Jenny McCarthy Asks; the Internet Slam Dunks

I love this one! JR

Jenny McCarthy Asks; the Internet Slam Dunks

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By Phil Plait

Just when you think that Internet commentary is nothing more than a wretched hive of scum and villainy, a light shines through so strongly it can help restore your optimism about people.

Ask, and oh boy shall ye receive.

Photo by s_bukley / Shutterstock.com

By now you know about anti-vaccination mouthpiece Jenny McCarthy. I’ve written about her many times: how she claims vaccines cause autism (they don’t), how she “cured” her son of autism with a gluten-free diet (she didn’t), how she rails about vaccines being full of toxins (they aren’t) while literally injecting her face......Yeah, that Jenny McCarthy. It’s possible she’s more well-known in the general public for being a comedian, host of the The View, and of course a Playboy model, but on the ‘Net she’s widely understood to be a voice for frankly dangerous anti-vax nonsense.

On Thursday, McCarthy asked a question of her fans on Twitter to see what they’d say. What she got was a dose of the reality she helped spawn. The question:

Really, she should’ve known what would happen.......

More here

Study: Latino children's autism is often overlooked

An interesting study shows that Latino children are diagnosed with autism an average of two years later than white children.

Latino children typically are diagnosed with autism more than two years later than white children, and new research suggests that language-appropriate screenings and access to autism specialists are two big factors in that delay.

"Parents need to know that early identification of autism is important," said study author Dr. Katharine Zuckerman, an assistant professor of pediatrics at Oregon Health and Science University in Portland. "It leads to better outcomes for the child and better family outcomes. It may even save money. All children should be screened."

Yet Zuckerman's study found that only one in 10 pediatricians administered the general developmental screenings and autism-specific screenings in Spanish for their Spanish-speaking patients.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven & Alexandra Cohen Children's Medical Center in New Hyde Park, N.Y., said there's a screening tool with yes-or-no answers that a pediatrician can still score and assess the risk of autism even if they don't speak Spanish.

But, Adesman said, language barriers can definitely pose problems when trying to assess a child's risk for autism. "To the extent that a language delay is the core symptom, it becomes more difficult to assess the language if the clinician doesn't speak the language," he said. "If the child is living in a bilingual household, it can be difficult to assess differences in language development."

"The signs of language issues can be subtle, and they're hard to identify in the first place," Zuckerman said, which makes it even harder if the pediatrician and the child don't speak the same language.

Still, according to the more than 250 pediatricians surveyed for the study, the biggest barrier to getting a firm autism diagnosis is access to autism specialists.

Adesman agreed that this is a big problem, especially in certain parts of the United States. He recommended, however, that any parent with concerns about their child should request an evaluation through their state's early intervention service, which typically is offered through the department of health. He said these services are free and offered whether or not a child has health insurance. These screenings also are often available in a child's native language.

The pediatricians included in the survey were all from California, and 60 percent were female. Slightly more than half have been in practice for more than 20 years. About half said more than 25 percent of their patients are Latino.

Seventy percent of the doctors said they didn't speak Spanish, or spoke it poorly. Thirty percent said they spoke good or excellent Spanish.

Eighty-one percent offered some form of developmental screening, but just 29 percent offered autism screening in Spanish, according to the American Academy of Pediatrics guidelines. Only 10 percent offered general developmental and autism screenings in Spanish.

Communication and cultural barriers also were cited as reasons for the delay in diagnosis. The pediatricians said they felt that Latino parents don't have as much knowledge about autism as white parents do.

"Latino parents may know less about autism, so they bring up fewer concerns," Zuckerman said. She said autism awareness needs to be raised in Latino communities.

"We need to try to increase the information availability. Parents need to know the early signs of autism," she said, noting that a language delay, a lack of eye contact, not pointing to show interest, not wanting to play interactive games such as peekaboo, and playing with toys in an unusual way, such as only spinning the tires of a toy car instead of pretending to make the car drive, are some possible signs of autism.

