Mass Killers – 2 New Books – Can we identify a mass murderer (e.g. pilot, school shooter etc) in advance?

BTB 2 Young Violent and Dangerous to know

These are extremely rare events and it is almost impossible to predict with any degree of accuracy rare events. Nevertheless, we must try but at the same time realise that many of the individual features of the profile I describe about potential mass killers are not rare in the general population. It’s the more overall picture that is relevant.

We must look at:-

1. Medical history pattern deviating from average medical history pattern of pilots, students, military personnel etc

2. Childhood history of being bullied, being a loner, being very routine bound person with special interests in death, perversions, dead animals, serial killers, mass killing, police work, military activities, horror movies, killing of animals, e.g. cats etc showing callous and unemotional trails, moodiness and showing gross lack of empathy, problems reading other people’s minds emotionally, being excessively controlling and dominating, problems with reciprocal social relationships, having sensory problems, noise, taste, touch, being significantly clumsily, being very unpopular in school but having special talents with numbers, mathematics, technology, engineering, construction and logic.

Other features would include poor eye contact, problems reading non-verbal behaviour, problems sharing emotional thoughts, problems turn taking and being very poor at group games. Many or most readers will dismiss this profile as nonsensical. The only answered to them is to ask them to produce a better alternative approach to the problem. Clearly we have to be extremely careful in labelling people inappropriately. If one is totally anti-labelling or identifying potential mass killers then one has to accept the activity of mass killers.

If one hears of a person who is in an average job and who has never performed above the average or indeed less than the average level and they state they will one day be famous and that “everyone will know my name” and they have the profile outlined above then airline management or schools managers or army commanders should ask some questions and explore the background and motive of this person a little more. If in addition to the above profile already described, a person is depressed, has recently experienced stress at his job, has had personal relationship breakup or conflict with his employers or problems with his work performance, is in a position of major responsibility e.g. airline pilot, then they should be examined further, if they make unusual and bizarre statements which could be taken as a joke if one wasn’t listening carefully.

Another scenario is a pupil (almost always male) with the profile described, who shows strange comments on his social media sites, has been bullied (or is being bullied in school), is depressed, ostracised, can’t relate to girls, is a loner, has had an academic crisis or access to guns at home or elsewhere and makes violent threats, these should be investigated by the health and safety officer in school (who should be responsible for gun attacks in school) in conjunction with the management of the school where a thorough investigation should take place. People like the readership keep Adam Lanza, Harold Shipman and Timothy McVey in mind.

References:

1. ‘Autism and School Shooting’ by Michael Fitzgerald has been published in April 2015 in the book ‘Autism Spectrum Disorders – Recent Advances’ by InTech Publishing in a book edited by Michael Fitzgerald.

2. ‘Young Violent and Dangerous to Know’, a book by Michael Fitzgerald was published by Novinka, New York in 2013 and focuses on mass killers and serial killers.

3. A new book called “Psychopathy” published in 2014, edited by Michael Fitzgerald, published by Nova Science, New York, has a chapter on ‘Criminal Autistic Psychopathy’ by Michael Fitzgerald, a not uncommon diagnosis in mass killers.

