Background and Clinical Characteristics of Young Adult Males with Autism Spectrum Disorders Sentenced to Prison for Violent or Sexual Offences

Background:  Among young people, violent crime is a leading cause of reduced health, disability, and death world-wide and offenders as a group are at particular high risk of becoming victims of violence themselves . Violent crimes are perpetrated by a small group of individuals in society and an even smaller group is responsible for a disproportionate number of these crimes. The majority of this small group of repetitive offenders has had childhood adjustment problems, early onset of crimes and substance abuse. The prevalence and significance of socio-communicative deficits in violent criminals is still largely unknown. For the detection, treatment and prevention of further violent criminality of convicts with autism spectrum disorders (ASDs) it is important to describe the clinical and criminological characteristics of these offenders and follow them after discharge. 

Objectives:  

Early onset behaviour disorders (i.e. oppositional defiant disorder, conduct disorder, attention deficit-/hyperactivity disorder and ASDs) form the antecedents of complex psychiatric problems with an increased risk for psychosocial marginalization and recidivistic criminal careers in adulthood. The current study investigates the clinical, psychosocial and criminological characteristics in a subgroup of young adult criminal offenders with ASDs, the coexistence of ASD and other early onset behaviour disorders as well as personality disorders.

Methods:  

Young adult male offenders (18-25 years of age) sentenced for “hands-on” violent and/or sexual offences who were serving prison time in correctional facilities (n=9) in the Western Region of the Swedish Prison and Probation Service were invited to participate in the study. The project started in April 2010 and closed in July 2012 when 271 subjects had taken part in the study. The participation rate was about 70 %. Clinical diagnostic assessments (SCID-I and –II), psychosocial history (including antisocial behaviours/ substance abuse), basic neurological examination, structured neuropsychiatric status, neuropsychological testing, and genetic work-up were carried out. In addition to a structured DSM-IV based interview on ASD criteria, the Asperger’s syndrome /high functioning autism Diagnostic Interview (ASDI) was used. When possible, collateral DISCO interviews or ADOS ratings were made.

Results:  This group of young males with ASD and antisocial behavior has a complex picture of coexisting mental health problems. Patterns of psychiatric comorbidity (including substance use disorders), neuropsychological data, characteristics of their background, index crime and crime history will be reported.

Conclusions:  

The study emphasizes the importance of a broad focus when assessing for psychiatric comorbidity in individuals with the combination of antisocial behaviour and ASD. Data on clinical, psychosocial and crime characteristics will possibly increase our knowledge of which ASD individuals are at highest risk of an antisocial development and which kinds of crimes individuals with ASDs are most likely to commit.