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Many patients in residential and secure settings have no formal diagnosis of Autism but may in fact be on the spectrum. This paper seeks to outline the diagnosis and subsequent treatment and intervention planning for a young woman in a low secure hospital.

This paper summarises the literature in relation to the diagnosis of Pathological Demand Avoidance (an atypical presentation of Autism Spectrum Disorder) in children and describes how this diagnosis may present in adults. This search revealed that whilst there was a growing literature around PDA in Children, there was very little literature available about either the clinical presentation or management guidance in adults. A case study design was adopted.

The paper concludes that the lack of an appropriate diagnosis and inappropriate formulation of the underlying causes of challenging behaviour can lead to patients becoming impossible to manage. Many may benefit from diagnosis and Autism‐specific intervention.

This paper highlights the challenges of adult diagnosis of Autism in highly complex individuals and outlines novel approaches to treatment.

The purpose of this paper is to explore the different clinical features of pathological demand avoidance (PDA) and antisocial personality disorder (ASPD) presented in the form of a single case study. The study highlights the potential of misdiagnosis and conceptual confusions to practitioners in forensic settings between the two conditions when working with offenders with personality disorders.

A case formulation using the “five Ps” method based on the personal history of an incarcerated male is presented and the clinical similarities and differences between PDA and ASPD are delineated. These differences and similarities are evaluated and applied to offender management including intervention options.

There are considerable similarities between ASPD and PDA making the two conditions difficult to separate. Both diagnostic criteria identify childhood behavioural problems, aggression, destructiveness, conduct disorder (CD), manipulation and non-compliance as indications of the disorder. For example, the criteria for later adult ASPD are the presence of childhood antisocial behaviour and CD. However, these behaviours may also be suggestive of the attention deficit hyperactivity disorder and non-compliance that are part of PDA. Violent behaviours and aggression can also be perceived in a similar way. Misdiagnosis of PDA as ASPD reduces the efficiency of treatment programmes.

The implications of these findings could prove useful in the successful risk management of offenders with PDA. Given the similar behavioural characteristics between PDA and ASPD, the prevalence of PDA among offenders may be higher than observed. The aim of this study is to raise awareness of potential conceptual complications and clinical confusions between the two conditions with a view to aid offender management through case formulation. A large scale study into offenders with PDA would draw attention to the prevalence of the condition as well as its association with offending behaviour.

This study aims to investigate the influence of social camouflaging on victimisation and offending in relation to autism and pathological demand avoidance (PDA) traits. Camouflaging aims to overcome or conceal difficulties in social and communication skills. Autistic individuals report camouflaging in response to threat and being verbally and physically assaulted when they have not camouflaged. Thus, camouflaging could be associated with victimisation. Camouflaging could also impact on specialist support available to an individual, potentially increasing the risk of victimisation or offending.

Cross-sectional study was conducted using 220 participants from the general population who completed online questionnaires measuring victimisation and offending, autism and PDA traits, camouflaging and symptoms of depression and anxiety.

Correlational analysis found positive associations between camouflaging and victimisation, and camouflaging and lifetime offending. Greater camouflaging and PDA traits predicted greater offending, whereas greater autism traits predicted fewer offending behaviours. While correlated, camouflaging was not significantly predictive of victimisation. Victimisation was predicted by symptoms of depression and PDA traits.

To the best of the authors’ knowledge, this study is the first to consider camouflaging as an influencing factor on offending and victimisation in autistic and PDA individuals.

The purpose of this paper is to examine the prevalence of posttraumatic stress symptoms (PTSS) in adults and children who were exposed to applied behavior analysis (ABA) autism early childhood intervention. Using an online questionnaire to survey autistic adults and caregivers of autistic children, the author collected data from 460 respondents on demographics, intervention types, and current pathological behaviors with symptom severity scales. This study noted PTSS in nearly half of ABA-exposed participants, while non-exposed controls had a 72 percent chance of being asymptomatic. ABA satisfaction ratings for caregivers averaged neutral or mild satisfaction. In contrast, adult satisfaction with ABA was lower on average and also tended to take on either extremely low or extremely high ratings. Exposure to ABA predicted a higher rate and more severe PTSS in participants, but the duration of exposure did not affect satisfaction with the intervention in caregivers.

Participants were recruited for an online survey through social media networks, adult gatherings, social skills groups, and autism support groups nationwide. Adult inclusion criteria consisted of autism – diagnosed or self-diagnosed – and an age of 18 or older. A total of 460 respondents, consisting of autistic adults and caregivers of autistic children, completed an online survey. The caregiver entries (n=217) concerned 79 percent male children, 21 percent female children (male to female 3.80:1), and one MtF transgender child, ages 1-38, with an average age at diagnosis of 4.69 years. The adult entries (n=243) concerned 30 percent males, 55 percent females (male to female 0.55:1), and 14 percent other gender, ages 18-73, with an average age at diagnosis of 25.38 years.