Pediatricians need to be encouraged to conduct both developmental and autism screenings, and whenever possible these screenings should be done in the child's primary language. "Early identification of autism is super-important," Zuckerman said. "It's a condition that we know will get better with early therapy. We need to be assessing kids for this."

"Autism affects all genders and ethnicities," Adesman said. "Any family with a concern about their child should [have their child] screened by their pediatrician or through early-intervention services from their state."

Results of the study were released online Aug. 19 and in the September print issue of the journal Pediatrics.

Read more here

Brain differences in those with Autism: Think Local Not Global

A new study shows that a person with autism's brain is wired differently than those without autism, and this finding may help explain some of the typical symptoms of autism. 

Increased connectivity may favor local connections over global. - JR

The way the gray matter in the brain is wired appears to be different in people with autism, new research shows.

Specifically, those with the disorder are more likely to have enhanced connections in the brain that are associated with common autism symptoms, such as narrow interests and repetitive behaviors, the scientists reported.

"Our study [and others] reliably and repeatedly demonstrate that the brain in autism is built and functions differently, which explains a variety of autistic symptoms," said study author Christine Ecker, a lecturer in neuroimaging at King's College London.

"From neuropsychology, we also know that people with autism often have a preference for processing [fine details] over global features (the ability to integrate piecemeal information into a coherent whole)," she said. "Our findings may therefore represent a neuroanatomical correlate of these behaviors, although a direct causal link remains to be established."

Results of the study were published online July 22 in the Proceedings of the National Academy of Sciences.

Autism spectrum disorders are a group of neurodevelopmental disorders, common symptoms of which include impaired social communication, social reciprocity and repetitive behaviors, according to background information included in the study. Experts believe that differences in the brain account for these behaviors, but the exact changes that might occur in someone with autism aren't yet clear, according to the study.

The current study looked at 34 adult males with autism and 34 males without autism to serve as the control group. All of the study volunteers underwent MRI.

The researchers found that there were significant differences in the length of the connections between regions of the brain when they compared people with autism to those without. The minimum length of these connections in the cortical gray matter was dubbed "wiring costs" by the researchers. These wiring costs were significantly reduced in people with autism, meaning the lengths of their connections were shorter.

"These differences are predominantly observed in brain regions that we know are anatomically different in autism, and that are underlying autistic symptoms and traits," Ecker said. "We think that such differences in neuronal wiring may lead to locally over-connected networks in the brains of [patients with autism spectrum disorders] that could explain some autistic symptoms, such as repetitive behaviors."

One expert said the findings help define the biological basis of autism more clearly.

"We've known that there is a history of wiring differences that appear in individuals with autism. What's novel is that they used structural imaging to assess whether neurons are connected in the same way structurally," said Daniel Smith, senior director of discovery neuroscience at Autism Speaks.

"Gray matter connections are referred to as microcircuits, and they're everywhere," Smith said. "They're very important in the cerebral cortex, and the highest levels of thinking occur in the cerebral cortical regions of the brain."

"This study is another component in building our knowledge base," he added. "It's a step toward better understanding of what's happening in the brain and, ultimately, that will help lead to new treatments. But this study won't lead to an immediate impact on treatment."

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Children's Medical Center in New Hyde Park, N.Y., agreed that this study won't lead to any immediate changes in the field.

"Unfortunately, despite the many advances in our ability to study the brain and identify a range of structural and functional differences associated with autism, we are still left with more questions than answers," Adesman said.

"[But] studies such as this bring us one step closer to understanding the neurobiological underpinnings of the mysterious and enigmatic condition known as autism spectrum disorder," he said.

Ecker said she hopes to conduct a study that follows young people as their brains are developing to see how the connections in the brain behave over time in people with autism.

