Largest study to date finds autism alone does not increase risk of violent offending

Conditions such as ADHD that co-occur with autism may increase risk

Washington, DC, June 1, 2017

A diagnosis of autism alone does not increase the risk of violent offending, suggests a study published in the June 2017 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). The study analyzed data from 295,734 individuals in Stockholm County, Sweden, of whom 5,739 had a diagnosis of autism. The researchers tracked these individuals for violent crime convictions between ages 15 to 27 years using records from the Swedish National Crime Register.

The team, led by researchers at the University of Bristol’s School of Social and Community Medicine and the Karolinska Institute in Stockholm, found that individuals diagnosed with autism initially appeared to have a higher risk of violent offending. However, this association was significantly reduced once the presence of additional attention-deficit/hyperactivity disorder (ADHD) or conduct disorder was taken into account. These conditions, along with other psychiatric disorders and alcohol and drug misuse, were the most important predictors of violent criminality in autism, not autism by itself.

“We know that some people with an autism diagnosis have challenging behavior and may come into contact with the criminal justice system; however, whether having autism increases the risk of violence or not has not been clear,” said Dr. Ragini Heeramun, Consultant Forensic Psychiatrist at the Avon and Wiltshire Partnership National Health Service Mental Health Trust in Bristol. “Our findings, from the largest study to date, show that at the population level, autism in itself doesn’t seem to be associated with convictions for violent crimes. However, other conditions, such as ADHD, which can co-occur with autism, may increase such risks.”

Interestingly, when researchers considered individuals with ADHD or conduct disorder, an additional diagnosis of autism was actually found to reduce the risk of violent criminality, compared to individuals with ADHD or conduct disorder alone.

There was also some evidence that a delayed diagnosis of autism was associated with a greater risk of violent crime, while better school performance and intellectual disability appeared to be protective.

“Interestingly, the additional presence of an autism diagnosis was actually associated with a relatively lower risk of convictions, compared to having these conditions without autism,” said Dr. Dheeraj Rai, Consultant Senior Lecturer in Psychiatry from Bristol’s School of Social and Community Medicine. “We think that these findings could be important for autism services, which often focus on providing a diagnosis of autism, rather than on the identification of, and support for, the conditions that commonly occur alongside it.”

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Notes for editors
The article is "Autism and Convictions for Violent Crimes: Population-Based Cohort Study in Sweden," by Ragini Heeramun, Cecilia Magnusson, Clara Hellner Gumpert, Sven Granath, Michael Lundberg, Christina Dalman, and Dheeraj Rai (http://dx.doi.org/10.1016/j.jaac.2017.03.011). It appears in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 56, issue 6 (June 2017), published by Elsevier.

Copies of this paper are available to credentialed journalists upon request; please contact Mary Billingsley at mbillingsley@aacap.org or +1 202 587 9672. Journalists wishing to interview the authors may contact Shona East, Media Manager, University of Bristol, at shona.east@bristol.ac.uk or +44 (0)117 394 0181.

About JAACAP
Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families. www.jaacap.org

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

About Elsevier
Elsevier is a global information analytics business that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com

Media contact
Mary Billingsley
JAACAP Editorial Office
+1 202 587 9672
mbillingsley@aacap.org