Elsevier

Aggression and Violent Behavior

Volume 14, Issue 5, September–October 2009, Pages 306-312
Aggression and Violent Behavior

Risk and dynamics of violence in Asperger's syndrome: A systematic review of the literature

https://doi.org/10.1016/j.avb.2009.04.003Get rights and content

Abstract

The main purpose of this article is to delineate findings from a review of the literature on the empirical basis for the existence of a relationship between Asperger's syndrome (AS) and violence risk. A second aim is to examine whether certain characteristics of the disorder may have a higher violence-triggering potential. Results of this review show that there are very few empirical studies that confirm a stable link between AS and violence. Only 11 studies involving 22 patients and 29 violent incidents met the criteria for inclusion in the review after the search of the literature. However, a qualitative analysis of the studies yielded some indications of possible patterns of dynamics of violence that may prove to be typical of persons with AS. A tentative comparison of AS and psychopathy indicated that there may be qualitative differences in the characteristics of violent behavior between the disorders. Suggestions for further research are presented.

Section snippets

Some clinical features associated with Asperger's syndrome

Despite some differences in diagnostic criteria, sustained impairments in social interaction and restricted repetitive patterns of behavior are common criteria in the DSM and ICD systems. Paradoxically, even if AS is a neurodevelopmental disturbance already present in early childhood, most of its clinical expressions and the significant impairment it causes tend not to be manifested until late puberty and early adulthood. It has been suggested that this may explain the relatively late diagnosis

Asperger's syndrome and violence

In a review of the literature, Fombonne and Tidmarsh (2003) found only one epidemiologic study that investigated AS alone and six studies that provided specific estimates for the prevalence of the disorder, together with estimates of other subtypes of pervasive developmental disorders. The prevalence rates reported in these studies ranged from 0.3 to 48.4 per 10,000. The authors concluded that the reviewed studies were flawed by methodological problems, and that further research was needed to

Data collection

Two searches were conducted on the possible relationship between Asperger's syndrome and violence in the anglophonic literature. Studies were obtained through electronic data searches on CINAHL (1982 to medio February 2007), Cochrane Reviews (1992 to medio February 2007), Medline (1966 to medio February 2007), ProQuest (1992 to medio February 2007), PsycInfo (1967 to medio February 2007), and ScienceDirect (1995 to medio February 2007). The search terms for the first search were review of and

Is there an empirical basis for the existence of a relationship between Asperger's syndrome and violence risk?

Of the 11 studies, only 5 accentuated the link between AS and violence as an explicit research aim in the title, the abstract, and the introduction. England was the country of origin for five studies and Israel, for two. The remaining four studies came from Austria, USA, Australia/New Zealand, and Italy. The oldest article was published in 1985, and the most recent, in 2006.

Main findings

The main finding of this review was that despite anecdotal reports of increased violence risk in people with AS, little systematic research about its frequency and character has been published. That being the case, the review suggests that (a) there is no empirical evidence to support a claim that there is a link between Asperger's syndrome and violence, and, at the same time, (b) because of the paucity of studies on this issue, there is no evidence to preclude the claim that there is an

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    I thank Ingrid Astrup for assistance with the literature search.

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