Nearly half (46 percent) of the ABA-exposed respondents met the diagnostic threshold for PTSD, and extreme levels of severity were recorded in 47 percent of the affected subgroup. Respondents of all ages who were exposed to ABA were 86 percent more likely to meet the PTSD criteria than respondents who were not exposed to ABA. Adults and children both had increased chances (41 and 130 percent, respectively) of meeting the PTSD criteria if they were exposed to ABA. Both adults and children without ABA exposure had a 72 percent chance of reporting no PTSS (see Figure 1). At the time of the study, 41 percent of the caregivers reported using ABA-based interventions.

The majority of adult respondents were female, raising questions about the population of online autistic survey respondents. Further, the high numbers of reported gender other than male or female in the adult respondents, as well as at least on MtF child from the caregiver respondents indicates that future studies should consider these intersections. These accompanied significant discrepancies in reporting bias between caregivers and ABA-exposed individuals, which highlight the need for the inclusion of the adult autistic voice in future intervention design. Based on the findings, the author predicts that nearly half of ABA-exposed autistic children will be expected to meet the PTSD criteria four weeks after commencing the intervention; if ABA intervention persists, there will tend to be an increase in parent satisfaction despite no decrease in PTSS severity.

The purpose of this paper is to introduce a contextualistic account of antisocial responding, with the addition of recent developments on the study of personality.

A behavioural and contextualistic view point is developed to account for antisocial personality and related topics, inasmuch as traditional definitions of antisocial personality disorder as provided on formal diagnostic manuals derive on several and not always coherent classifications of antisocial behaviours. Some of these classifications centre on issues like guilt, impulsivity or aggressiveness for establishing different types of offending and antisocial patterns. This paper focuses on functional personal backgrounds.

A total of five types of “potentiated contingencies” are described as being the main underpinnings involved in antisocial patterns. An analysis of the transformation of aversive functions of antisocial behaviours, leads to specify a distinctive rule-following behaviour that is concerned with that responding. Finally, the exposition of the four verbal clinical contexts that behaviour analysis highlights as taking place at therapeutic settings, serves to propose a fitter contextualistic intervention for antisocial personality patterns.

Novel investigations should contrast the functional classification of antisocial responding. Those studies should experimentally demonstrate the way in which the different instances of transformation of antisocial functions the author has described are prompted.

The analysis also allows for the anticipation of the behaviour of individuals fitting to every category of antisocial avoidance. And as the functional analysis of “antisocial avoidance” uncovers specific relations between environmental stimuli as they are produced and established in the history of interactions of individuals, a more fitting intervention based upon those relations is feasible.

An exhaustive functional taxonomy of antisocial personalities and delinquent behaviours has never been presented before elsewhere. Besides the author reinterprets from a contextualist position traditional empirical studies.

Purpose – This chapter offers an integrative review of psychological and neurobiological differences between younger and older adults that might impact economic behavior. Focusing on key health economic challenges facing the elderly, it offers perspectives on how these psychological and neurobiological factors may influence decision-making over the life course and considers future interdisciplinary research directions.

Methodology/approach – We review relevant literature from three domains that are essential for developing a comprehensive science of decision-making and economic behavior in aging (psychology, neuroscience, and economics), consider implications for prescription drug coverage and long-term care (LTC) insurance, and highlight future research directions.

Findings – Older adults face many complex economic decisions that directly affect their health and well-being, including LTC insurance, prescription drug plans, and end of life care. Economic research suggests that many older Americans are not making cost-effective and economically rational decisions. While economic models provide insight into some of the financial incentives associated with these decisions, they typically do not consider the roles of cognition and affect in decision-making. Research has established that older age is associated with predictable declines in many cognitive functions and evidence is accumulating that distinct social motives and affect-processing profiles emerge in older age. It is unknown how these age differences impact the economic behaviors of older people and implies opportunities for path-breaking interdisciplinary research.

Originality/value of the chapter – Our chapter looks to develop interdisciplinary research to better understand the causes and consequences of age-related changes in economic decision-making and guide interventions to improve public programs and overall social welfare.

