Autistic individuals without intellectual disabilities are sometimes not diagnosed until adolescence/adulthood. Due to increased risk of co-occurring mental health problems, these individuals may initially be referred to general, mental health services and not always be identified as autistic; some may be misdiagnosed with personality disorder (PD) prior to identification of autism. To explore possible mechanisms in misdiagnosis of autism, we report on the case of a young man with severe, non-suicidal self-injury (NSSI) and attention deficit disorder (ADD) who had been diagnosed with and treated for borderline PD prior to being diagnosed with autism. Following reassessment by mental health clinicians with experience of working with autistic individuals, the patient was diagnosed with autism, ADD, and depression—but not PD. Experiences from this case suggest that presence of co-occurring NSSI, depression, and ADD, as well as lack of comprehensive assessment and lack of autism knowledge in general mental health services, may contribute to risk that autism is misdiagnosed as PD. These findings highlight the need for autism expertise in general mental health services to facilitate appropriate diagnosis for autistic individuals who encounter these services, as well as the importance of undertaking comprehensive assessments.
Defense lawyers (n = 51) and psychologists (n = 49) with experience in court cases involving child witnesses were surveyed on their beliefs about young child witnesses, defined as children in the age range of 3-6 years. The survey included 13 questions probing the reliability of testimony of young child witnesses and eight questions regarding factors influencing professional judgments of young child witnesses' credibility. Results indicated that both professional groups had fairly balanced opinions of child witnesses, with their opinions in general agreement with current research literature, although defense lawyers were somewhat more skeptical than psychologists were. However, considerable intra-sample variation existed on most items, with a minority of participants expressing opinions that were somewhat at odds with current child witness research. Results are discussed in the context of child maltreatment, the rule of law, and children's rights to safety and security.
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