Read more here

Full article

Tipping Point in Autism: What is Whole-Exome Sequencing? How it Identifies Inherited Mutations in Autism

If your child has undergone testing before without diagnosis, consider re-visiting testing. JR

Whole-Exome Sequencing Identifies Inherited Mutations in Autism

Jan. 23, 2013 — While autism clearly runs in some families, few inherited genetic causes have been found. A major reason is that these causes are so varied that it's hard to find enough people with a given mutation to establish a clear pattern. Researchers at Boston Children's Hospital have pinpointed several inherited mutations -- among the first to be identified -- through an unusual approach: using whole-exome sequencing to study large Middle Eastern families with autism.

The study, published in the January 23 issue of the journal Neuron, also found evidence for some of the same mutations in U.S. families. It shows that a number of genes implicated in severe genetic syndromes can have milder mutations that primarily cause autism, and could broaden the number of genetic tests available to families.

Researchers Tim Yu, MD, PhD, Maria Chahrour, PhD, and senior investigator Christopher Walsh, MD, PhD, of Boston Children's Hospital, began with three large Middle Eastern families that had two or more children with autism spectrum disorders (ASDs), looking for recessive mutations -- those requiring a "double hit" for the child to have an ASD.

"Families from the U.S. are not ideal for finding inherited genetic mutations, since family sizes are often small," says Walsh, chief of Genetics at Boston Children's and an investigator of the Howard Hughes Medical Institute.
In all three families, the parents were first cousins, a common tradition in the Middle East and one that greatly facilitates the identification of inherited mutations. The researchers first used genetic mapping techniques to narrow their search to specific chromosomal locations, then sequenced the protein-coding genes in those areas (known as whole-exome sequencing).

That turned up recessive mutations in three genes not previously known to be involved in autism, but rather in severe genetic syndromes:

• Mutations in AMT, a gene classically associated with a severe metabolic syndrome known as nonketotic hyperglycinemia, marked by severe seizures and death during infancy.
• Mutations in PEX7. Typical PEX7 mutations cause rhizomelic chondrodysplasia punctata, a severe syndrome causing metabolic and bone abnormalities, cataracts, severe epilepsy and early death.
• Mutations in SYNE1, a gene associated with brain malformation, severe motor and muscle problems, and possibly bipolar psychiatric disease.

The severe syndromes linked to these genes often include autistic behavior or intellectual disability, but not as the primary symptom. Interestingly, the milder mutations discovered in these families seemed to cause disease that is more brain-specific.
"This is the first time these genes have been associated with autism," says Chahrour, who shares first authorship of the study with Yu. "The AMT and PEX7 mutations weren't picked up by standard tests for metabolic disorders, but when you're able to sequence the entire exome, you can find them."
These findings inspired the team to look for other metabolic and other genetic syndromes affecting cognition and behavior with milder forms showing up simply as autism. They screened 163 Middle Eastern families with autism for mutations in 70 genes associated with these syndromes, using a whole-exome approach but analyzing only the 70 genes of interest.
This approach turned up several additional families with ASD mutations, including:

• An additional family with a recessive mutation in AMT
• Two families with recessive mutations in VPS13B (known to cause Cohen syndrome, which includes intellectual disability, obesity, vision and joint problems, and small head size)
• A family with a recessive mutation in POMGNT1 (known to cause muscle-eye-brain disease, marked by brain malformation, intellectual disability, muscle and vision problems)
• A family with an X-linked mutation in MECP2 in two boys (MECP2 mutations are known to cause Rett syndrome in girls, but are typically lethal in boys)

"We have textbook descriptions of all these diseases, but in real life, there can be atypical, milder presentations of the same disease," says Yu. "The kids we were studying with autism were alive at age 13. They had double hits for these mutations, but they were much milder mutations. The proteins retained a bit of their function."

