ARE ADOLESCENTS WITH ASPERGER SYNDROME MORE LIKELY TO BE INVOLVED IN CRIMINAL ACTIVITIES?
Sindromul Asperger, aşa cum îl cunoaştem astăzi, presupune un amestec particular de intelect normal însoţit uneori de limbaj extrem de sofisticat, cu deficit al abilităţilor sociale şi empatie scăzută, ceea ce face ca acesti adolescenti să pară imaturi social şi naivi, putând fi extrem de vulnerabil în faţa provocărilor sociale. Marea variabilitate a simptomatologiei poate face ca unele cazuri să rămână nediagnosticate în cursul copilăriei şi adolescenţei. În unele dintre aceste cazuri diagnosticul s-a putut stabili retrospectiv, la autori ai unor gesturi extrem de violente. În literatură există date care raportează asocierea semnificativă între tulburarea Asperger şi potenţialul violent al acestor pacienţi însă mulţi dintre autori subliniază faptul că cei mai mulţi dintre aceştia au fost de fapt victime ale provocărilor sociale. Cu toate acestea majoritatea autorilor sunt de acord că există situaţii în care adolescentul cu Asperger poate deveni extrem de violent, putând comite acte criminale. Nedreptatea de care au avut parte sau simple experimente psihologice pot fi justificarea lor pentru unele crime.
Various publications, primarily case reports, have associated the Asperger Syndrome (AS) with violent and criminal behavior (1, 2, 3). This gave rise to an impression that violent and/or criminal behavior was more frequently associated with AS. This association seemed particularly reasonable given the typical combination, in AS, of high levels of intelligence and verbal ability with problems in empathy and social skills.
A number of seriously delinquent people in the criminal justice system fall into the diagnostic categories of schizoid, schizotypal disorders, or Asperger Syndrome (4). There is a study to date that attempts to correlate pervasive developmental disorders in forensic settings implying that 15 % of 126 young people (15–22-year-old) evaluated in a forensic setting in Sweden had autistic spectrum disorders – including 12% with pervasive developmental disorder (PDD) and 3% with AS (5). In 1994, Scragg and Shah reported also relatively high rates of individuals with AS (about 1.5%) within a secure hospital setting (6). Fombonne found that the prevalence of AS in a forensic setting is startling, given that the general prevalence of Asperger’s disorder is 2.5 per
10,000 (7). An other review of epidemiologic studies in 2003 cited rates of aggression in autism as high as 38 percent (8) but the proportion of people with AS who present conduct problems or become offenders is unknown.
Ghaziuddin, Tsai, and Ghaziuddin, conducted the first attempt to examine the relationship between high-functioning autism spectrum disorder (HFASD) and criminal behaviour. They reviewed 21 peer-reviewed articles regarding patients with AS included 132 individuals with and found that only three (2.3%) had a history of violence. The authors concluded that there is no support for such an association (9).
In the following we will refer to a few characteristic features of Asperger Syndrome that predispose them to offending / criminal acts. We’ll also discuss about particularities of aggresion committed by patients with Asperger Syndrome.
The social naivety and immaturity of adolescents with Asperger’s syndrome can make them vulnerable to being ‘set up’ by peers, who encourage them to commit an offence. Some adolescents with Asperger’s syndrome realize they have difficulties with empathy and understanding the emotions of other people, and develop a special interest in creating situations and making statements as a ‘psychological experiment’ to be able to predict someone’s emotional reaction. They typically are at the periphery of social interaction, they have emotional insensitivity but are also rather isolated from others (1, 10,11).
People suffering from AS display rigid behavior patterns and preference for order, discipline, organization and rules and regulations. The overwhelming majority of people with Asperger’s syndrome are law- abiding citizens, often with very clear and conventional opinions as to what is morally and legally right and wrong. But for those adults with Asperger’s syndrome who commit an offence, there are types of crimes that are relatively more common due to the nature of Asperger’s syndrome (11). The child, and sometimes the adult, with Asperger’s syndrome may ruminate for many years over past slights and injustices and seek resolution and revenge by means that are illegal (1).
It may be triggered by idiosyncratic stimuli nourished by rumination over past slights; displaced from provoking the person onto a safer target at a later date; and uninhibited by empathic response to the intended victim’s fear. Sometimes the explanation for violence may be similar to that given by Raskolnikov in Dosteyevsky’s Crime and Punishment: that it is of an „experimental” nature (4). The morbid intellectual curiosity or desire to make someone suffer, as he or she has suffered, can be of great concern to the person’s family and could come to the attention of the police, depending on who the person chooses as a subject of his or her experiment (11). When people with AS are charged with offences they are quick to confess since they do not feel any guilt and are convinced that their actions were suitable to the situation. In addition they are very honest and true people and they are not aware of the social and legal implications of their confession (12).
