Violence is Rare in Autism: When It Does Occur, Is It Sometimes Extreme?

Extreme overvalued beliefs and identities: revisiting the drivers of violent extremism

Recent efforts to understand violent extremism have appealed to the concept of extreme overvalued beliefs as a way of explaining fixation and extremist commitments. Extreme overvalued beliefs refer to an ego-syntonic fixation that grows more intense, absolute and emotional over time and is shared with a sub-community. However, while extreme overvalued beliefs precede many targeted attacks, most people who hold them do not resort to violence. Previous research has highlighted four 'ingredients' associated with an increased risk of violent extremism, only three of which are captured in studies linking extreme overvalued beliefs to violence: perceived outgroup threat, demonization of the outgroup, and endorsement of violence. We argue that the fourth element-missing from the literature on extreme overvalued beliefs-is identity fusion: a visceral sense of oneness with the group in which personal and group identities become functionally equivalent. The goal of this paper is to improve current understanding of the circumstances where individuals with extreme overvalued beliefs turn into potential attackers. We show that when certain types of extreme overvalued beliefs are combined with identity fusion it can lead to violent self-sacrifice. Drawing on evidence from psychiatry, evolutionary anthropology, behavioural psychology and computational linguistics, along with a forensic analysis of three high-profile case studies of lone-actor grievance-fuelled violence, we explore the interplay of these risk factors and propose a more encompassing construct for explaining violent extremism. We call this hybrid framework Extreme Overvalued Beliefs and Identities (EOBI), synthesising the findings of interdisciplinary research on pathological fixation and identity fusion.

Neurodivergence and Threat: A Case Study on the Risk of Violent Fixations in Autism Spectrum Disorder

Mass shootings have increasingly captured public attention in recent decades, prompting closer examination of the mental health of those responsible. This scrutiny often focuses on individuals with neurodevelopmental disorders, such as autism spectrum disorder (ASD). While epidemiological evidence is mixed on whether these individuals are more likely to commit acts of violence than the general public, certain behavioral characteristics may make them more vulnerable to extremist ideations. This case study focuses on a 17-year-old male patient who initially presented with suicidal behavior, later diagnosed with ASD following clinical evaluation. He was also found to have additional comorbidities such as major depressive disorder, gender dysphoria, and unspecified eating disorder, while harboring threats of extreme violence. Despite displaying characteristics similar to previous mass shooters with ASD, the patient has never acted on his violent thoughts, a pattern consistent with most individuals with violent ideations. The case overviews the complexity of assessing when such threats are legitimate and the potential consequences of misinterpretation. There is urgent need for standardized protocols to differentiate between behaviors stemming from ASD and violence unrelated to ASD. The findings highlight the importance of understanding the vulnerabilities and presentations of neurodivergent individuals to provide appropriate care and prevent potential tragedies.

Breaking Down the Stigma: A Review of the Literature on the Relationships between Autism Spectrum Disorder and Criminal Behavior

Background: In recent years, there has been growing interest in the evaluation of autism spectrum disorder (ASD) and autistic traits in prison populations and offenders. Due to misleading headlines and highly publicized criminal cases, the belief that autistic individuals are more prone to commit crimes has spread among the general population, also leading to increasing research on this matter. Aims: In this context, this narrative review aimed to analyze the available scientific literature on the bi-directional link between ASD and criminal behaviors and to assess the key characteristics of eventual ASD offenders, including sociodemographic data, comorbidities, crime-related features, and interactions with the criminal justice system. Results: Our review highlighted that the available studies lack methodological rigor and present controversial results. Overall, the current state of research does not support any definitive correlation between ASD or autistic traits and the predisposition to engage in criminal conduct. Further studies are needed to confirm or reject this hypothesis.

A latent class analysis of mental disorders, substance use, and aggressive antisocial behavior among Swedish forensic psychiatric patients

BACKGROUND

Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial behavior (AAB) are sometimes referred to as the 'triply troubled'. They suffer poor treatment outcomes, high rates of criminal recidivism, and increased risk of drug related mortality. To improve treatment for this heterogeneous patient group, more insight is needed concerning their co-occurring mental disorders, types of substances used, and the consequent risk of AAB.

