Monday, October 12, 2015

Are neurodiversity bloggers giving an accurate description of the association between autism and violence?

The mass shooting in Oregon by Chris Harper Mercer and his mother's publicly writing about his autism diagnosis have stirred controversy in the autism community as to whether or not his autism was responsible for the mass murder of innocent people.  A facebook page was created implying that numerous autistic people were shooters and that autism is associated with violent crime and murder.  After a plethora of protests and petitions, Facebook removed the page.  In response, there were a flurry of articles published on the internet by a list of authors that reads like a who's who list of some of the most prominent members of the neurodiversity movement, including Michael John Carley, Emily Willingham and the Autistic Self Advocacy Network and Matt Carey of the Left Brain Right Brain blog.   The common theme of these articles is that there is no association whatsoever between autism and violence.

Renowned writer Andrew Solomon also weighed in, writing in a new york times article about autism shooters, asking why no one was suggesting diabetes and pattern baldness as causes of mass shootings if they were suggesting autism was one.  See Gadfly's answer toward the end of the post.  

This is nothing new.  The Newgate shootings of Adam Lanza less than three years ago are still fresh in the minds of most people, particularly Lanza's diagnosis of Asperger's.  Well-known neurodiversity advocate John Elder Robison was quick to write a response absolving autism for blaming murderous behavior.  The IACC, which has had several members of the neurodiversity movement (and zero pro-cure autistics) serving on it since its inception also wrote an article disputing the association between autism and violence after the Lanza shootings.

Aside from the fact that all of these writers advocate neurodiversity, another common denominator in all these pieces is the nearly complete neglect to cite any scientific evidence that there is absolutely no association between autism and violent crime.  The trivial exception to that being Carey's citing a study by  Ghaziuddin and the studies by Mouridsen in Denmark purporting not to show an association between autism and violence.  These were the three publications cited by the IACC's statement on the Sandyhook shooting.

What does the actual literature show?  One of the problems of Ghaziuddin's report was that he only did literature reviews of isolated cases and neglected to check court records to ascertain the relationship between autism and violence.  This is an old paper nearly twenty-five years old.  What do other more recent publications have to say? Only the abstract of Mouridsen's 2012 paper is available online and I have not been able to read the entire paper.  One limitation of his 2008 paper is that it only includes convictions and not arrest data such as cases of people on the spectrum that were thrown out for lack of evidence, let alone killers who committed suicide.

Are these writers correct that there is no general association between autism and violent crime, particularly murder?  The short answer is probably yes, though it is still questionable (at least to Gadfly) how much is known about the prevalence of violence in autism spectrum disorders.

However, even if there is no clear-cut association between autism and violence and the vast majority of autistic persons are not prone to violence, particularly murder, could there be a subset of those on the spectrum who are predisposed to violence and murder as a result of their brain dysfunction, including co-morbid mental conditions that appear in addition to the symptoms of the ASD?  The answer to this question appears to be yes also.

Various case studies have been reported in the literature that gives suggestive evidence (though not specific proof of this).  For example Baron-Cohen reported on a 21-year-old man who would take a knife to his 71-year-old girlfriend.  Psychiatrist Donna Schwartz-Watts cites three case histories of individuals on the spectrum who committed murder.  She concludes their illness was in fact related to their crimes.  Newman and Ghaziuddin(author of the original 1991 study concluding there was no relationship between ASD's and crime), in the journal of autism and developmental disorders, stated that there was a relationship between some forms of autism with premorbid psychiatric conditions and certain violent crimes (I have not read this article, but the reports on it).

Psychologist Matt Lerner writes about how theory of mind, impulsivity and other problems may in fact be related to violent crime in some (emphasis added) autistic individuals.

Though the research in this area may have its limitations and not come to any definite conclusions, it would suggest that there is a small subset of persons on the autism spectrum who are predisposed to violent acts, including mass murder.  Part of the reason for this may be comorbid psychiatric conditions such as schizoaffective disorder, depression, bipolar, and other things that accompany some of the many forms of autism.

