Autism Spectrum Disorders in high secure psychiatric care : a review of literature, future research and clinical directions

Murphy, D; Allely, CS

Abstract

Autism spectrum disorder (ASD) refers to a group of neurodevelopmental disorders including
Autism, high functioning autism, Asperger’s syndrome and atypical autism. Although
different diagnostic classification systems have been adopted over the years, contemporary
criteria follow those set out in the Diagnostic and Statistical Manual of Mental Diseases
version five - DSM 5 by the American Psychiatric Association (APA, 2013) and the
International Classification of Diseases eleventh edition by the World Health Organisation –
ICD 11 (WHO, 2018) that group all under the single category of Autism Spectrum Disorders.
Prevalence studies suggest that ASD is not rare with approximately one in a hundred
individuals in the general population (Baird, Simonoff, Pickles, Chandler, Loucas et al.
2006). Although males are more likely to receive the diagnosis of an ASD (Brugha,
McManus, Bankart, Scott, Purdon et al., 2011; Loomes, Hull, & Mandy, 2017), it is likely
that the prevalence rate among women is significantly underestimated (Beggiato, Peyre,
Maruani, Scheid, Rastam et al. 2016) and with the reasons poorly understood (Adamou,
Johnson, & Alty, 2018). Additional studies also suggest that the skewed male / female ratio is
unevenly distributed across the spectrum (Kikovski et al. 2013) and may actually decrease as
the symptom severity of ASD increases (Werling & Geschwind, 2013). Having an ASD is
also considered to be life-long. Whilst the causation behind having an ASD remains unknown, likely explanations include genetic / environmental interactions (Chaste &
Leboyer, 2012) resulting in atypical brain maturation and a disconnection between key brain
regions (Ecker, 2016). It is also common for individuals with an ASD to have other
neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD)
(Matson, Rieske & Williams, 2013; Taylor, Charman, & Ronald, 2015; Antshel, Zhang-
James, Wagner, Ledesma, & Faraone, 2016) and intellectual difficulties (Matson &
Shoemaker, 2009), neurological issues such as epilepsy (Brookes-Kayal, 2010) and sensory
difficulties related to vision and hearing (Kancherla, Naarden Braun & Yeargin-Allsopp,
2013). Co-morbid psychiatric disorder including anxiety, depression, obsessive compulsive
disorder and a psychosis may also be present (Ghaziuddin, Ghaziuddin, & Greden, 2002;
Hammond & Hoffman, 2014; Matson & Williams, 2014; Moss, Howlin, Savage, Bolton, &
Rutter, 2015; Maddox & White, 2015; Bruggink, Huisman, Vuijk, Kraaij, & Garnefski,
2016).

Citation

Murphy, D., & Allely, C. (2020). Autism Spectrum Disorders in high secure psychiatric care : a review of literature, future research and clinical directions. Advances in Autism, 6(1), 17-34. https://doi.org/10.1108/AIA-10-2018-0044

• Journal Article Type: Article
• Acceptance Date: Dec 13, 2018
• Online Publication Date: Feb 26, 2019
• Publication Date: Jan 6, 2020
• Deposit Date: Dec 14, 2018
• Publicly Available Date: Feb 28, 2019
• Journal: Advances in Autism
• Print ISSN: 2056-3868
• Publisher: Emerald
• Volume: 6
• Issue: 1
• Pages: 17-34
• DOI: https://doi.org/10.1108/AIA-10-2018-0044
• Publisher URL: https://doi.org/10.1108/AIA-10-2018-0044
• Related Public URLs: https://www.emeraldinsight.com/loi/aia