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1 – 7 of 7Esther Skelhorn, Alessandra Girardi and Sam Cooper-Evans
Some individuals with autism may engage in violent behaviour. Research into autism specific factors (ASFs) that may contribute to violence is limited. The purpose of this paper is…
Abstract
Purpose
Some individuals with autism may engage in violent behaviour. Research into autism specific factors (ASFs) that may contribute to violence is limited. The purpose of this paper is to explore the feasibility of use of an ASF framework which was developed to inform risk formulation and treatment needs.
Design/methodology/approach
Retrospective identification and evaluation of ASFs in offenders with autism (N = 13) at childhood, time of index offence and in current risk behaviours. The ASFs described in the framework were repetitive behaviours and circumscribed interests; poor social understanding and empathy; sensitivity to sensory stimulation; and disruption to rigid behavioural routines or difficulties coping with change.
Findings
There was evidence for all four ASFs being consistently present in childhood, contributing to violent behaviour at the index offence and current risk behaviours in at least one case. Poor social understanding and empathy was often present at both childhood and index offence in all cases. Of the seven cases with offence paralleling behaviour, five had at least one ASF present at each timepoint.
Practical implications
This proof-of-concept study provides initial support that ASFs play a role in offending behaviour of individuals with autism. Clinicians working in specialist and generic forensic services, with an in-depth knowledge of autism, could use the ASF framework to enhance risk assessments and facilitate more targeted treatment planning for offenders with autism in specialist and general forensic services.
Originality/value
To the best of the authors’ knowledge, this study is the first to test the application of the ASF framework in an autistic offending population.
Ryan Little, Peter Ford and Alessandra Girardi
Understanding the psychological risk factors in radicalisation and terrorism is typically limited by both a lack of access to individuals who carry out the acts and those who are…
Abstract
Purpose
Understanding the psychological risk factors in radicalisation and terrorism is typically limited by both a lack of access to individuals who carry out the acts and those who are willing to engage in research on the matter. The purpose of this study is to describe the process of self-radicalisation of an otherwise law-abiding individual who engaged in single-actor terrorism activities.
Design/methodology/approach
A single case study, based on clinical interviews and psychometric testing, of an individual with autism who engaged in multiple acts of terrorism through online activity. The case is presented within existing frameworks of radicalisation, and describes how it developed along the steps described in the path to intended violence.
Findings
A number of variables are identified as contributing towards the individual’s vulnerability to radicalisation, such as deficits in higher order cognition, psychopathology, autism spectrum disorder traits, personal interests, social isolation and life stressors.
Originality/value
Unique to this study is how the process of radicalisation and the possibility to carry out the individual’s attacks was made possible only through the use of internet technology.
Details
Keywords
Alessandra Girardi, Elanor Webb, Inga Stewart, Simon Stokes and Kieran Breen
The development and clinical application of digital devices to support individuals with dementia can be challenging due to difficulties meeting the needs of a patient population…
Abstract
Purpose
The development and clinical application of digital devices to support individuals with dementia can be challenging due to difficulties meeting the needs of a patient population with largely heterogeneous and progressive symptoms. Memjo Ltd has developed a digital interactive prototype tablet to promote cognitive stimulation and reminiscence. This proof-of-concept case-study aims to understand whether the engagement of individuals with dementia and Huntington's disease (HD) at an early stage is a useful approach to inform the initial development of meaningful digital activities and ultimately its potential introduction into clinical practice.
Design/methodology/approach
Five patients with dementia and HD at different stages of progression were recruited from an inpatient secure psychiatric hospital. Engagement, usability and preliminary benefits were assessed using a mixed-methods approach through observations, open-ended questions and subjective ratings.
Findings
The content of the tool triggered reminiscence, discussion and positive behavioural and emotional responses. The participants were confident using the tablet but needed support interacting with the touchscreen and, at times, to encourage communication. “Music” and “Videos”, were particularly successful in engaging most participants despite their cognitive and physical difficulties.
Originality/value
This case-study shows that co-production in clinical practice can be successfully implemented to develop activities that meet the interests and needs of patients with dementia and Huntington's disease. The varied and flexible assessment provided rich feedback that will be used to improve the device. This highlights avenues of focus for the development of future pools of activities.