To answer Andrew Solomon's question.  Diabetes and pattern baldness are not brain conditions that affect behavior, autism is.  There is no comorbidity with mental disorders documented in diabetes and pattern baldness the way there has been in autism.  It's another neurodiversity comparison between apples and hurricanes.  

The neurodiversity movement often try to separate comorbidity from autism, saying that the seizure disorders that accompany autism are separate from the autism itself.  We should just regard this as epilepsy and not part of the individual's autism.  Even if the research proves that some mass murderers have a form of autism with comorbidities, they will state that it is these comorbidities that are the culprit and not the autism per se.  However, I believe when epilepsy and comorbidities exist they are all a part of one brain disorder with the autism being one symptom.  I don't believe you can separate one from another.  They are all part and parcel for the course.  Therefore, I suspect it is likely that in a small number of cases (though not the vast majority) there is an association between murder and autism.  I concede that further research may have to be done to completely validate that conclusion.  However, I don't think it is helpful for members of the ND movement and others to claim there is no association whatsoever between autism and murder when at least some scientific evidence would seem to contradict them. 


Shanti said...

Food for thought. I agree that the 'co-morbidities' are conveniently separated from autism by the ND movement. John Elder Robison recently wrote "Self destructive behavior has a cause, and it’s not autism. It’s frustration and abuse and sensory issues." As if sensory issues are completely unrelated to autism. Yeah, right.

farmwifetwo said...

These "neurodiverse" advocates aren't helping anyone. The school's are full of high behavioural, ASD children from across the spectrum. Parent's don't want them in their children's classrooms, nor do the children want them there. I'm very glad we went to high school this year because there is an ASD child in last years class that has FOUR aides because of the behaviour. We'd be home schooling this year if that was our class.

Thing is... most don't spend the time at it. "It's ASD, it's OK or it's the school's fault" is the mantra of parents and professionals. This leads to isolation at school, frustration, there is no "filters" on the majority of them and I'm not surprised that they lash out. Considering the daily stories in the local school's of elementary students lashing out... why would you not expect it to happen as adults. They "pass for normal"... it's time teachers, Dr's, behaviouralists and parents realize that social skills, behaviour management, mental health etc need to be taught to the HFA crowd.

You can tell people it doesn't exist. But the general population will tell you it does. It's time to own up to it and request services starting when they are small for all ends of the spectrum.

jonathan said...

I agree that neurodiversity proponents are not helpful to anyone, except maybe ari ne'eman to himself where he can start a nonprofit and give himself huge payraise and use a significant percentage of the revenue to pay his own salary.

I think most ND advocates have mental problems and social skills training is not going to help them.

......I'm Anonymous said...

Well, to buy into the argument that autism causes violence, is to validate the recent surge in questionable autism diagnosis as being legitimate. Autism has strayed very far from Kanner's observations and the definition of autism up until 1994 when it was expanded to include the "weird". There are no murderous classic autism people, but then again, neurodiversity doesn't even acknowledge that classic autistics exists. This is a case of the chicken coming home to roost. They argued for these loose definitions of autism, accepted self diagnosis as legitimate, now let them deal with the aftermath. No one in the general public that works with classic autistics believe they are capable of planning and murdering people. Its only these super high functioning non-autistic self diagnosed bullshiters that are getting trapped in this guilt by association. The only crime I see is the expanded definition of autism.

Anonymous said...

"Thing is... most don't spend the time at it. "It's ASD, it's OK or it's the school's fault" is the mantra of parents and professionals. This leads to isolation at school, frustration, there is no "filters" on the majority of them and I'm not surprised that they lash out. "

*Here* is the link. Reduce the deterrent for someone doing something, don't be surprised to see that person become more likely to do that something. This is true no matter if the exceuse for reducing the deterrent is "but s/he's neurodiverse" or "but it's part of his/her culture" or "but s/he's a pillar of the community" or whichever else.

Anonymous said...

