Fire-setting and psychopathology : a brief overview of prevalence, pathways and assessment

Purpose: There is increasing attention on investigating the association between fire-setting and psychopathology and also the degree to which fire-setting is a manifestation of mental disorder. Despite the actual prevalence of pyromania remaining elusive, there is growing evidence in the literature highlighting the higher rates of psychiatric mental health disorders in fire-setters, the most common being: schizophrenia, mood disorders (such as anxiety and depression), personality disorders, alcohol abuse, and intellectual disability. The purpose of this paper is to highlight more recent work on prevalence, pathways and assessment in offenders who have engaged in fire-setting. methodology/approach: This paper provides an overview of the literature on fire-setting and psychopathology with a focus on prevalence, pathways and assessment. Findings: This review identified key literature which has identified a variety of distinct pathways to fire-setting and also highlights two assessments/measures for fire-setters. Such information is useful for clinicians when they encounter this group of offenders. Practical implications: This paper has identified in the literature and recommends the use of the ‘Fire Setting Scale’ and the ‘Fire Proclivity Scale’ in clinical and/or forensic practice. Originality/value: There is a very real need for additional empirical research in this area. There is also a need for an increased awareness and understanding of how various types of psychopathy can contribute to fire-setting in both a legal and clinical context

Prevalence and assessment of traumatic brain injury in prison inmates : a systematic PRISMA review

The primary objectives of the present systematic PRISMA review was: (1) to explore the range of prevalence of TBI in offenders, and whether this is higher than in a control sample; (2) to determine which screening measures are available, and evaluate the evidence on these; and lastly, (3) to evaluate whether prevalence of TBI is associated with increased prevalence of other health conditions and/or offending behaviour. The present systematic PRISMA review explores the peer reviewed literature published since 2005 which has investigated TBI in incarcerated populations using five databases (CINAHL, MEDLINE, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO) in addition to separate searches conducted on ‘Google Scholar’ using specific search criteria. Seventeen studies were identified which explored the prevalence of TBI in inmates. Only five of the seventeen studies which investigated prevalence of TBI in offender populations looked at juvenile offending. Interestingly, only seven of the 12 studies included both male and female samples (two of which did not report findings separate for males and females. In terms of the assessments used to investigate prevalence, three studies investigated the prevalence of TBI using The Ohio State University (OSU) TBI Identification method (OSU-TBI-ID). Nine studies used one or two questions in order to elicit information on whether the offender had previously experienced a TBI. Only two studies used the Traumatic Brain Injury Questionnaire (TBIQ). One study used the Brain Injury Screening Index (BISI). Lastly evidence of TBI checklist from medical record (14-items) was used in one study. In terms of the implication for further research and practice, the studies identified in this review clearly emphasise the need to account for TBI in managing care in offender populations, which may contribute to reduction in offending behaviours. Additionally, there is a need for further research investigating the clinical utility of screening tools for detecting TBI in offender populations such as The Traumatic Brain Injury Questionnaire (TBIQ), The Brain Injury Screening Index (BISI) and The Ohio State University (OSU-TBI-ID) TBI Identification method

Understanding and recognising the female phenotype of autism spectrum disorder and the “camouflage” hypothesis : a systematic PRISMA review

Purpose: Females with ASD may display superficial social skills which may mask their autism spectrum disorder (ASD) symptomology impacting on the identification of the disorder – known as the “camouflage” hypothesis. Compared to males with ASD, it is increasingly recognised that females with ASD have a stronger ability to imitate behaviour which is socially acceptable, particularly those females who have higher cognitive abilities (i.e., intelligence considered to be within the normal range) (Ehlers & Gillberg, 1993). Design/methodology/approach: This present paper will explore the literature on camouflaging or masking behaviour in females with ASD. A systematic PRISMA review was conducted. Findings: The capacity to ‘camouflage’ social difficulties in social situations is considered to be one of the main features of the female phenotype of ASD (e.g., Kenyon 2014). Social imitation or camouflaging enables some level of success and coping which results in some females never receiving a diagnosis of ASD. They typically may not exhibit any observable functional impairments. However, under the surface of the camouflage, females may experience high levels of subjective stress, anxiety and exhaustion and a need to re-charge or recuperate by withdrawing from any social interaction. Practical implications: There is a need for the development of a camouflaging measure. Research limitations/implications: There is a relatively little understanding and knowledge of the female phenotype of ASD. This lack of understanding and knowledge impacts significantly on the ability to identify females with ASD (Lai et al., 2015; Bargiela et al., 2016) which can have a number of negative consequence (Adamou et al., 2018; NICE, 2012). Originality/value: There is a real need for further research exploring the positive and negative impact of the phenomenon of ‘camouflaging’, or ‘pretending to be normal’ in females with ASD

