1. On Correlation between Asperger Syndrome and Violence

    May 13, 2013

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    by Derek Whitney

    Asperger syndrome, coined in 1944 and recognized by the DSM-IV in 1994, is a type of pervasive developmental disorder (PDD) is similar to autism; however individuals with Asperger disorder typically have a higher level of functioning than those with autism. Asperger’s is typically diagnosed in young children and the disorder will carry on throughout an individual’s life, as there is no definitive cure or medication therapy to treat the disorder. Due to recent media coverage about the Sandy Hook shooting’s gunman allegedly suffering from Asperger syndrome, increasing concern has arisen from society about the link between the disorder and violence.

    It is important to note that, as with any neurodevelopmental disorders, not all individuals with Asperger’s experience the disorder the same way and some function better than others. The common traits for people with Asperger syndrome  are poor social skills and a limited range of interests. This, in turn, leads to these individuals feeling isolated and having higher likelihood of developing anxiety and depressive disorders. While many people respond to depression with feelings of sadness or emptiness, increasing irritability can take the place of these feelings, particularly in younger patients such as Adam Lanza, the Sandy Hook shooter. Combined with an inability to concentrate and suicidal ideation, in addition to feelings of withdrawal from the world, Asperger’s sufferers can become likely candidates for violence, both as victims and perpetrators. Those with co-occurring bipolar disorder can be especially concerning because of the high energy and impulsive behavior associated with bipolar mania and mixed states. However, patients with bipolar disorder can be violent regardless of whether they have Asperger’s or not.

    Another feature that correlates with violence is a deficit in, or complete lack of, empathy in individuals with Asperger’s. A 1985 study by Mawson et. al found that a man with Asperger syndrome repeatedly engaged in violent acts throughout his life knowing they were wrong, but without feeling any remorse. However, this trait is not exclusive to Asperger’s; individuals with antisocial and narcissistic personality disorders also share a lack of empathy.

    The key feature of interest in shootings like Sandy Hook is that individuals with Asperger’s tend to obsess over singular interests and have very well-defined talents. In the case of Adam Lanza, who allegedly had Asperger’s, investigations after the shooting found a large collection of weaponry inside his home and reported that his mother had taught him target shooting. To the public, the media portrayed that Lanza was a gun enthusiast and that firearms were his singular obsessive interest. An obsession with firearms combined with lack of empathy or the bullying associated with Asperger’s sufferers and their lack of social connection, which Lanza reportedly experienced, make violence probable. Adam Lanza, like many other children with Asperger’s, was a victim of bullying. In other major shootings such as Columbine and Virginia Tech, the shooters were also victims of bullying. However, bullying is what links these shootings together and not Asperger syndrome.

    Traits commonly shared by individuals with Asperger’s have a correlation with committing acts of violence, but not every child with the condition is violent. Being victims of bullying, having a lack of empathy, co-occurring disorders such as depression and an obsession with violence, crime or weaponry can all correlate with an increased risk for the individual with Asperger’s to engage in violent behaviors.

    Image Credit: Courtney Lynch

    Editor’s Commentary

    Correlation between Asperger’s syndrome and violence has become a hot topic after the Sandy Hook shooting tragedy. We asked an expert on Asperger’s syndrome to comment on this article.

    Editor’s Interview with Clinical Psychologist Dr. Tali Shenfield, PhD, CPsych

    Q: Dr. Shenfield, I understand that you have extensive experience treating patients with Asperger’s syndrome (AS). Do you feel that this group is particularly prone to violence?

    This topic is highly controversial and there is no consensus even among clinical psychologists working with Asperger’s syndrome patients. While there is extensive clinical research (see references section below) showing that people with Asperger’s syndrome are more likely to commit violent acts, there is little psychological research linking Asperger’s to planned acts of committed violence. It is important to keep in mind that:

    1. Most people with Asperger’s are not violent.

    2. Stigmatizing people with Asperger’s as potential criminals could cause further alienation and trigger violent behavior.

    3. People with Asperger’s are more likely to be the victims rather than the perpetrators of violence.

    4. A small subset of people with Asperger’s are violent, which can lead to criminal behavior, including murder.

    5. Most patients with Asperger’s who commit violent acts have a co-morbid mental health disorder.

    6. The chances of violent behavior can be greatly reduced if Asperger’s patients receive psychological help during their childhood and beyond.

     

    Q: Do you think that generalizing from individual cases to the group as a whole can create unwarranted prejudice and fear in the public?

    Like with all mental health disorders, there are many misperceptions about Asperger’s syndrome. It is important to understand that all individuals diagnosed with this syndrome are different. There are many who do experience feelings of empathy and compassion, but might have a different way of expressing these feelings. Most commonly, Asperger’s patients are quiet, soft-spoken and peaceful people. They like to follow rules and established patterns of behavior. It is concerning to me that individual cases of violence by persons allegedly suffering from Asperger’s  can paint the whole group as violent and dangerous.

    Q: Perhaps it would be helpful to understand what factors can lead to aggressive behavior in persons with AS?

    I believe that the main contributing factor is difficulty in interpreting other people’s emotions and intentions. They might perceive a harmless joke as a threat and react irrationally. They may also be prone to outbursts of pent-up frustration. They have a hard time expressing and understanding their own feelings, and they sometimes allow them to accumulate to the point of uncontrollable explosion.