METHODS

A three-step latent class analysis (LCA) was used to identify clinically relevant subgroups in a sample of patients (n = 98) from a high-security FMHS clinic in Sweden based on patterns in their history of mental disorders, SUD, types of substances used, and AAB.

RESULTS

A four-class model best fit our data: class 1 (42%) had a high probability of SUD, psychosis, and having used all substances; class 2 (26%) had a high probability of psychosis and cannabis use; class 3 (22%) had a high probability of autism and no substance use; and class 4 (10%) had a high probability of personality disorders and having used all substances. Both polysubstance classes (1 and 4) had a significantly more extensive history of AAB compared to classes 2 and 3. Class 3 and class 4 had extensive histories of self-directed aggression.

CONCLUSIONS

The present study helps disentangle the heterogeneity of the 'triply troubled' patient group in FMHS. The results provide an illustration of a more person-oriented perspective on patient comorbidity and types of substances used which could benefit clinical assessment, treatment planning, and risk-management among patients in forensic psychiatric care.

From violent lone-actor types to lone-actor grievance-fueled violence: The Aarhus University shooting as an example of multi-facetted offender motivations and context-sensitive boundaries between violent lone-actor categories

Over the last decade, western societies have experienced an increase in acts of mass violence carried out by lone actors. While this concept is mostly associated with lone-actor terrorists, it also involves the actions of other single perpetrators, e.g., school shooters, workplace attackers, rampage shooters, and some forms of incel violence. In this article, we argue in favor of moving away from such categorization of violent lone-actor types and toward the unifying concept of lone-actor grievance-fueled violence. We illustrate the analytical benefits gained from such a conceptual shift by analyzing the Danish Aarhus University Shooting in 1994, where a single offender killed two students. While this attack is widely accepted as the only Danish school shooting in history, we identify signs of an extremist misogynist worldview held by what we today would call incels. This case serves as an illustration of the blurred and context-sensitive boundaries between violent lone-actor types and how nuances in offender motivation can be lost when lone-actor attacks are classified within a typological framework. Rather than simply recasting the Aarhus University Shooting as an incel attack considering the recent development of this category, we argue for the need to embrace the conceptualization of lone-actor grievance-fueled violence, which points toward the common genesis of lone-actor violence and allows for multi-faceted offender motivations. Using the Aarhus University shooting as a steppingstone, we discuss the pitfalls of lone-actor violence typologies and the advantages of the unifying lone-actor grievance-fueled violence conceptualization for both academia and practice.

Vulnerability to Ideologically-Motivated Violence Among Individuals With Autism Spectrum Disorder

People with autism spectrum disorder (ASD) are represented among those who espouse extremist thought and have committed violent acts associated with their beliefs. Media often highlight a perpetrator's psychiatric diagnosis following acts of mass violence, which in some instances has included ASD. ASD may itself not provide useful information for understanding motivations. Instead, understanding specific traits and neuropsychological and other vulnerabilities may offer an opportunity to make sense of these very complex events.

Young Adults with Autism Spectrum Disorder and the Criminal Justice System

This study describes charges, outcomes, and recidivism in both the juvenile and adult criminal justice systems (CJS) for young adults aged 17 to 23 years with autism spectrum disorder (ASD; n = 606). Results are compared to individuals with ID (n = 1271) and a population control group (n = 2973). About 3% of individuals with ASD were charged with at least one offense by the time they reached young adulthood. Few differences were found in CJS involvement across groups. Young adults with ASD were not over represented in the CJS in general, and were less likely to be involved in the adult justice system than their peers. They received similar charges and outcomes and were as likely to reoffend as their peers.