The team also examined a cohort of U.S. patients, looking for recessive mutations in six of the genes they identified. They analyzed whole-exome sequence data from 612 families with ASDs, part of a registry known as the Simons Simplex Collection. The analysis suggested that some of the affected children had causative recessive mutations in at least two of the genes identified in the Middle Eastern families, and that larger-scale efforts to examine all 70 genes more fully for recessive mutations may prove fruitful.

"It's not clear yet how many U.S. families have these recessive mutations," says Yu. "Further studies could begin to estimate what fraction of autism cases might fall under this model."

"Together, these two studies firmly establish that recessive mutations contribute importantly to autism, not just in specialized populations but in the population at large," says Yu. "Genome sequencing is going to be a huge advance in identifying more of these mutations, since there are a lot of rare syndromes that are otherwise very difficult to detect."

Study claims heavy metal removal does not help autism symptoms

Let's ring in the new year by dispelling some "neuro flapdoodle"! -  A study shows that removing heavy metals from the blood through a process called chelation does not help children who have autism. JR

Removing heavy metals from the body through a process traditionally used to treat mercury and lead poisoning doesn't help relieve autism symptoms, a new analysis suggests.

During chelation therapy, patients are given injections of a chemical that binds to heavy metals, lowering their concentration in the blood and ultimately allowing the metals to be excreted through urine.

Chelation gained traction as an alternative treatment for autism due to a theory that mercury poisoning might play a role in the developmental disorder. However, evidence hasn't supported that idea and it's been essentially discarded in the scientific community, researchers said.

The procedure also carries safety concerns, including risks of kidney damage and gastrointestinal problems.

Lead researcher Tonya Davis from Baylor University in Waco, Texas, said the study team's goal was not to tell parents which treatments they should or shouldn't seek for their children.

"I see that they want to try everything, and they are well intentioned," she told Reuters Health.

"But there are risks involved with any treatment choice, and some of those risks are very serious. So far science does not support (chelation) as being an effective treatment, and that's a big risk to take when you have limited resources and limited time."

The Centers for Disease Control and Prevention estimates that one in 88 kids in the U.S. has an autism spectrum disorder.

Davis and her colleagues found five studies that tested the effects of chelation in kids with autism. Those studies each had between one and 41 children, from age three to 14.

Researchers had given the kids chelation therapy - sometimes along with vitamin supplements or other treatments - between one and 12 times a week for up to seven months. They used tests and questionnaires or anecdotal reports from parents to see how symptoms changed over time.

The study with only one child, a four-year-old boy, found chelation had positive effects on autism symptoms based on a parent report. The other four studies all showed mixed results, with some kids improving on some symptom measures.

However, none of the studies provided any certainty that those benefits were due to chelation itself, and not another treatment or just kids getting older, the researchers wrote in the journal Research in Autism Spectrum Disorders.

Davis said she and her colleagues were surprised to find so few studies measuring the effects of chelation, given how many families they each knew that were using it. That lack of evidence was a concern, she said, along with the questionable study designs and conclusions.

"I just hope that parents get as much information as they can" before trying a new treatment, Davis said.

A typical package of chelation treatments runs for about $2,000 to $5,000. In addition to treating lead poisoning, chelation has also been used for cancer and heart disease.

But when it comes to autism, even calling chelation an alternative therapy is a stretch, said one autism researcher not involved in the new study.

"There's really no evidence that mercury causes autism or has a place in causing autism, and also we know that chelation can be dangerous as well. Even the underlying theories don't make sense," said Dr. Joyce Mauk, head of the Child Study Center, an organization that treats kids with developmental disabilities in Fort Worth, Texas.

"Most children with developmental disabilities, what gets them better is a really skilled therapist and lots of work," Mauk told Reuters Health.

"If you hear about something when all you do is inject something or take a pill, it's unlikely to work."

Read more here

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]
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	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]
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	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]
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	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]
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	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]
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	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]
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	MeSH Terms Adolescent Adult Aggression/psychology* Autistic Disorder/diagnosis* Autistic Disorder/psychology Child Humans Social Behavior Syndrome Violence*