New Book on Psychopathy edited by Prof. Michael Fitzgerald

Psychopathy: Risk Factors, Behavioral Symptoms and Treatment Options
Psychopathy: Risk Factors, Behavioral Symptoms and Treatment Options
Click to enlarge
Editors: Michael Fitzgerald (Department of Psychiatry, Trinity College Dublin (TCD), Dublin, Ireland)
Book Description:
Psychopathy is one of the most serious and challenging conditions that society and mental health professionals face. The consequences of the actions of persons with psychopathy on other individuals or society at large are very great. Persons with psychopathy are extremely difficult to treat and indeed some treatments in the past have been shown to cause deterioration affects. This book explores the issue of psychopathy from the point of view of the individual with psychopathy, brain aspects of the condition, cultural aspects, treatment aspects and it’s relation to autism and other empathy disorder which it can on occasion overlap with.
Offenders with high levels of psychopathy are among the most challenging persons mental health professionals have to treat. They need very careful and skilled interventions. Chromis is an innovative programme described by Tew, Bennett and Atkinson which shows promise. It is a future focused programme which pays attention to control and choice, collaboration and transparency and has a cognitive skills component, a motivation and engagement components. Marc Wilson and Samantha Harley have an interesting chapter on narcissism, psychopathy and Machiavellianism. They found a relationship between vertical individualism and all three constructs and between hierarchical and narcissism. Their conclusions suggest that hierarchical, autonomous societies may socialise members in such a way that may foster aversive personalities. Don Ambrose in his chapter on unmeritorious meritorocy focuses on a topic that severely affected almost everyone in the developed world in some way. He highlights the admiration for businessmen with psychopathic traits and the negative consequences of this. In the chapter on criminal autistic psychopathy Fitzgerald highlights the overlap between psychopathy and autism. Hans Asperger in his initial descriptions recognised the overlap between psychopathy and autism with his term autistic psychopathy. This idea faded from view over the last thirty years because there was a wish to separate autism from psychopathy. This wish did not prevent the overlap. Fitzgerald (2010) has introduced the sub group of autism spectrum disorders called criminal autistic psychopathy to cover the section of the spectrum where criminality occurs. It links with the new work on callous and unemotional traits (Fitzgerald 2003) and with mass killings, school and other location shootings where criminal autistic psychopathy is not rare.The chapter on cognitive neuroscience in child and adolescent psychopathy by Halty and Prieto point out among other issues that in the case of children with psychopathic features there is evidence of fewer references to welfare of victims when they have to justify transgressions. The chapter by Halty and Prieto on psychopathy in child and adolescent populations discuss the issue of psychopathy in children and adolescents and the importance of callous and unemotional traits as well as the influence of parenting practices in the development of child and adolescent psychopathy. Laura Nunes’s chapter on psychopathy: risk factors and behavioural symptoms focuses on treatment of options in extremely difficult area and proposes a biogram. In the chapter on Hans Asperger autistic psychopathy revisited focuses on the neglected paper of 1938 long before Leo Kanner wrote his paper on autism. Asperger worked on this topic throughout the 1930′s. It also focuses on the differential diagnosis of autism and schizophrenia, obsessive compulsive disorder and other personality disorders. Ana Calzada and colleagues give us a very important chapter on brain scanning and psychopathy. These neuroanatomic differences in violent individuals are very important in terms of aetiology diagnosis and treatment problems and important areas for future research. (Imprint: Nova)References:
Fitzgerald M. (2003) Callous-Unemotional Traits and Asperger’s Syndrome. Journal of the American Academy of Child and Adolescent Psychiatry 42, 9, 10-11.
Fitzgerald M. (2001) Autistic Psychopathy. Journal of the American Academy of Child and Adolescent Psychiatry 40, 8, 870.
Fitzgerald M. (2010) Young Violent and Dangerous to Know. Nova Science: New York.
Table of Contents:
PrefaceChapter 1. The Treatment of Offenders with High Levels of Psychopathy through Chromis and the Westgate Service: What have we Learned from the Last Eight Years?
(Jenny Tew, A.L. Bennett and R. Akinson, National Offender Management Service, Ministry of Justice, United Kingdom and The Centre for Forensic and Criminological Psychology, The University of Birmingham, Birmingham, England; The Westgate Personality Disorder Treatment Service, HMP Frankland, and National Offender Management Service, Ministry of Justice, UK)Chapter 2. Psychopathy: A Proposal for an Integrated Evaluation
(Laura M. Nunes, Fernando Pessoa University, Oporto / Portugal)Chapter 3. MRI Study in Psychopath and Non-Psychopath Offenders
(Ava Calzada-Reyes, Alfredo Alvarez-Amador, Mitchell Valdes-Sosa, Lester Melic-Garcia, Alonso Y. Aleman and Jose del Carmen Iglesias-Alonso, Department of Clinical Neurophysiology, Institute of Legal Medicine, Independence Avenue, Plaza, Havana City; Cuban Center of Neuroscience, Havana City and Department of Clinical Neurophysiology, Carlos Juan Finlay, General Hospital, Havana, Cuba)Chapter 4. Unmeritorious Meritocracy: The Ascendance of Psychopathic Plutocracy in the Globalized 21st-Century
(Don Ambrose, Rider University in Lawrenceville, New Jersey, US)