The child with AS often uses social interaction to engage the conversational partner in long-winded, verbose conversations about his or her topic of special interest, with, however, little attention to the often distancing reactions of others. Individuals with AS may express an interest in having friends, including girlfriends/boyfriends, but usually become frustrated as a result of their frequent failures (1). In older children and adolescents, the social difficulties observed in AS appear to include problems with spontaneous social interaction, particularly in situations requiring a measure of quick and intuitive social adjustment, even though the individual may be able to describe in great cognitive detail aspects of social conventions (4).
When the child with Asperger’s syndrome feels alienated from peers, due to a lack of social competence and acceptance, and perhaps further alienated because of learning difficulties or superior intellectual abilities, he or she can achieve authority in a social situation by intimidation. The child becomes a ‘little dictator’, using threats of violence (more likely to be used by males with Asperger’s syndrome) and emotional blackmail (more likely to be used by females with Asperger’s syndrome), to gain power and control over peers and family. Experience indicates that such behavior is not modelled on a parent (11).
A lack of expected empathy and remorse could suggest the person has signs of being a psychopath. A psychopath usually has a superficial charm and a previous history of ingenious and intuitive ways of exploiting and manipulating others. (13). Both have problems with empathy, but for different reasons.
The National Comorbidity Survey Replication (NCS-R) reported 12 risk factors, named Childhood Adversities (CAs) (14), which were selected through a review of risk factor studies that influenced the development of psychiatric disorders. These Cas included maladaptive family functioning (i.e., parental mental illness, substance use, criminality, family violence, physical and sexual abuse, and neglect) and were significantly related to the initial age of onset of disruptive behaviours (14). Other CAs that are related to criminal behaviour include a history of being bullied (4) and childhood hyperactivity (15). As we well know, children with AS are often ridiculed and become targets of bullying because they fail to comprehend the intentions of others and this rise their risk to commit offences.
Sexually motivated crimes are also unusual and, when they occur, may be a consequence of a lack of understanding on the part of the person with AS. People with AS may be aggressive and commit offenses against other people, but it is unclear how frequently and what proportion of people with AS are at risk of doing so. Many people with AS have a hypertrophied sense of right and wrong and are unusually conscientious and unwilling to break the law, although this does not preclude isolated instances of lawbreaking which the person with AS feels are justified. People with AS are also more likely to be the victims than the perpetrators of aggression (4).
The compulsive nature of the special interest could make some adults with Asperger’s syndrome, who are usually very honest, can lead to charges of stealing to obtain money to buy items to add to the collection, or stealing the item of special interest itself. The item stolen can be unusual, such as a rare lamppost or tractor, which may have no practical use to the person and cannot be sold for financial gain. The likely culprit is often quickly identified, and incriminating evidence easily found by the police (11).
The mental state and sense of reality of the person with Asperger’s syndrome deteriorates into a ‘blind rage’ with fatal consequences and murder can be the consequence of an argument that became unexpectedly violent (11). The homicide can be premeditated as a formof self-defence, or may be for personal gain, for example taking a weapon to school to prevent further bullying and initiating the assault that was intended to be fatal. Although the homicide by a person with Asperger’s syndrome is extremely rare, there are also case studies of murder clearly and simply for personal advantage (13).
Criminal activity associated with ASD psychopathology can be divided into two road domains: (1) deficits in Theory of Mind (ToM) abilities and/or (2) abnormal, repetitive narrow interests (16). Theory of Mind (or mentalization) refers to the ability to estimate the cognitive, perceptual, and affective life of others as well as of the self. This relative inability to utilize ToM abilities has been termed “mindblindness.” (10) ASD individuals have substantial difficulties with reading social cues and generally present with significant deficits in their abilities to know that another person has a different emotional cognitive experience of a shared event (10).
They may suffer from an inability to read the necessary interpersonal cues telling the perpetrator to disengage from a social encounter. Frith introduced the concept of central coherence (17), a process that involves the natural tendency for human beings to construct their view of the world as a rich, but unified, tapestry of lived experience. However, many people with ASDs live key aspects of their lives, including their social, moral and physical environments, outside of the unified whole more common to normal human experience. Therefore, individuals with deficits in central coherence may engage in criminal behavior because of their excessive preoccupation with highly focused internal interests, while ignoring social consequences, including legal sanctions. Another model for this is “top-down modulation,” which posits that one makes behavioral choices based on long-term goals, which prevents their being distracted or overloaded by stimuli. Frith and others have noted a failure of top-down modulation in ASD. Children with Asperger syndrome often become the victims of bullying. In such cases it may take a very long time for an appropriate diagnosis to be established. From about age 10 years, many children with Asperger syndrome (at least one third) become depressed, sometimes in connection with bullying, sometimes not. Depression can also cloud the clinical picture and delay diagnosis of Asperger syndrome. A small proportion of those with Asperger syndrome commits severe antisocial acts (break-in and entry, Wre-setting or violent crimes). They are often taken into the care of social authorities, and diagnosis of the basic impairments may be delayed for years, sometimes, probably, forever (10).
