Inpatient aggression in forensic psychiatric patients with autism spectrum disorder: the role of risk and protective factors
| Pages | 93-100 |
| Date | 03 February 2020 |
| DOI | https://doi.org/10.1108/JIDOB-05-2019-0008 |
| Published date | 03 February 2020 |
| Author | Rianne Bosch,Farid Chakhssi,Ko Hummelen |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Offending behaviour,Sociology,Sociology of crime & law,Deviant behaviour,Education,Special education/gifted education,Emotional/behavioural disorders |
Inpatient aggression in forensic psychiatric
patients with autism spectrum disorder:
the role of risk and protective factors
Rianne Bosch, Farid Chakhssi and Ko Hummelen
Abstract
Purpose –Patients with autism spectrum disorder (ASD) are overrepresented in forensic samples.
However, researchon risk assessment in forensic patients with ASDis scarce. The purpose of this paper
was to examine the prevalence of short-term inpatient aggression and explore the risk and protective
factorsfor aggression in forensic psychiatricpatients with ASD (N = 32).
Design/methodology/approach –The association between two commonly used violence risk
assessment instruments (HKT-R and SAPROF) and physical aggression during ten weeks of inpatient
stay was examinedin a Dutch forensic psychiatric hospital.
Findings –Results showed no significant association between HKT-R and SAPROF and incidents of
physical aggression. Thissuggests that the commonly used assessment instruments maybe of limited
use for assessingthe risk of short-term inpatient aggressionin patients with ASD.
Research limitations/implications –Limitationsto the current studyinclude the relatively small sample
size and the lack of information on index offenses. Further research with a larger, more homogeneous
sample and longer follow-upis indicated to confirm the results of this study. Future researchshould also
include the possibleassociation between aggressive behavior of peoplewith ASD and other factors that
might be relevant, such as social cognition deficits, cognitive and sensory impairments, deficient
empathyand emotion regulation problems.
Originality/value –To the authors’knowledge, this is the first study to directly examinethe prevalence of
inpatient aggressionof forensic psychiatric patients with ASD and itsassociation with risk and protective
factors.
Keywords Autism, Aggression, Risk assessment, Autism spectrum disorder, Forensic psychiatry,
Physical aggression
Paper type Research paper
Autism spectrum disorder (ASD) is characterized by social impairments and
restricted, repetitive and stereotyped patterns of behavior, interests and activities
(American Psychiatric Association, 2013). Mostly because of selection bias and the
different types of methodology used (e.g.self-report, observational screening and review of
forensic psychiatric investigations), the variability in reported prevalence rates of ASD in
forensic psychiatric samples ranges from 1.5 to 27 per cent (Im, 2016;King and Murphy,
2014) compared to 0.3 to 1.2 per cent in community samples (Elsabbagh et al.,2012;Lai
et al., 2014). Although some evidence suggested that ASD increases the risk of violent
behavior (Bronsard et al., 2010;Horrigan and Barnhill, 1997), not much is known about the
prevalence of inpatient aggression of forensic psychiatric patients with ASD nor about risk
factors for aggression of these patients(Im, 2016;Murphy, 2013).
Inpatient aggression is shown to be highly prevalent in forensic psychiatric hospitals
(Broderick et al.,2015;Verstegen et al.,2017). To our knowledge, only one study has been
published that addressed the prevalence of inpatient aggression of forensic psychiatric
Rianne Bosch is based at
FPA De Boog, GGNet,
Warnsveld,
The Netherlands.
Farid Chakhssi is based at
Scelta, GGNet, Apeldoorn,
The Netherlands and the
Department of Psychology,
Health and Technology,
University of Twente,
Enschede,
The Netherlands.
Ko Hummelen is based at
FPA De Boog, GGNet,
Warnsveld,
The Netherlands.
Received 12 May 2019
Revised 22 December 2019
Accepted 23 December 2019
DOI 10.1108/JIDOB-05-2019-0008 VOL. 11 NO. 2 2020, pp. 93-100, ©Emerald Publishing Limited, ISSN 2050-8824 jJOURNAL OF INTELLECTUAL DISABILITIES AND OFFENDING BEHAVIOUR jPAGE 93
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