Rare instances of individuals with autism supporting or engaging in terrorism

Purpose: The prevalence of individuals with an Autism Spectrum Disorder being associated with terroristic threats, lone wolf terrorism or affiliating with terroristic groups is rare. Design/methodology/approach: However, several cases are presented, where individuals with autism are involved in making a naïve, empty terroristic threat, or uttering serious serial terroristic threats. Other cases are also presented of individuals being at risk for an abduction or being used by a terrorist group, and finally committing an act of domestic lone wolf terrorism. Findings: Essential to the analysis was establishing a functional connection between autism-based deficits and the terroristic threats, terrorism, and when to not criminalize naïve, empty terroristic threats or acts. Originality/value: Currently, tools available to law enforcement and prosecutors exploit the vulnerabilities and liabilities which arise as a result of group interactions, a “preventive” approach to terrorism that is not applicable to the solitary, “lone wolf” terrorist (Barnes, 2012; Zierhoffer, 2014).There has been relatively little research (including case studies) examining individuals with ASD who engage in terrorism. For instance, when dealing with an individual with ASD who is charged with terrorism, it is crucial to consider how the diagnosis of autism may have presented as a contextual vulnerability, and to make sure that justice, rehabilitation and management, are informed by an understanding of the person’s diagnosis of ASD (Al-Attar, 2016)

Clinical profile, risk and critical factors and the application of the “path towards intended violence” model in the case of mass shooter Dylann Roof

A threat assessment perspective, namely the Path towards Intended Violence, was applied in the case of the mass shooting perpetrated by Dylann Roof on June 17, 2015 at an Emanuel African Methodist Episcopal Church in Charleston, South Carolina. This perspective is important since it attempts to build on accounts regarding how he progressed towards his mass shooting, beyond the information presented in the forensic evaluations already available. The Path towards Intended Violence was found to be a critical and proximal factor for the mass shooting. This suggested finding is also consistent for other individuals, who were diagnosed with an autism spectrum disorder (ASD), as well as neurotypical individuals, who have engaged in a mass shooting. The Path towards Intended Violence is also discussed as a potential way forward towards trying to identify individuals who may be more vulnerable and at-risk, so that appropriate interventions and supports can be put in place in order that such extreme violence can be prevented

Autism Spectrum Disorders in high secure psychiatric care : a review of literature, future research and clinical directions

Autism spectrum disorder (ASD) refers to a group of neurodevelopmental disorders including Autism, high functioning autism, Asperger’s syndrome and atypical autism. Although different diagnostic classification systems have been adopted over the years, contemporary criteria follow those set out in the Diagnostic and Statistical Manual of Mental Diseases version five - DSM 5 by the American Psychiatric Association (APA, 2013) and the International Classification of Diseases eleventh edition by the World Health Organisation – ICD 11 (WHO, 2018) that group all under the single category of Autism Spectrum Disorders. Prevalence studies suggest that ASD is not rare with approximately one in a hundred individuals in the general population (Baird, Simonoff, Pickles, Chandler, Loucas et al. 2006). Although males are more likely to receive the diagnosis of an ASD (Brugha, McManus, Bankart, Scott, Purdon et al., 2011; Loomes, Hull, & Mandy, 2017), it is likely that the prevalence rate among women is significantly underestimated (Beggiato, Peyre, Maruani, Scheid, Rastam et al. 2016) and with the reasons poorly understood (Adamou, Johnson, & Alty, 2018). Additional studies also suggest that the skewed male / female ratio is unevenly distributed across the spectrum (Kikovski et al. 2013) and may actually decrease as the symptom severity of ASD increases (Werling & Geschwind, 2013). Having an ASD is also considered to be life-long. Whilst the causation behind having an ASD remains unknown, likely explanations include genetic / environmental interactions (Chaste & Leboyer, 2012) resulting in atypical brain maturation and a disconnection between key brain regions (Ecker, 2016). It is also common for individuals with an ASD to have other neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD) (Matson, Rieske & Williams, 2013; Taylor, Charman, & Ronald, 2015; Antshel, Zhang- James, Wagner, Ledesma, & Faraone, 2016) and intellectual difficulties (Matson & Shoemaker, 2009), neurological issues such as epilepsy (Brookes-Kayal, 2010) and sensory difficulties related to vision and hearing (Kancherla, Naarden Braun & Yeargin-Allsopp, 2013). Co-morbid psychiatric disorder including anxiety, depression, obsessive compulsive disorder and a psychosis may also be present (Ghaziuddin, Ghaziuddin, & Greden, 2002; Hammond & Hoffman, 2014; Matson & Williams, 2014; Moss, Howlin, Savage, Bolton, & Rutter, 2015; Maddox & White, 2015; Bruggink, Huisman, Vuijk, Kraaij, & Garnefski, 2016)