I agree with Donna Schwartz-Watts on that the connection between autism and violence is the crime of violence, then a series of mental changes leads to autism. And such causes for autism should be harder to be treated to a better situation with the help of medical chemicals. drug discovery can help little unless the a change in altitude occur.

spinoff said...

The problem with the pro-cure people is that they believe in cures which do not exist and will never exist for autism is a disorder of wiring not an infectious, or a toxic, o metabolic disorder. The problem with the ND people is they do not believe in disability, a disability that can lead, through excessive atention to details and lack of reciprocity, to alienation from people with various consequences which favour violence.

Many autistic however are completely unable to be seriously violent because the level of disability prevents them from being so. Thus studies should consider other variables. My son pulls hair and throws small objects without aim, that is how far his violence goes. Yet some typical including professionals, have spoken of his extreme violence when he has never harmed anybody but he has been hurt. I will not go here into the subject of stigma or explotation for purposes other than the interests of the afected. This is one of the biggest problems.

ND people idealize autism. For example they forget that Wittgenstein , perhaps the most likely candidate of their club, threatened Popper with a poker, and had many problems as a school teacher in Austria ending up in court for beating one of his pupils unconcious. His genialiality, his spectrum, his lonelyness and his angry un-empathic impetuosity were related. NDs could never consider that Hitler is a much better candidate for asperger than Jefferson. Etc

Autism exists. It can be a severe disability which needs substantial asistance or it can be a phenotype that is an important risk factor (of course not the only one) in failure to form or mantain relationships and might need some form of therapy.

Mariano Almudevar, Spain

jonathan said...

@ Mariano I believe there are some forms of autism which can arise through a metabolic problem such as cerebral folate deficiency which one of my readers, Roger Kulp, has. If he happens to read this comment he might be able to elaborate further. Some pro-cure people do embrace quack cures such as chelation or bleaches, etc., but you can be pro-cure and believe in a real cure which admittedly does not exist at this point in time, but might at some point in the future. I fall into the latter category.

As far as violence is concerned, I and the people who have published studies on the subject have only referred to a small subset of all autistics.

I don't think Hitler was a good candidate for an ASD diagnosis as he had incredibility ability and talent to influence people and had Ava Braun as live-in girlfriend. Of course Jefferson, etc. are poor candidates also in my opinion. Interesting info about Wittgenstein. muchas gracias for your comment.

spinoff said...

Thank you Jonathan. I also feel lonely over here, not easy to debate at a decent level.

Today, st Francis Xavier, is disability day and, hope it all goes well, we have managed to get our son in a day centre after nearly 5 years of exclusion based in part on his supposed violence, and our negative to use anti-psychotics. We had to go to law that here in Spain is expensive and complicated, we finally won, yet we will have to see if ther are reprisals and we are not spring chicks. Their stubborn defence was "procedural", they did not dare to get the facts (including death for neuroleptic asphixia, NMS, dystonias etc in some of my sons mates) and see what happend with a teacher bloody shirt, the blood being our son not the teachers.

I say that for I follow your polemics with the neurodiversity people with much interest and great ambivalence. It is possible to think of autism as a phenotype (my son is a syndromic through grand prematurity and its treatment, our phenotype is rather oppsite to that of autism), which in a small number of cases is a severe disability and in others simply a risk factor for various things. But I find ND people unbeilievable in their idealization, their attempts to draw a positive stigma etc, when I compare that with the realities of kanners in my son and others around. But when I turn to yo I fear that what I see is a treatment which is unrealizable for the disease is not longer active; it is rather like a scar a knot in the wires or something like that. And the practical realities of treatmet is the use of medications which particularly in the case of antipsychotics produce severe adverse effects including brain damage ( I am a retired old fashion, british trained psychiatrist) and early death. And that on people that cannot exercise informed consent, cannot defend rights with their parents being often hostages of professionals and even politicians. Is it Aktion T4 again?.So I think RIGHTS and go back to de ND lot, and I fear that they are not only idealizing their lot but denying and even despising the lot of people like my son.
¿Could it no be another way, that marked by the Convention of Rights of Persons with Disability? I find this document enormous at the level of the emantipation of women and the liberation of slaves. And it leaves sufficient room for aspies to understand their problems and investigate solutions which causal or nor biochemical o therapeutic. You could not imagine what sort of troubles my oversemantic, oversociable phenotype, with the help of some traumas, have given me. There more neurodiversities than autism.

