ASD and Psychopathy: Clinical and Criminal Justice Considerations

Zoltan BokaIRB and Bioethics Director

Lehman CollegeJanuary 2016

The beginning of Asperger's

Asperger’s insight Asperger (1944) was the first person known to have

described the symptoms of Asperger's disease.

He referred to boys, in whom he diagnosed “autistic psychopathy”.

The symptoms, as per Asperger included “a lack of

empathy, little ability to form friendships, one-sided conversation, intense absorption in a special interest, and clumsy movements.”

Asperger was convinced that these boys were not deviant but that they had special gifts which would emerge in adulthood.

An example of early Asperger’s

One of Asperger’s early patients in Vienna was Gottfried K.

Gottfried was nine years old

He cried at the smallest change in routine

He also failed an IQ test because when asked to name similarities between objects (e.g. a chair or a ladder), he would name differences instead since he thought the differences to be more important.

Vienna 1943-44 By the time Asperger submitted his paper diagnosing

these children, Vienna’s medical community was obsessed with eugenics and sterilization.

In Germany in 1934, 62,400 people with schizophrenia, epilepsy, inherited blindness and other conditions viewed as human imperfections were brought to the newly formed Genetic Health Court and were given forced sterilizations.

Given the foregoing, Asperger’s desire to broaden the definition of “normal” can be seen as both a medical and a political act.

Autism and Psychopathic Behavior

Fitzgerald (2011) suggested that autistic psychopathy and Asperger’s syndrome are one and the same and implied that individuals on the autism spectrum are likely to exhibit  psychopathic behavior and commit antisocial criminal activities.

We (Boka and Leibman 2015) expand upon and revise Fitzgerald (2011) thesis to assert that individuals with ASD do not  perform acts with the same malice, intent, and deception as psychopaths

Central Fitzgerald Thesis Fitzgerald (2011) argued that “Hans

Asperger’s autistic psychopathy be retained for persons with autism who engage in serious criminal activity” (p. 301).

Flaws in Fitzgerald Fitzgerald does not describe “serious criminal

activity”.

Fitzgerald does not distinguish between psychopathic and autistic individuals

Fitzgerald over-relies on points of co-morbidity in these conditions in order to conflate these populations

Fitzgerald does not discuss how patterns of criminal activities differ between these populations

The Asperger Patients Fitzgerald relies heavily on Asperger’s

notes on seven patients where Asperger describes them as autistic psychopaths

However, Miller and Ozonoff (1997) re-examined these cases and found that each exhibited at least six traits of autism as per the DSM-IV

Intent to Harm One of the distinctions between ASD individuals and

psychopaths is a question of intent

Hippler, Viding, Klicpera and Happe (2010) examined the Asperger patient files (n=46) and found only seven who committed “intentional acts of malice, with malicious pleasure and apparent pride in what they had done.”

This sample is too small for the sweeping Fitzgerald (2011) admonition to “keep dangerousness in mind when assessing persons with autism and Asperger's syndrome.”

Emotion and Engagement It is well known that individuals on the ASD spectrum have difficulty with

forming and sustaining relationships

However, this is not due to intentional callousness. As early as 1971, van Krevelen described patients who were desperate to engage.

By contrast, psychopaths can be very charming and bond without feeling a bond.

Jack Abbott, a famous NYC murderer said of friendships “I can imagineI feel these emotions but I do not.”

This distinction is further supported by Lockwood, Bird, Bridge, and Viding (2013), who studied one hundred and ten adults and note that “psychopathy appears characterized by problems with resonating with others’ emotions,” while “ASD appears characterized by problems with cognitive perspective-taking.”

Malice In describing autistic psychopaths, Fitzgerald

(2011, p. 301) cautions that these individuals “show gross lack of empathy, [and] are dangerously perverse.”

As Frith (1991) cautioned, although the Asperger patients were deemed malicious by society, malice was not their intent: rather, these children found emotional states difficult to navigate and wanted to provoke an emotional response that they could feel confident about interpreting.

Intent Farmer and Aman (2011) note the difficulty in assigning intent to the behaviors of those

on the autism spectrum

Farmer and Aman monitored children’s behavior and noted that ASD children were less calculating, more impulsive and more defensive. For example, fourteen percent were willing to insult someone to their face but only five percent did it behind someone’s back

ASD children far outscored their peers with other intellectual developmental disabilities on subscales centering on behaviors that were reactive and impulsive

By contrast, the ASD group scored low on subscales that would indicate malice

Recall that many on the ASD spectrum desire to engage with others whereas psychopathic individuals tend to mimic engagement successfully without being truly engaged.

