A systematic PRISMA review of individuals with autism spectrum disorder in secure psychiatric care: prevalence, treatment, risk assessment and other clinical considerations

Allely, Clare S.

doi:10.1108/jcp-06-2017-0028

Cited by 20 publications

(15 citation statements)

References 131 publications

(256 reference statements)

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“…Recent results of a pilot study with the “Framework to Aid Risk Assessment with Offenders on the Autistic Spectrum” (FARAS) are promising, indicating that this tool might enhance risk assessment with autistic offenders (Al-Attar, 2019). Also, previous studies suggest an association between aggressive behavior of people with ASD and other factors that might be relevant such as social cognition deficits, cognitive and sensory impairments, deficient empathy and emotion regulation problems (Allely, 2018; Gunasekaran, 2012; Im, 2016). More specifically, Alexander et al (2016) suggested an ASD typology defined by the presence or absence of psychosis, the presence or absence of psychopathic personality traits and the severity of behavior.…”

Section: Discussionmentioning

confidence: 99%

Inpatient aggression in forensic psychiatric patients with autism spectrum disorder: the role of risk and protective factors

Bosch

Chakhssi

Hummelen

2020

JIDOB

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Purpose Patients with autism spectrum disorder (ASD) are overrepresented in forensic samples. However, research on risk assessment in forensic patients with ASD is scarce. The purpose of this paper was to examine the prevalence of short-term inpatient aggression and explore the risk and protective factors for aggression in forensic psychiatric patients 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 examined in a Dutch forensic psychiatric hospital. Findings Results showed no significant association between HKT-R and SAPROF and incidents of physical aggression. This suggests that the commonly used assessment instruments may be of limited use for assessing the risk of short-term inpatient aggression in patients with ASD. Research limitations/implications Limitations to the current study include the relatively small sample size and the lack of information on index offenses. Further research with a larger, more homogeneous sample and longer follow-up is indicated to confirm the results of this study. Future research should also include the possible association between aggressive behavior of people with ASD and other factors that might be relevant, such as social cognition deficits, cognitive and sensory impairments, deficient empathy and emotion regulation problems. Originality/value To the authors’ knowledge, this is the first study to directly examine the prevalence of inpatient aggression of forensic psychiatric patients with ASD and its association with risk and protective factors.

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Section: Discussionmentioning

confidence: 99%

Inpatient aggression in forensic psychiatric patients with autism spectrum disorder: the role of risk and protective factors

Bosch

Chakhssi

Hummelen

2020

JIDOB

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“…ASD in secure psychiatric care Allely (2018) completed a literature review of ASD in low, medium and high secure psychiatric care (HSPC). Although a number of issues were raised such as a general over prevalence of ASD in such environments, these were in the context of a limited number of published studies.…”

Section: Asd In the Prison Environmentmentioning

confidence: 99%

“…Five areas of research are described reflecting the topics addressed to date including: the prevalence of ASD within HSPC; a discussion of the findings examining what cognitive and clinical differences have been found between individuals with an ASD and other patient groups; a discussion of the views of staff who work in HSPC of individuals with an ASD; a discussion of the experiences and quality of life of individuals with an ASD in HSPC, some discussion of how individuals engage with psychological interventions and the role of ASD awareness training. Although the review by Allely (2018) included studies investigating ASD within HSPC, the present review builds on this previous review by providing an experienced clinician's perspective and analysis of the findings and issues raised in the papers which investigated ASD in relation to specifically HSPC. In addition, the review concludes with a personal reflection on possible future research targets and the development of an HSPC clinical service for ASD.…”

