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.

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

As usual, I disagree with farmwifetwo. She has also bought into the lie and perpetuates the lie that these people are autistic. They are not autistic, though they may have a diagnosis of autism. Autistics are not mainstreamed, they are in special education. By even recognizing these people as autistic degrades the lives of the truly autistic whom don't have the ability to even plan to go to the bathroom let alone collect guns and plan to murder people.

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.

One Joy 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.