Chapter 5. Narcissism, Psychopathy and Machiavellianism: Associations between Cultural Factors and Interpersonal Dominance
(Marc Stewart Wilson and Samantha M. Hartley, School of Psychology, Victoria University of Wellington, New Zealand)

Chapter 6. Hans Asperger’s Autistic Psychopathy: Revisited
(Michael Fitzgerald, Department of Psychiatry, Trinity College Dublin (TCD), Dublin, Ireland)

Chapter 7. Criminal Autistic Psychopathy.
(Michael Fitzgerald, Department of Psychiatry, Trinity College Dublin (TCD), Dublin, Ireland)

Chapter 8. Stability of Psychopathic Traits in Youth: Long-term Trends and Comparisons with the Stability of the Five Factor Model of Personality
(Mary Ann Campbell, Rosemary Beauregard and Fred Schmidt, Psychology Department & Centre for Criminal Justice Studies, University of New Brunswick-Saint John Campus, Saint John, New Brunswick; Children’s Centre Thunder Bay, Thunder Bay, Ontario; Psychology Department, Lakehead University, Thunder Bay, Ontario, and Centre for Criminal Justice Studies, University of New Brunswick-Saint John Campus,
New Brunswick, Canada)

Chapter 9. Disordered Self in Schizophrenia and Autism Spectrum Disorders. The Autisms and the Self.
(Michael Fitzgerald and Victoria Lyons, Department of Psychiatry, Trinity College Dublin (TCD), Dublin, Ireland)

Chapter 10. Exploring Treatment Options for an Allegedly “Untreatable” Disorder, Psychopathy: An Integrative Literature Review
(Chasity Bailey, Rahul Sehgal, Adrian Coscia, Deborah Shelton, University of Connecticut, Center for Correctional Health Networks-CCHNet, School of Nursing, CT, USA, and others)

Index

Series:
Psychiatry – Theory, Applications and Treatments
   Binding: ebook
   Pub. Date: 2014
   Pages: 7×10 – (NBC-C)
   ISBN: 978-1-63463-090-0
   Status: AN

Persons of Genius with High Functioning Autism or Asperger’s syndrome.

There are few conditions that have received as much coverage in the popular press in recent times or have been the subject of as much controversial debate as autism.  Public awareness regarding the condition has grown exponentially but many healthcare professionals may still lack confidence in making the diagnosis of autism according to Dr. Louise Gallagher who has conducted genetic research in autism at Trinity College Dublin.

 

This article aims to give an overview of the disorder of autism staring off with a clinical description and diagnostic criteria.  Theories on causation and a review of the current accepted interventions will also be outlined.

 

It can be associated with ability of genius proportions. Examples include Godel, Hans Christian Andersen, Gregor Mendel, Archimedes, and Charles Lindberg.

 

Autism is very commonly associated with low functioning and Learning Disability.  This is a false conception of the condition.  High Functioning Autism or Asperger’s syndrome can occur in persons with very high I.Q.