In this study, we aimed at examining the unique and interactive effects of peer violence in cyberspace on adolescents’ emotion regulation and socioemotional adjustment, as well as the mediational role of resilience in the link between adolescent’s pathogenic relational experiences and behavioral outcomes. Specifically, we intended to explore emotion differentiation and regulation in reaction to bullying perpetration and victimization and in terms of positive (proud, confident, good) and negative (ashamed, excited, guilty), Passive (sad, embarrassed, humiliated) and Reactive (angry, scared) emotions and how it impacted and predicted positive and negative outcomes.

A stratified convenient sample of 494 Italian students aged 13–19 years (M = 15.27, SD = 1.23) was selected to represent all different school types in Italy and the students were administered a self-report questionnaire on school bullying involvement. General Linear Models, ANOVA, and T-tests were employed to explore gender differences, the relationships between variables, and their contribution to the predictive model. A two-step Cluster analysis was used to profile adolescents based on patterns of resilience, health outcomes, and cyberbullying involvement.

Results showed significant gender differences, with females using internet and Facebook more than males and being more resilient, positive, and prosocial, but also responding to victimization with higher levels of alienation, anger, humiliation, and psychosomatic and emotional symptoms. Males perpetrated peer violence more than females, were less likely to be victimized, and were generally less emotionally impacted by it. Victimization rates (63.7%, n = 296) were higher than perpetration rates (51.7%, n = 233) and bully-victimization was prevalent (47.1%). Victims prevalently experienced passive emotions (sadness, humiliation, embarrassment) while perpetrators experienced negative ones (guilt and shame). Cluster analysis evidenced different pathways and trajectories of resilience and cyberbullying involvement: Resilient victims (RV), Healthy uninvolved (HU), Healthy Bullies (HB), Alienated Bully-Victims (ABV), and Resilient Bully-Victims (RBV). RV, HU, and HB resulted all well-adjusted, despite the different involvement in cyberbullying, and also RBV and despite the double involvement in cyberbullying, ABV were the only maladjusted and at-risk group in our sample characterized by very low Positivity, very low Resilience, and extremely high Alienation.

This study proposes a comprehensive, developmental, ecological, relational, and self-regulatory resilience approach to cyberbullying, which represents an innovative and advanced contribution to the literature with significant implication for research and practice. Fully understanding and measuring the emotional impact of cyber peer violence and resilience following cyberbullying victimization and perpetration can help in developing targeted interventions for both victims and bullies. This study highlighted the need for a self-regulatory model of resilience for modulating emotions, arousal, and behaviors across contexts, relationships, and difficulties. It also evidenced that moderate levels of resilience and positivity are sufficient to buffer youth from involvement in cyberbullying and to predict healthy adjustment and less pathological outcomes.

By profiling adolescents based on resilience levels, health outcomes, and cyberbullying involvement, we evidenced five distinct trajectories of risk evaluation for cyberbullying beyond participating roles. Our results confirmed the fundamental importance of assessing resilience and emotion regulatory resources together with peer violence involvement in identifying and targeting adolescents at risk.

Psychological research on fire has focussed primarily on its misuse in the form of arson and firesetting, which reflects a tradition in forensic psychology for focussing on risk and pathological behaviour. However, this is inconsistent with the strengths-based approach because it fails to account for positive aspects of fire and law-abiding/ healthy interactions with fire. This study aims to explore the psychology of non-criminalised forms of fire use. It is predicated on a novel, dimensional, conceptualisation of fire-related behaviour – the continuum of fire use (CoFU; Horsley, 2020, 2021).

Semi-structured interviews were conducted with 12 adults who use fire in law-abiding forms. Data were analysed using techniques informed by grounded theory. Steps were taken to ensure reliability and validity, including a Cohen’s Kappa calculation, which indicated an agreement level of 0.8 between two raters.

Four core themes were identified relating to the benefits of fire on psychological well-being, namely, immediate gratification; hope and empowerment; self-concept and emotional security.

Drawing on findings from this study, a theoretical framework of the psychology of non-criminalised fire use is presented. This is a preliminary conceptualisation and more work is needed to address this under-researched topic.

The findings can inform the work of forensic practitioners. They highlight the importance of considering service users' positive interactions with fire, alongside maladaptive/ criminal use. This has implications for the assessment of fire setters, as well as rehabilitative approaches.

It is argued in this paper that a society-wide approach is key to firesetting reduction. More specifically, findings can inform the development and refinement of early intervention programmes, which focus on supporting young people to develop a healthy relationship with fire.

To the best of the authors’ knowledge, this study is the first to explore the psychology of non-criminalised forms of fire use. It is predicated on a novel, dimensional, conceptualisation of fire-related behaviour – the continuum of fire use (CoFU; Horsley, 2020, 2021a, 2021b).