    The best prevention is to teach AS children from early on about their own and other people’s emotions and facilitate processing and expression of their feelings. This usually leads to better social skills and reduces their frustration.

    Q: What are some other less known facts about people with AS?

    It is important to acknowledge the role of individuals with AS in the history of humankind. Remember that many famous scientists, writers, artists and innovators we admire  today (such as Albert Einstein, Bill Gates, Alfred Hitchcock, Bobby Fischer and others) had traits of Asperger’s. The world would not be the same without them. I think we should focus on understanding and supporting these people rather than ostracizing and fearing them.

    References:

    1. Allen D, Evans C, Hider A, et al (2007) Offending behaviour in adults with Asperger syndrome. Journal of Autism and Developmental Disorders38:748–58.

    2. Attwood T (2007) The Complete Guide to Asperger’s Syndrome. Jessica Kingsley Publishers.

    3. Blair J, Mitchell D, Blair K (2005) The Psychopath: Emotion and the Brain. Blackwell Publishing.

    4. 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. The National Autistic Society.

    5. 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.

    6. 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.

    7. 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

    8. 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’

    9. 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 Disorders30: 205–23.

    10. 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.

    11. 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 Psychology14: 506–24.

    12. 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 Psychology18: 20–126.

    13. 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

    14. Research Units on Pediatric Psychopharmacology (2002) Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine347: 314–21.

    15. 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

    16. Schwartz-Watts DM (2005) Asperger’s disorder and murder. Journal of the American Academy of Psychiatry and the Law33: 390–3.

    17. Scragg P, Shah A (1994) Prevalence of Asperger’s syndrome in a secure hospital. British Journal of Psychiatry165: 679–82.

    18. 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 Law29: 420–6.

    19. Soderstrom H, Nilsson T, Sjodin AK, et al (2005) The childhood-onset neuropsychiatric background to adult psychopathic traits and personality disorders. Comprehensive Psychiatry46: 111–6.

    20. Viding EM (2007) Re: The callous unemotional traits (e-Letter). British Journal of Psychiatry; 29 May

    21. 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 Psychology16: 747–63.

    22. 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 Psychology17 :108–20.

    23. 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.


  2. Robotic Pets for Animal Therapy?

    May 2, 2013

    animal therapy

    by Sandy Cosser

    You may have heard of animal therapy. In fact, you have almost definitely heard of animal therapy because it was used quite a lot after 9/11 to help survivors deal with the trauma. It is exactly what it says on the tin; animals (pets) are used as therapeutic aids. They’re used in a variety of circumstances. Psychologists use pet therapy to help autistic children, ADHD children, children in hospitals, and the elderly in aged care facilities. In fact, animal therapy goes back all the way to Greek God of Healing Asclepius.

    You may immediately think of dogs as therapy animals, but a number of animals can be used, including cats, birds, and horses.

    Even robotic seals get in on the action.

    Say again?

    Paro is a robotic seal that was first developed in Japan (where else) as a substitute for real pets in aged care homes. This was way back in 1993 – well, that’s when development started. By 2002 he was setting world records (for the most therapeutic robot, so he’s not alone in the world), and by 2004 he was winning over people in old age homes. In 2009, he started to achieve international success, especially in Denmark (web-japan.org).

    It’s not as crazy as it sounds because the furry therapeutic robot has proven to be as successful as real animals. In fact, Paro has a couple of advantages over the real thing; foremost of which is that he doesn’t need to be house trained.

    He’s also hypoallergenic, so there is no worry that ill children or fragile old people will end up in hives or with chronic sinus problems. And, there is no chance that he will be spooked or get overexcited and hurt someone (therapy animals are carefully selected for their mild nature, but let’s face it, all animals can be unpredictable – people included).

    Thanks to his robotic nature, Paro is not merely a passive toy, absorbing cuddles and giving nothing back. Shibata Takanori, senior research scientist at the National Institute of Advanced Industrial Science and Technology (AIST), designed him to be interactive. He responds to attention – spoken and tactile – and even has a range of facial expressions to express his joy at being petted. And, he doesn’t like it when people get too rough, which helps teach autistic kids some important lessons.

    Better than the real thing?

    Surely a robotic seal, no matter how cute and hygienic, couldn’t be preferred over a real live dog or cat? Well, it seems that the aged in Japan really do prefer their automated therapy.

    In April 2010, Robotic Zeitgeist reported that the demand for Paro was so great that Fujitsu was inspired to make its own therapeutic aid, this time in the form of a robotic teddy bear. It also comes with sensors galore so that it can respond to touch and voice.

    So, is it better than the real thing?

    Not everyone is sold on the idea of robot animal therapists. People in western world, for example, haven’t taken to robots with the zeal of those in the Orient. Perhaps too many sci-fi books and movies have made us wary of artificial intelligence, at least as far as trusting it with the mental health of our loved ones goes.

    As far as children are concerned, it seems that real animals are better than the robotic kind. This is because children form a real bond with the animals. In many cases, the animals have their own disabilities to overcome, which deepens the bond and promotes healing on both sides.

    Whether you like you therapy pets with real flesh and blood or with programmed emotional responses, there is a growing body of evidence that proves furry friends can play a vital role as companions and therapeutic aids in hospitals, aged care facilities, and even jails.

    Image Credit: yogamama.co.uk