 

Clinical Description

 

Autism is a neuro-developmental disorder of childhood that was first described by Leo Kanner.  He described a group of children with impaired language, lack of eye contact, lack of social interaction and repetitive behaviour. In 1944, Hans Asperger published a paper describing a pattern of behaviours in several young boys who had normal intelligence and language development, but who also exhibited autistic-like behaviours and marked deficiencies in social and communication skills.  Asperger’s syndrome went largely unrecognised until the 1980s. Now it is commonly used to describe individuals with an Autistic Spectrum Disorder and normal intellectual functioning.

 

Asperger’s syndrome, and described the following difficulties in the first two years of life of children with the condition:

 

(a)       A lack of normal interest and pleasure in people around them.

 

(b)       A reduction in the quality and quantity of babbling.

 

(c)       A significant reduction in shared interests.

 

(d)      A significant reduction in the wish to communicate verbally or non-verbally.

 

(e)       A delay in speech acquisition and impoverishment of content.

 

(f)       No imaginative play or if it does occur it is confined to one or two rigid patterns.

 

Gillberg’s diagnostic criteria for Asperger’s syndrome:  social impairments; narrow interests; repetitive routines; speech and language peculiarities; non-verbal communication problems; motor clumsiness.

 

High Functioning Autism or Asperger’s syndrome is not uncommonly misdiagnosed as Schizoid, Narcissistic Borderline or Obsessive Compulsive Personality Disorder or Schizophrenia.

 

Genetic of Autism

 

Heritability estimates of over 90% have been made in relation to autism.  Louise Gallagher points out that approaches to genetic studies have involved candidate gene studies and genome-wide, affected, sib-pair linkage studies. Association studies with variants within the Serotonin transporter gene have been conducted based on the well-established findings of elevated platelet Serotonin. Findings between studies have been inconclusive to date.  Other genes, which have been studied, include UBE3A, GABRB HOXA1/B1, all of which have had conflicting reports of association.  Reelin and WNT have had initial studies reporting association but these require replication.

 

Seven genome-wide linkage studies have been published to date and a large number of regions of putative linkage have been identified.  The most convincing evidence has been found on Ch2q and 7q.  Efforts are underway to narrow these regions down to find candidate genes.

 

Interventions

 

A comprehensive management plan should be put in place once the diagnosis has been established.  Management involves a multidisciplinary approach involving the following:

 

(a)       Speech and Language Therapy.

 

(b)       Psychological assessment for appropriate school placement.

 

(c)       Education interventions.

 

(d)      Educational interventions.

 

(e)       Pharmacotherapy.

 

(f)       Theory of mind and empathy training (higher intellectual functioning).

 

Speech and Language Therapy is essential and should be provided regularly (at least once a week) for children with speech and language delay. Pharmacotherapy has limited application but Ritalin may be considered in the presence of marked hyperactivity although children with autism are reported to be more sensitive to the side effects. Risperidone has been shown to have some beneficial effects on global assessments of psychiatric morbidity but not on individual autistic symptoms.  Naltrexone has been reported to have beneficial effects on self-injury and stereotyped behaviours but well-controlled clinical trials are still required. SSRIs are widely used in the US but not in Europe. There are some reports of improvements in repetitive behaviours but randomised, controlled trials (RCTs) are required.  The use of Melatonin in sleep disorders including those associated with autism, has been reported as beneficial by a number of groups. Again there is an absence of well-controlled RCTs.

 

As mentioned above, the evidence supporting a casein and gluten-free diet is limited.  Knivsber et al. report an overall benefit in their review of the area but the studies in question have a number of methodological flaws including small sample sizes.  Secretin has not been shown to be helpful.

 

The following examples of people with High Functioning Autism or Asperger’s syndrome and contributors of genius.

 

Kurt Godel was very much a loner and a genius.  He was fascinated by mathematics and contributed greatly to it.  He was a linguist and an autodictat.  Even in junior school he was fascinated by mathematics and physics.  He was socially immature and had severe difficulties in social relationships.  He had non-verbal behaviour difficulties and had a tremendous capacity for focus on mathematical problems.  He was extremely naïve.  He suffered from severe depression.  His verbal contributions are characterised by extreme brevity. He was also quite paranoid and fearful of emissions from refrigerators.