Asperger’s differentiation between autistic psychopaths, who in his opinion retained the ability (and presumably the desire) to forge genuine interpersonal relationships, and the classical schizophrenic psychotic individuals who lacked this ability (Hippler & Klicpera, 2003) should be retained.

Mindblind One persistent theme is that ASD individuals do not understand that

their acts are inappropriate.

Kibbie (2012) refers to this as mindblindness: a deficiency in understanding another’s mental state

Kibbie described a stockbroker who, when clients started losing money, would refuse to speak to them, lock himself in his office, call them up to scream obscenities and hang up- all actions undertaken to relieve his own stress without understanding how it impacted others.

By contrast, psychopaths are very attuned to the emotional states and needs of others. They have many ways of deceiving their targets including speech: Modulating their voices in order to control and manipulate interactions (Louth, Williamson, Alpert, Pouget & Hare, 1998).

The Lies They Tell Both ASD and psychopathic persons can lie. However,

psychopaths are infinitely better at lying.

This goes back to the issue of perception: Psychopaths are able to emphasize with their victims.

Indeed, for psychopaths, mimicking engagement and empathy are part of the thrill: Some enjoy the moment their victims are made aware of their lack of genuine concern- this becomes part of the thrill for this population (Murphy and Vess, 2003).

By contrast ASD people are usually forthright to the point of rudeness. They have difficulty lying and difficulty sensing when they are lied to. These are facets of mindblindness.

ASD and Criminality Men are five times likelier to be

diagnosed with autism and fifteen times more likely to be caught up in the criminal justice system. Women are incarcerated at a rate of 58:100,000, men at 896:100,000. (Covington and Bloom 2003).

Mens Rea Mens Rea is the term for the intent to

commit a crime. It is translated as having a “guilty mind.”

ASD and Engagement with the Justice System

Murie et al. (2002) evaluated six case studies from a forensic setting, identifying a number of other dynamics that significantly influenced the commission of unlawful acts by individuals with Asperger’s syndrome, as well as their convictions for the acts.

Among these dynamics were deficits in identifying with others’ feelings, inexperience in interpreting interpersonal cues, frustration with sexual performance, and prompt confessions without forethought to consequences of same.

ASD v. Psychopaths in the Justice System

Although people with ASD may engage in unlawful interactions with others if their routines are interrupted, psychopaths easily change their plans to assure that they have the opportunity to achieve their criminal goals.

Cleckly (1982) and Hare (1999) found that achievement of personal aims was a major factor in psychopaths’ actions (both legal and illegal).

In contrast, individuals with ASD may be both reactive to a large extent as well as proactive. Accordingly, the psychopath will commit crimes to further his/her goals, whereas the person with ASD often reacts to a situation that upsets them or that they do not understand.

The results of their actions may be viewed as psychopathic: This is why intent and motive are crucial to understand.

Conclusions We argue that the key point differentiating criminal acts by

psychopaths and individuals on the autism spectrum is that of intent.

We also posit that some crimes committed by those on the autism spectrum could be prevented through the provision of proper treatment.

Lack of familiarity with autism spectrum disorders has led judges and others to treat ASD-afflicted individuals with a harshness typically reserved for the most remorseless of recidivists.

Articles like Fitzgerald’s (2011) encourage this trend without educating individuals about the ingrained distinctions between individuals on the autism spectrum and individuals with psychopathic features.

Selected Sources: Asperger H. (1944). Die ‘autistischen Psychopathen’ im Kindesalter. Archive fur Psychiatrie und

Nervenkrakheiten117, 76-136.

Boka Z. And Leibman F. (2015). Autism spectrum disorders and psychopathy: Clinical and criminal justice considerations. Journal of Cognitive Science 16(1), 17-40.

Farmer C.A. & Aman M.G. (2011). Aggressive behavior in a sample of children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1),317-323.

Fitzgerald M. (2011) Necrophilia and autistic psychopathy. Clinical Neuropsychiatry 8(5), 301-302.

Kibbie K.S. (2012). Maleficent or mindblind: Questioning the role of Asperger’s in quant hedge fund malfeasance and modeling disasters. American Criminal Law Review, 49(2), 367-402.

van Krevelen A. (1971). Early infantile autism and autistic psychopathy. Journal of Autism and Developmental Disorders 1(1), 82-86,

Lockwood, P. L., Bird, G., Bridge, M., & Viding, E. (2013). Dissecting empathy: High levels of psychopathic and autistic traits are characterized by difficulties in different social information processing domains. Frontiers in human neuroscience, 7.

Miller J.N. & Ozonoff S. (1997). Did Asperger’s cases have Asperger disorder? Aresearch note. Journal of Child Psychology and Psychiatry, 38(2), 247-251.