Section: Present Reviewmentioning

confidence: 99%

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

Murphy

Allely

2019

AIA

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Purpose The purpose of this paper is to review available literature targeting the assessment and management of individuals with an autism spectrum disorder (ASD) admitted to high secure psychiatric care (HSPC). Key areas of examination include the prevalence of ASD in HSPC, how individuals with an ASD differ from other patient groups in clinical and cognitive characteristics, the views of staff regarding patients with an ASD, an exploration of the experiences and quality of life of patients with an ASD, as well as treatment and interventions. Design/methodology/approach A review of the published literature. Findings Although individuals with an ASD comprise a relatively small proportion of the total HSPC cohort, they appear to be over represented relative to the general population prevalence. Several research projects suggest that individuals with an ASD present with difficulties and needs different to other patient groups, as well as being viewed by staff as potentially vulnerable and requiring a different care approach. Individuals with an ASD report both positive and negative aspects to life in HSPC. Practical implications Suggestions are made with regard to how individuals with an ASD might be better managed in HSPC. Following the spirit of various pieces of government legislation such as the Autism Act (2009) and the Equalities Act (2010) the role of a specialist ASD HSPC service is proposed. Originality/value This paper provides a detailed review of the research to date exploring the assessment and management of individuals with an ASD detained in HSPC. It outlines key research findings, highlights limitations with it and provides a personal perspective on future research and clinical targets.

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“…The paper further allows for exploration of possible ambiguities in the diagnostic assessment of ASDs. Women in secure and forensic hospital settings are significantly restricted in terms of autonomy and opportunity to maintain or develop a positive sense of self-concept (Allely, 2018). How such conditions may compromise their presentation and (potentially) lead to an incorrect mis-diagnosis of ASD are considered.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of ASD in women in secure and forensic hospitals

Markham

2019

AIA

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Purpose The purpose of this paper is to explore the experience and possibilities for misdiagnosis of women with ASD in secure and forensic hospitals, via the medium of a lived experience case study. To consider the clinical value of the patient perspective of and insight into their disorder. The case study is supplemented by relevant associations to the MHA Code of Practice, the CQC report, Monitoring the Mental Health Act (MHA) 2016–2017, published on 27 February 2018 and current research findings in the fields of service provision, quality of care and treatment of female patients with a diagnosis of ASD. Design/methodology/approach A review and commentary of the author’s lived experience of a formal diagnostic assessment for ASD as a female patient in a secure and forensic hospital. In reviewing aspects of the author’s clinical assessment, the author has made contextual reference to the MHA Code of Practice, the CQC report, Monitoring the MHA 2016–2017, published on 27 February 2018, and current research findings. The account focuses on aspects of the author’s recent experience assessment and treatment for ASD which the author believes may be of use in informing clinical practice. Findings Open-ended exploration of a lived experience account/case study of a diagnostic assessment of an adult female patient for ASD, demonstrating the possible ambiguity of responses to questionnaire-based assessment tools and other deficiencies inherent to the assessment process and care and treatment of adult female ASD sufferers in secure and forensic hospitals. Research limitations/implications The author uses the lived experience as a patient to review and provide commentary on the clinical assessment for ASD. This review is, therefore, informed by an authentic patient perspective and not clinical perspectives. This paper highlights the need for further research into the diagnostic assessment of females for ASD in a secure and forensic hospitals. Practical implications First, to encourage practitioners to extend their range of thinking to be more inclusive of the patient perspective when performing a diagnostic assessment. Second, to increase practitioner awareness of the deficiencies in the current service provision for adult female patients diagnosed with ASD in secure and forensic hospitals. Social implications To improve patient experience of diagnostic assessment for ASD and the quality of the assessment and patient outcomes in secure and forensic hospitals. Originality/value The paper is original in concept in that it considers the inclusion of patient experience/views in assessment and formulation and links them to wider social policy and practice guidance. The case study is an authentic patient account informed by the author’s experience of secure and forensic psychiatric hospitals. The value of the paper may be determined by the extent to which the paper encourages practitioners to consider the patient perspective and experience of the diagnostic assessment and how this and subsequent care and treatment may affect the adult female patient in secure and forensic hospitals.

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A systematic PRISMA review of individuals with autism spectrum disorder in secure psychiatric care: prevalence, treatment, risk assessment and other clinical considerations

Cited by 20 publications

References 131 publications

Inpatient aggression in forensic psychiatric patients with autism spectrum disorder: the role of risk and protective factors

Inpatient aggression in forensic psychiatric patients with autism spectrum disorder: the role of risk and protective factors

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

Diagnosis and treatment of ASD in women in secure and forensic hospitals

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