Zainab Al-Attar and Rachel Worthington
Early bio-psycho-social experiences can dramatically impact all aspects of development. Both autism and traumagenic histories can lead to trans-diagnostic behavioural features…
Abstract
Purpose
Early bio-psycho-social experiences can dramatically impact all aspects of development. Both autism and traumagenic histories can lead to trans-diagnostic behavioural features that can be confused with one another during diagnostic assessment, unless an in-depth differential diagnostic evaluation is conducted that considers the developmental aetiology and underpinning experiences and triggers to trans-diagnostic behaviours.
Design/methodology/approach
This paper will explore the ways in which biological, cognitive, emotional and social sequelae of early trauma and attachment challenges, can look very similar to a range of neurodevelopmental disorders, including autism. Relevant literature and theory will be considered and synthesised with clinical knowledge of trauma and autism.
Findings
Recommendations are made for how the overlap between features of autism and trauma can be considered during assessments alongside consideration for interventions to enable people to access the most appropriate support for their needs.
Originality/value
Many features of the behaviours of individuals who have experienced early childhood trauma and disrupted or maladaptive attachments, may look similar to the behaviours associated with autism and hence diagnostic assessments of autism need to carefully differentiate traumagenic causes, to either dual diagnose (if both are present) or exclude autism, if it is not present. This has for long been recognised in child and adolescent autism specialist services but is less well developed in adult autism specialist services.
Zainab Al-Attar and Rachel Worthington
Clinically, it is often observed that autistic people may have a heightened need for rules and may find rule violations very distressing. It is clinically plausible that autistic…
Abstract
Purpose
Clinically, it is often observed that autistic people may have a heightened need for rules and may find rule violations very distressing. It is clinically plausible that autistic individuals may be prone to hyper-morality and greater reactivity and adverse experiences arising from moral threats and violations. Such adverse experiences may, in some instances, lead to moral distress (MD) or in more extreme cases moral injury. Thus, this study aims to examine how MD can operate in the context of autism.
Design/methodology/approach
The authors explore clinical hypotheses on how MD can intersect with different features of autism by drawing on clinical and research knowledge of autism spectrum disorder and how it contextualises experiences of morality.
Findings
Based on a review of the literature and theory, the authors hypothesise that autistic individuals may be more prone to MD where they have a lower threshold for MD. As a result of this lower threshold, they may have more frequent exposure to MD, experience more immediate and intense subjective reactions to moral transgressions, for more protracted periods. Also, they may find it more difficult to over-ride and neutralise moral outrage. As a result, they may be more susceptible to mental health sequelae and impaired social and occupational functioning. Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.
Practical implications
Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.
Originality/value
Understanding MD in an autistic context is important for detecting and treating the adverse impacts of MD on autistic individuals. Importantly, erroneous preconceptions about moral reasoning in autism need to be mitigated to fully understand the moral experiences and harness the many strengths of people with autism.
Details
Keywords
Lino Faccini and Clare S. Allely
The prevalence of individuals with an autism spectrum disorder (ASD) being associated with terroristic threats, lone wolf terrorism or affiliating with terroristic groups is rare…
Abstract
Purpose
The prevalence of individuals with an autism spectrum disorder (ASD) being associated with terroristic threats, lone wolf terrorism or affiliating with terroristic groups is rare. This paper aims to discuss this issue.
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. 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.