Thanks again J.

Oren Franz2 said...

But it depends on the severity of ASD.

Autism is a spectrum developmental disorder that goes from profound Learning Disorder or profound Intellectual Disability to Autism without any Learning or Intellectual Disorder. the third problem is that you can have Autism or any communication disorder without having Learning or Intellectual Disability.

It is rare for a person with Intellectual Disability to commit crimes on their own and are more likely to be victims, because they have problems with Learning and have problems with Intellectual and adaptive functioning. However there are exceptions and reports that some people with developmental disorders commit crimes, because they are high-functioning. Statistics says that most people with mental health and developmental disorders are more likely to be victims than being perpetrators compare to people in the general population. However we should be careful, because not everyone in the general population commit crimes ether.

But I wanted to ask if death penalty should only be used as a last resort, not as punishment or revenge, but for the sake of safety for others if there is proof that a person is constantly being dangerous and is trying to escape, regardless if they have mental health and developmental disorders. But other than that I have mixed feeling about the death penalty, because some people can be wrongly convicted for death penalty.

Sources of the study of who will more likely to be victims or criminals:

Sources of some criminals with mental health and developmental disorders:

Oren Franz2 said...

My explanation why some criminals are part of the ASD community.

Most studies say that people with ASD are more likely to be victims than being perpetrators. While that is true, that statement is too broad, people with co-morbid diagnosis of Intellectual Disability and Autism are actually 20 times more likely to be victims than being perpetrators, compared to people who are on the higher functioning end of the autistic spectrum. Another problem why that statement from most studies is too broad, it is because the diagnostic criteria for Pervasive Developmental Disorders became more broad for the last decade and it was lumped as Autism Spectrum Disorder, and it's broad to the point where even some people with Antisocial Personality Disorder can be considered to have Autism Spectrum Disorder.

A lot of you guys wonder why more criminals happen to have a diagnosis of Autism Spectrum Disorder than a decade earlier, it is because the diagnostic criteria for Autism Spectrum Disorder is a lot more broad than it was a decade ago. It was thought that only people with Intellectual Disabilities have Pervasive Developmental Disorder, but after few years, they made the diagnostic criteria for ASD more broad to include people who have symptoms of PDD but without Intellectual Disability, and after few more years, the diagnostic criteria became more broad to include Asperger Syndrome. And In 2013, it was lumped as Autism Spectrum Disorder, and recently it was lumped as Autism Spectrum Disorder in ICD-11.

It's true that most people with ASD are more likely to be victims than perpetrators, but if we get more technical, people who have ASD without Intellectual Disability are more likely to commit crimes than people who are Intellectually Disabled. There are some people with Intellectual Disability that commit crimes, but it's so rare, because the diagnostic criteria for Intellectual Disability includes problems with Intellectual and adaptive functioning. People with ASD without Intellectual Disability are able to do neurotypical tasks and some people with ASD without Intellectual Disability are able to defend themselves than people with Intellectual Disability.

Since the diagnostic criteria for Autism became more broad in the last decade, I wonder if I am correct that there are some crimes that with ASD without Intellectual Disabilities are more likely to commit, but due to lack of social skills and repetitive behaviors.

You guys are wondering why more criminals happened to have ASD than a decade ago, it's because the diagnostic criteria for Pervasive Developmental Disorders became more broad in the last decade and lumped it as Autism Spectrum Disorder in recent years.

There are a lot of people that say it's impossible to have Antisocial Personality Disorder and ASD, but the problem is that the diagnostic criteria for ASD is much more broad than a decade ago, that it's is considered possible to have comorbid diagnosis of Antisocial Personality Disorder and ASD.

Now, you know why more criminals happened to have ASD than a decade ago.