 

Mendel was a genius who was also very much plodding in his work, hard working, and completely single minded. He proposed laws of inheritance that ultimately became the underpinning of the science of genetics.  He had severe difficulties in social relationships. He was extremely shy. In front of a class he was an extremely poor teacher. In teaching he never was fully certified and was always a substitute teacher.  He was a man of absolute routines.  He regarded his plants as his children.  He was a monk who became rather paranoid and saw his fellow monks as traitors.

 

Hans Christian Andersen was a great storyteller.  He was socially immature.  He had very significant social interactional problems.  He was very much a loner.  He never married.  He was a great writer of fairytales and showed enormous creativity in this area. He read an enormous amount of books. He was bullied and called names at school.  He was very much an outsider.  He spoke with a high pitch tone of voice.  He was extremely obsessive.  He was very ritualistic in his behaviour. He was very controlling and at meal times his food had always to be served first. He suffered very much from depression throughout his life. He had identity diffusion. He wrote endlessly and compulsively.

 

Archimedes was a great Greek mathematician and inventor. He was a loner. He was mechanically and mathematically minded.  He hyper focussed on his researches.  His interests were extremely narrow.  He would forget to eat his meals.  He was regarded as extremely eccentric.

 

Charles Lindberg was a great aviator.  He was a loner as a child.  He was painfully shy in social relationships, he was naïve in accepting an award from Hitler. He liked solitude. He was extremely logical and obsessed with aviation. He also worked on the issues in high altitude flying and on a pump that blood could be pumped if the heart was being operated upon.  This work was carried out at the Rockerfeller Institute.  His greatest achievement and one that he was well suited for was in flying solo across the Atlantic over Ireland to Paris.  The link between psychiatric disorders and genius has often been made and these are further examples of that link.

 

Godel, Mendel, Andersen, Archimedes, Lindburg had High Functioning Autism

Autism is very commonly associated with low functioning and Learning Disability.  This is a false conception of the condition.  High Functioning Autism or Asperger’s syndrome can occur in persons with very high I.Q. and indeed ability of genius proportions. The following people demonstrate this high ability as well as High Functioning Autism:

 

Kurt Godel was very much a loner and a genius.  He was fascinated by mathematics and contributed greatly to it.  He was a linguist and an autodictat.  Even in junior school he was fascinated by mathematics and physics.  He was socially immature and had severe difficulties in social relationships. He had non-verbal behaviour difficulties and had a tremendous capacity for focus on mathematical problems.  He was extremely naïve.  He suffered from severe depression.  His verbal contributions are characterised by extreme brevity. He was also quite paranoid and fearful of emissions from refrigerators.

 

Mendel was a genius who was also very much plodding in his work, hard working, and completely single minded. He proposed laws of inheritance that ultimately became the underpinning of the science of genetics.  He had severe difficulties in social relationships. He was extremely shy. In front of a class he was an extremely poor teacher. In teaching he never was fully certified and was always a substitute teacher.  He was a man of absolute routines.  He regarded his plants as his children.  He was a monk who became rather paranoid and saw his fellow monks as traitors.

 

Hans Christian Andersen was a great storyteller.  He was socially immature.  He had very significant social interactional problems.  He was very much a loner.  He never married.  He was a great writer of fairytales and showed enormous creativity in this area. He read an enormous amount of books. He was bullied and called names at school.  He was very much an outsider.  He spoke with a high pitch tone of voice.  He was extremely obsessive.  He was very ritualistic in his behaviour.  He was very controlling and at meal times his food had always to be served first. He suffered very much from depression throughout his life.  He had identity diffusion.  He wrote endlessly and compulsively.

 

Archimedes was a great Greek mathematician and inventor. He was a loner. He was mechanically and mathematically minded.  He hyper focussed on his researches.  His interests were extremely narrow.  He would forget to eat his meals.  He was regarded as extremely eccentric.

