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

LAY ABSTRACT: Autistic adults who have a history of committing crimes pose challenges for the criminal justice system in terms of disposal and treatment. For this reason, we investigated the validity of a proposed sub-typology of autistic adults detained in secure psychiatric hospitals. Initially, we ran a focus group with psychiatrists, clinical psychologists, healthcare workers, family members and autistic adults who had been detained in hospital to consider a sub-typology of autistic adults who may come into contact with secure psychiatric hospitals. We asked 15 psychiatrists and clinical psychologists to rate 10 clinical vignettes based on our sub-typology with three rounds; 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. The findings suggested that the further validity of the sub-typology should be investigated within a larger study using a clinical sample. These subtypes may help inform treatment and care pathways within hospital.

Exploring the link between personality disorder and criminality in a community sample.

This study sought to identify, among a sample of 224 community residents with DSM-diagnosed personality disorder (PD), those personality and criminal history features associated with a combination of antisocial and borderline PDs (APD/BPD). After identifying first- and higher-order factors through factor analysis of IPDE item scores, forensic history and personality correlates of the identified higher-order factors were identified using regression analysis. Those having APD/BPD were more likely than the remainder to have received a conviction for violence and a custodial sentence. They showed higher trait anger and impulsivity and a greater history of aggression, and scored significantly higher on a higher-order "psychopathy" factor. In contrast, anankastic traits were inversely related to criminal history variables. It is concluded that APD/BPD represents a particularly criminogenic blend of traits likely to be overrepresented in high-secure forensic samples, and underrepresented in community PD samples. Future research should address the mechanisms through which PDs are related to criminality.