The face validity of an initial sub-typology of people with autism spectrum disorders detained in psychiatric hospitals

Autistic adults who have a history of committing crimes present a major problem for providers of services in terms of legal disposal options and possible interventions, and greater understanding of this group and their associated needs is required. For this reason, we aimed to investigate the face validity of a proposed sub-typology of autistic adults detained in secure psychiatric hospitals in the United Kingdom. Initially, a focus group was completed with psychiatrists, clinical psychologists, healthcare workers, family members and autistic adults who had been detained in hospital, leading to revisions of the sub-typology. Following this, a consensus rating exercise of 10 clinical vignettes based on this sub-typology with three rounds was completed with 15 psychiatrists and clinical psychologists; revisions to the vignettes to improve clarity were made following each round. The findings indicated that these subtypes possess face validity and raters were able to classify all 10 clinical case vignettes into the sub-typology, and percentage of agreement ranged from 96% to 100% for overall subtype classification. This study suggests that the further validity of the sub-typology should be investigated within a larger study, as these subtypes have the potential to directly inform the hospital care pathway such that length of stay can be minimised.

Conceptualising social and communication vulnerabilities among detainees in the criminal justice system

More people with autism spectrum disorder (ASD) are now being identified in the criminal justice system, and in parallel with this increase, the prevalence of ASD in the community has risen more than 150 % in the same time period. In this article, I will argue that this increase is due to a reclassification of those individuals whose social, communicative and behavioural function is at the lower end of the normal range. Put simply, extremes of these quantitative traits are now being conceptualised as 'disorder'. This has particular relevance for the criminal justice system as such traits are over-represented in this population: as such, it is likely that increasing numbers of people who are incarcerated will receive an ASD diagnosis. This will have major implications for where best, and how best, to manage such individuals using a framework of 'disorder' versus 'difference'.

"I feel that if I didn't come to it anymore, maybe I would go back to my old ways and I don't want that to happen": Adapted sex offender treatment programmes: Views of service users with autism spectrum disorders

BACKGROUND

The cognitive and behavioural profile associated with autism spectrum disorders (ASD) includes difficulties with social interaction, communication and empathy. Each of these may present barriers to effective participation in sexual offending treatment, leading to poorer outcomes.

METHOD

Semi-structured interviews were conducted with 13 men with autism and an intellectual disability (including the borderline range) who had completed an adapted sex offender treatment programme. Grounded Theory was used to explore the men's experiences of treatment and perceptions of risk.

RESULTS

The men's perceptions of sexual risk were inextricably linked to constructs of identity and shaped their opinions of treatment effectiveness. Risk of reoffending was conveyed through narratives of changes in self and circumstances and included notions of blame and culpability.

CONCLUSIONS

The findings illustrated some clear benefits for men with ASD associated with attending adapted sex offender treatment programmes, including delivery of treatment within groups and opportunities for social development. The study supports the view that difficulties with empathy and cognitive flexibility complicates treatment for sexual offending.

Criminal Behavior and School Discipline in Juvenile Justice-Involved Youth with Autism

The objective was to delineate the prevalence of criminal behavior and school discipline in juvenile justice-involved youth (JJY) with autism. A sample of 143 JJY with autism was matched to comparison groups of JJY without a special education classification, JJY with learning disabilities, and JJY with other special educational needs (N = 572). Results showed that JJY with autism committed significantly fewer property crimes. With regard to school discipline, JJY with autism were least likely to receive policy violations, out-of-school suspensions, and in-school suspensions. Finally, regardless of special education classification, JJY who had a history of fighting in school were more likely to recidivate. Our results suggest that JJY with autism are not more likely to commit crimes compared to JJY without SEN.

Social cognition in aggressive offenders: Impaired empathy, but intact theory of mind

Aggressive, violent behaviour is a major burden and challenge for society. It has been linked to deficits in social understanding, but the evidence is inconsistent and the specifics of such deficits are unclear. Here, we investigated affective (empathy) and cognitive (Theory of Mind) routes to understanding other people in aggressive individuals. Twenty-nine men with a history of legally relevant aggressive behaviour (i.e. serious assault) and 32 control participants were tested using a social video task (EmpaToM) that differentiates empathy and Theory of Mind and completed questionnaires on aggression and alexithymia. Aggressive participants showed reduced empathic responses to emotional videos of others' suffering, which correlated with aggression severity. Theory of Mind performance, in contrast, was intact. A mediation analysis revealed that reduced empathy in aggressive men was mediated by alexithymia. These findings stress the importance of distinguishing between socio-affective and socio-cognitive deficits for understanding aggressive behaviour and thereby contribute to the development of more efficient treatments.