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Alessandra Girardi, Elanor Lucy Webb and Ashimesh Roychowdhury
Self-harm is a cause of concern for health-care professionals. The Short-Term Assessment of Risk and Treatability (START) is a short-term assessment instrument used to rate the…
Abstract
Purpose
Self-harm is a cause of concern for health-care professionals. The Short-Term Assessment of Risk and Treatability (START) is a short-term assessment instrument used to rate the likelihood of risk behaviours, including self-harm. As result of the assessment, interventions that are implemented to reduce the risk of self-harm may reduce the strength of the predictive validity of a risk assessment tool. The aim of this study was explore the impact of risk management interventions on the capacity of START to predict self-harm. It was predicted that the interventions would weaken the ability of START to predict self-harm in patients who received the intervention.
Design/methodology/approach
Secondary analysis of routinely collected data in a large sample of women in an inpatient secure care setting. Demographic and clinical information, self-harm episodes, safety management interventions and START assessments were extracted and used to build an anonymous database.
Findings
START significantly predicted self-harm in those with and without the safety management intervention. However, the strength of the predictive validity was smaller in those who received the intervention compared to those without.
Practical implications
The results suggest that the implementation of safety management interventions needs to be taken into account when assessing future risk of self-harm.
Originality/value
To the best of the authors’ knowledge, this is the first study to explore the impact of safety management interventions on the predictive validity of START in a large sample of women.
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Keywords
Alessandra Girardi, Lorraine Higham, Sarrah Fatima, Elanor Webb, Pieter Snyman, Paul Wallang and Kieran C. Breen
Social avoidance disorders can be disruptive to the individual as they begin to over-manage their lives, at times avoiding social and work commitments. A potential therapeutic…
Abstract
Purpose
Social avoidance disorders can be disruptive to the individual as they begin to over-manage their lives, at times avoiding social and work commitments. A potential therapeutic approach is exposure therapy and a virtual reality (VR) treatment approach, gameChange VR, has been developed. This provides an opportunity to test their fears in virtual environments. This study aims to investigate the feasibility of using this VR approach to treat people with social avoidance problems within a secure mental health setting.
Design/methodology/approach
Nine participants completed the gameChange VR sessions. Participants received 30-minute VR sessions for up to six weeks using selected scenarios at five levels of difficulty. Patients’ comments and behaviours were noted and clinical staff also provided feedback on their observations of patients’ use and experience with VR.
Findings
Overall, patients felt that the gameChange VR helped them to build their confidence and reduce their overall anxiety as they became more comfortable with the equipment. Both patients and staff generally found the intervention easy to use and the staff reported an overall high level of engagement among the participants. The key issues raised largely related to technical and safety issues.
Originality/value
While a previous study was carried out using gameChange VR with an outpatient cohort, this was the first using an inpatient group in a secure mental health setting. It has demonstrated that the intervention is viable in this setting, although further studies are required to identify the specific patient population that would benefit optimally from the therapy.
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Lorraine Higham, Alessandra Girardi and Holly Victoria Edwards
Autism-specific characteristics have been associated with internet criminal activities. Internet and non-internet offenders differ on a series of demographic, psychological and…
Abstract
Purpose
Autism-specific characteristics have been associated with internet criminal activities. Internet and non-internet offenders differ on a series of demographic, psychological and offending variables. However, the clinical and criminal presentation of individuals with autism spectrum disorder (ASD) in forensic secure care settings has been underexplored. This paper aims to explore the profiles of internet offenders with ASD admitted to a secure psychiatric unit.
Design/methodology/approach
This study provides the results of a service evaluation of individuals with ASD. The demographic, clinical and criminal characteristics of a small sample of internet offenders with ASD admitted to secure care are described and discussed.
Findings
Internet offenders present in secure care with high rates of comorbid disorders, histories of violence and traumatic experiences, mood disorders and difficulties with relationships. Of the 24 internet offenders discussed, 18 of them committed an offence of a sexual nature involving children.
Originality/value
This paper highlights the potential risks for individuals with ASD in using the internet and the possible difficulties associated with detecting this because of rapid advancements in technology.
Details