 

Charles Lindburg was a great aviator.  He was a loner as a child.  He was painfully shy in social relationships, he was naïve in accepting an award from Hitler. He liked solitude. He was extremely logical and obsessed with aviation. He also worked on the issues in high altitude flying and on a pump that blood could be pumped if the heart was being operated upon.  This work was carried out at the Rockerfeller Institute.  His greatest achievement and one that he was well suited for was in flying solo across the Atlantic over Ireland to Paris.  The link between psychiatric disorders and genius has often been made and these are further examples of that link.

 

Controversies in the Diagnosis Autism Spectrum Disorders

Certain aspects of Autism and Asperger’s syndrome remain controversial in Ireland.  These controversies cause enormous distress to families of persons with Autism. In reality these controversies are unnecessary and the distress to families is unnecessary, particularly as these families have sufficient demands on them with their child with Autism without unnecessary artificially created controversies.

 

The first controversy the families have to face is the controversy over narrow versus broad spectrum diagnosis of autism. The old fashioned concept of Autism, called Kanner’s Autism, which is a narrow conception of Autism is no longer believed by anyone.  Instruments called the Autism Diagnostic Interview and Autism Diagnostic Observation Scale are examples of instruments focussing on narrow Autism. Professor Michael Rutter pointed out that “the ADI-R is not a perfect instrument”.  He is 100% correct about this, indeed most of the ‘seasoned’ critics of the ADI-R believe it to be a highly imperfect instrument.  Adam Feinstein noted that at the International Meeting for Autism Research in London in 2008 that many of the most highly regarded researchers in Autism in the world ‘lambasted the tool (ADI-R) for missing many cases of Autism”, and that it was “an expensive and ineffective instrument”. It is extremely expensive and it is prohibitive for the developing world, and inhibits the possibility of research in Autism in the developing countries. At the 2008 meeting, which I attended, I heard researchers from Australia complaining about its prohibitive cost.

 

Professor Dorothy Bishop, Professor of Development Neuropsychology at the University of Oxford criticised the ADI-R for the vast time it takes for “training” in the use of the instrument, “time for administration and time for scoring, and consensus coding”.  Professor Bishop correctly pointed out that “if you could be shown that there were real benefits in accuracy of diagnosis from adopting this lengthy procedure” then she would be happy to go along with these tedious assessment procedure and instrument. There is absolutely no evidence for this tedious long-winded assessment procedure. Professor Bishop correctly concludes that “the originators of the instrument have never demonstrated that you actually need such a long process – it is really more an article of faith to them”. This has echoes of religious faith that has no place in science.

 

I have found the proponents of this instrument in a number of countries are fanatical in their support of the ADI-R, indeed have a “religious” faith in its value. Professor Bishop also points out that in relation to the ADI-R-ADOS that there are “plenty of children who come out as meeting criteria on one instrument only, and there seems to be no sensible guidelines as to how you proceed, other than to seek expert clinical opinion. Professor Bishop recommends “doing studies to see what is the minimal set of items you have to get reasonable diagnostic accuracy and I doubt that we really need a three our interview for each case”.

 

I am continuing to see parents with children with Autism who come to me in great distress and tears because they had been told their children did not meet criteria for Autism based solely on these tests, when it was absolutely clear to me and to the parents that the parents had classic Autism broader phenotype – Autism Spectrum Disorder. How long more am I going to have to deal with parents in tears?  I don’t think parents should have to suffer unnecessarily because of the above reasons. Their energy should be put into therapeutic activities for their children, not having to go from one professional to another to get a formal diagnosis.

Autism and MMR: A Medico-Media Catastrophe: Do We Now Have the Last Word?