Antisocial – in the psychiatric sense of the word, i.e. breaking social laws in ways which are considered ‘criminal’ – development is probably not much over-represented in autism spectrum disorders. However, some individuals with Asperger syndrome, in their pursuit of a specific interest or in the course of a particular ritual, may commit crimes. Conversely, among criminals convicted for violent crimes and in whom forensic psychiatric evaluation has been undertaken, the rate of autism spectrum disorders is increased. Bizarre violent acts are only rarely committed by people with autism spectrum disorders. One such example is the killing of innocent people in an institution by somebody with Asperger syndrome, who many years previously had felt bullied by completely different people but in the same institution. There is a need for forensic psychiatrists to keep abreast of new information emerging in this Weld (8, 10).
People with Asperger Syndrome are, of course, ‘antisocial’ in other ways; such behaviors are part and parcel of the clinical picture. However, in the vast majority of cases, there is often rigid adherence to rules, and any unlawful activity would be unthinkable. Physical violence is completely revolting to many. Thus, even though severe antisocial and criminal acts occur in a few cases, and Asperger syndrome may be over-represented among some groups of offenders, people with autism spectrum disorders generally are certainly not dangerous and do not pose ‘a threat’ to society! (10) HFASD repeat criminal behaviours (2). Restricted and repetitive patterns of behaviour, interests, and activities might contribute to recurrent criminal behaviour. Moreover, a lack of empathy for others (3), which relates to severe and sustained impairments in social interactions, might also be related to recurrent criminal behaviour (18).
More importantly, these individuals often repeat criminal behaviours even though they were seeing child psychiatrists and receiving traditional interventions. (19) These findings reflect the difficulty of intervening in cases of criminal behaviour. Preventive approaches should focus on ASD traits.
1.Tantam D. Asperger’s syndrome in adulthood. In: Frith U. (eds.). Autism and Asperger syndrome. Cambridge, UK: Cambridge University Press, 1991, 147–183.
2.Baron-Cohen S. An assessment of violence in a young man with Asperger’s syndrome. J Child Psychol Psyc 1988;29: 351– 60.
3.Wing L. Asperger’s syndrome: A clinical account. Psychol Med 1981;11: 115–129.
4 . S c h n e i d e r F , W e i s s U , K e s s l e r C , e t al. Neurofunctional models of autistic disorder and Asperger syndrome. In: Klin, A, Volkmar FR, Sparrow SS (eds.). Asperger Syndrome. New York: Guilford Press, 172–209.
5.Siponmaa L, Kristiansson M, Jonson C. Juvenile and young adult mentally disordered offender: the role of child neuropsychiatric disorders. J Psychiat Law 2001; 29: 420–6.
6.Scragg P, Shah A. Prevalence of Asperger Syndrome in a secure hospital. Brit J Psychiat 1994;5: 679–682.
7.Fombonne E. Epidemiological surveys of autism and other pervasive developmental disorders: an update. J Autism Dev Disord 2003;33: 365– 382.
8.Schwartz-Watts DM. Asperger’s Disorder and Murder. J Psychiat Law 2005; 33: 390–398.
9.Ghaziuddin M, Tsai L, Ghaziuddin N. Violence in Asperger syndrome. A critique. J Autism Dev Disord 1991;21: 349–354.
10.Gillberg C. A Guide to Asperger Syndrome. Cambridge University Press, 2002, 22-58.
11.Attwood T. The Complete Guide To Asperger’s Syndrome. London and Philadelphia: Jessica Kingsley Publishers, 2007, 300- 338.
12.Katz N, Zemishlany Z. Criminal Responsibility in Asperger’s Syndrome. J Psychiat Relat Sci 2006;43(3): 166–173.
13.Murrie DC, Warren JI, Kristiansson M. Asperger’s syndrome in forensic settings. Int J Ment Health 2002;1: 59 –70
14.Green JG, Mclaughlin KA, Berglund PA, et al. Childhood adversities and adult psychiatric disorders in the National Comorbidity Survey Replication I: Associations with first onset of DSM-IV disorders. Arch Gen Psychiat 2010;67: 113–123.
15.Biederman J, Mick E, Faraone SV, Burback M. Patterns of remission and symptom decline in conduct disorder: A four-year prospective study of an ADHD sample. J Child Adol Psychol 2001; 40: 290–298.
16.Haskins BG, Silva JA. Asperger’s Disorder and Criminal Behavior: Forensic-Psychiatric Considerations. J Psychiat Law 2006;34: 374–84.
17.Frith U. Autism and Asperger Syndrome. Cambridge University Press, 1991, 37-95.
18.Woodbury-Smith MR, Clare CH, Holland AJ, Kearns A, Staufenberg E, Watson P. A case–control study of offenders with high functioning autistic spectrum disorders. J Forensic Psychi Ps 2005;16: 747–763.
19.Kawakami C, Ohnishi M, Sugiyama T, Someki F, Nakamura K. The risk factors for criminal behaviour in high-functioning autism spectrum disorders (HFASDs): A comparison of childhood adversitiesbetween individuals with HFASDs who exhibit criminal behaviour and those with HFASD and no criminal histories. Res Autism Spect Dis 2012; 6: 949–957.