Jurors’ and judges’ evaluation of defendants with autism and the impact on sentencing : a systematic Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) review of autism spectrum disorder in the courtroom

Concern has been highlighted in the literature regarding how juries and judges handle cases which involve a defendant with autism spectrum disorder (ASD). The relatively little research on judicial perceptions or decision-making regarding individuals with ASD indicates that judges have limited understanding and familiarity with high-functioning ASD (hfASD) and ASD. The present systematic review will identify studies which investigate jurors’ (eg using mock jurors) and/or judges’ evaluations of defendants with ASD and studies which investigate whether the defendant diagnosis of ASD impacts on sentencing. Only four studies were identified which investigated jurors’ and/or judges’ evaluations of a defendant with an ASD or investigated whether the defendant diagnosis of ASD impacts on sentencing. Further research is recommended which should include an evaluation of cases involving a defendant with an hfASD or ASD diagnosis comparing charges, pleas entered, procedural adjustments at court, evidence adduced about the defendant’s condition, directions to juries, judicial remarks on the evidence (eg summing-up for the jury), verdicts and sentencing. This would enable the assessment of the specific offending behaviour and disorder of the defendant, and how these may be relevant to their mental capacity and culpability

A psycho-legal perspective on sexual offending in individuals with Autism Spectrum Disorder

It is important to consider whether there are innate vulnerabilities that increase the risk of an individual with an autistic spectrum disorder (ASD), predominantly those defendants with a diagnosis of Asperger’s Syndrome, being charged and convicted of a sexual offence. The significance of such can be readily seen in recent English case law, with judgments on appeal finding convictions unsafe where there have been a number of failings in the Judge's summing up. In this article, we will consider the gravity of Judges omitting to highlight a defendant’s diagnosis of autism spectrum disorder and the necessity of detailed explanations to jury members regarding the condition and its effect upon thoughts and behaviour. Consideration will be specifically given to the necessity to prove sexual motivation in such offences and the judicial direction required in relation to whether the appellant's actions had been sexually motivated. Recognition of the social impairments inherent in ASDs are vital to this work and we shall consider whether the difficulty with the capacity to develop appropriate, consenting sexual relationships as a result of impaired social cognition may be one of the factors which increases the risk of sexual offending in individuals with ASD (Higgs & Carter, 2015)

The relationship between psychopathy traits and neurodevelopmental disorders in forensic populations : a systematic PRISMA review

Background: Numerous studies investigate the rate of neurodevelopmental disorders in forensic populations. Studies have also investigated the rate of psychopathy in such settings. However, there appears to be a paucity of studies looking at both of these (co-morbidity between these disorders) and the possible relationships between the two in forensic populations. Method: Presented here are the findings from a systematic review conducted, following PRISMA guidelines, of the peer-reviewed literature. The review identified studies that investigated the rate and/or relationship of neurodevelopmental disorders (Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorders) and psychopathy in a forensic sample population without relying on previous childhood diagnosis of neurodevelopmental disorders. Results: Twenty-two studies were identified which investigated the rate and/or relationship of neurodevelopmental disorders and psychopathy in a forensic sample population without relying on previous childhood diagnosis of neurodevelopmental disorders such as attention-deficit/hyperactivity disorder and autism spectrum disorders. Conclusion: The findings highlight the need for the development of screening and diagnostic tools especially targeted at offenders and validated for this purpose