I read with interest a recent comment by Dr. Ronald Boland that in a survey of parents more than a quarter (were) ‘reluctant to vaccinate their children because of worries of vaccine safety and did not believe in infant vaccines at all’.  This is unfortunate.  It appears to me to be largely due to false information being distributed over the years through the media and by a publication in a prestigious medical journal, which under mines the great faith, the medical professional has in the peer reviewed process.  Six years after the report, an incredibly long time, ten of the thirteen authors of this article retracted what they wrote and stated that their original paper did not support the conclusion that the vaccine was to blame for autism.

 

It is interesting to see what the media has said about MMR and autism over the years.  The Daily Telegraph had the best headline ‘Chattering class endangers child lives over MMR’.  Claudia Winkleman in the Daily Telegraph has the following headline ‘I didn’t want the MMR – and now my baby has measles’.  She goes on to state ‘Jake tosses in his comfy cot and moans in his sleep. Yes I am a class A idiot: my son is ill – and it is my fault’.  Another excellent report in the Irish Times stated ‘Beware of giving bad reports a shot in the arm’.  Unfortunately this is what the media has done over many years. Misinformation and false information sells newspapers.  One might think that the media might have some concerns about false information and the potentially fatal affects of it.  A false story is a good story from the media point of view because it sells newspapers while truth is not of interest very often.  Many media outlets have lawyers to check on libel and maybe they should also have relevant medical doctors to check the veracity of medical information. Because of the focus on the ‘bottom line’ it is highly unlikely that this will take place. Of course doctors also have to take responsibilities for this because very few doctors ring up and point out to media sources the falsity of the information that they are giving out. Doctors only tend to respond when they are asked.

 

Another more recent media headline from the Sunday Times was ‘Vaccine patents and the MMR scare doctor’.  Another headline from the Irish Times ‘Parents urged to have rethink on MMR after measles cases treble’.  Another heading from the Medical Press ‘Latest figures show uptake rates from primary vaccines continue to fall’.  Colin Tudge writes in an article called ‘Mad, bad and dangerous: whether it is the MMR vaccine or GM foods, people distrust what scientists tell them’.  This was in the New Statesman.  The Irish Times in 2003 has a headline ‘Research finds no ill-effects from triple MMR injections’ and quotes Dr. O’Herlihy as saying that the Republic was witnessing the beginning of another outbreak of measles.  Dr. Ray O’Connor in an article entitled ‘MMR vaccine: controversies and fallacies in Modern Medicine’ states ‘measles is a particularly nasty disease.  Many doctors and parents have not seen a case of measles, and its severity – even on complicated cases – it is often forgotten’. He discusses the complications including severe cough, breathing difficulties, ear infections, pneumonia, and conjunctivitis.  He also discusses rare serious complications of measles including acute encephalitis and sub-acute sclerosing pan-encephalitis.  He puts the death rate at 1 to 2 per 1,000 infected people. The Irish Medicines Board in their newsletter points out that more than 500 million doses of MMR vaccine have been used worldwide and that there was no evidence to support the suggestion that single component vaccines should be administered separately.  They also point out that mono component vaccines given sequentially, children would be at risk of infection for longer periods.

 

Brian O’Shea in the Journal of the Irish Psychiatrist points out that the number of reported cases of measles jumped from 243 to 586 during 2000 / 2003.  More recently the Medical Research Council in the United Kingdom in a study of more than 5,000 U.K. children has ruled out any link between MMR, the measles, mumps, and rubella triple vaccine and autism.  This should be the last word but certainly will not.  There are many other authoritative reports and papers that have come to a similar conclusion.  Despite all this the Sunday Times in 2004 reports on a product that was made ‘by giving the measles virus to mice and extracting their white blood cells, which were then to be mixed with human cells before being infected into pregnant goats. After the goats gave birth their first milk was to be collected, and made into capsules and given to children’.  This was called a ‘combined vaccine / therapeutic agent’.  Professor Tom McDonald an immunologist described the recipe as ‘total bollocks’.  Another immunologist has a so-called ‘cure’ for autism who ‘sells a six month complete cure’ for autism, which he prepares in his kitchen using his own bone marrow. This has echoes of the potions of the early 19th century.  Those of us who work with children with autism are constantly being bombarded with ‘miracle cures’ for autism.  Unfortunately these raise parent’s hopes which are then dashed fairly quickly.

