* Asperger Syndrome/psychology Crisis Intervention* Depressive Disorder/diagnosis Depressive Disorder/psychology Diagnosis, Differential Emotions Humans Interpersonal Relations Male Personality Disorders/diagnosis Personality Disorders/psychology Stereotyped Behavior Suicide, Attempted/psychology* Violence/psychology

12.	J Autism Dev Disord. 1991 Sep;21(3):349-54. Brief report: violence in Asperger syndrome, a critique. Ghaziuddin M, Tsai L, Ghaziuddin N. University of Michigan Medical Center, Ann Arbor.
	PMID: 1938780 [PubMed - indexed for MEDLINE]
	Related citations
	MeSH Terms Adolescent Adult Aggression/psychology* Autistic Disorder/diagnosis* Autistic Disorder/psychology Child Humans Social Behavior Syndrome Violence*