 

I have seen over 900 persons with autism and Asperger’s syndrome. I have never seen a person with autism or Asperger’s syndrome that was ‘caused’ by a vaccine. Autism is highly genetic. Autism is not a side effect of MMR.

 

Autism, Asperger’s syndrome, Stalking, and other reasons for legal contact.

While most people with Asperger’s syndrome (who have higher functioning autism) are highly moral, highly ethical, a small minority get in trouble with the law.  This is probably slightly more common in those with Mild Learning Disability and Autism.  Persons with autism may get into difficulties with the law according to Denis Debbaudt an American expert on this issue because of:

 

(1)       Dangerous wandering.

 

(2)       May not respond to commands or instructions.

 

(3)       Lack of eye contact, may be misinterpreted as a sign of guilt.

 

(4)       May not recognise police uniforms, badges or vehicles.

 

(5)       Have a poor reaction to change in routine.

 

(6)       May reach for shiny objects.

 

(7)       May invade personal space of responder.

 

(8)       Inappropriate social responses.

 

(9)       Inappropriate laughing or giggling.

 

(10)      False confession or misleading statements during questioning.

 

(11)      Associated medical conditions like epilepsy.

 

(12)      Behaviour misunderstood by others resulting in calls for assistance.

 

(13)      A high pain tolerance.

 

(14)      Atypical responses during emergencies.

 

It is critical that professionals for example the police and staff working in forensic settings are aware of these features. Persons with autism are also easily led by others and as already stated misunderstand social cues.  Their obsessional thinking may have an aggressive theme. In one inpatient setting for Learning Disabled Offenders in the U.K. 12% had autism. There is insufficient training within forensic services on autism in most parts of the world.  Hopefully the Irish College of Psychiatrists, the Irish Psychiatric Association, and police authorities will deal with this matter in full. Police, parents and other professionals need to be able to identify the possibility that a person that they are interacting with may have autism or Asperger’s syndrome so that police and other contacts are less stressful for the person with autism or Asperger’s syndrome. In the U.S. research indicates that persons with developmental disabilities are approximately 7 times more likely to come into contact with law enforcement than others.  There is only a small likelihood that in the first instance the autism will be recognised either by the police or other professionals involved.

 

Persons with autism also can get involved in stalking and one of the reasons that persons with Autism Spectrum Disorders are predisposed to stalking according to Tom Berney a U.K. Psychiatrist is that they have impaired perception of social signals, misinterpretation of rules, misinterpretation of relationships, lack of awareness or concern for the outcome, and a focussed obsessive interest.  While this occurs it is not common.

 

Digby Tantum states that sexually motivated crimes are also unusual and when they occur may be a consequence of a lack of understanding on the part of the person with Asperger’s syndrome.  Persons with Asperger’s syndrome may be aggressive and commit offences against other people, but it is unclear how frequently and what proportion of people with Asperger’s syndrome are at risk of doing so. Many people with Asperger’s syndrome have a hypertrophied sense of right and wrong and are unusually conscientious and unwilling to break the law.  The Asperger’s syndrome are more likely to be victims than perpetrators.  Nevertheless even though it is uncommon persistent violence by a person with Asperger’s syndrome is a particularly difficult problem. Men with Asperger’s syndrome are over represented in a survey of one U.K. Secure Hospital.  Violence by a person with Asperger’s syndrome often has some special features.  It may be triggered by idiosyncratic stimuli nourished by rumination over past slights; displaced from provoking the person onto a safer target at a later date; and uninhibited by empathic response to the intended victims fear.  Sometimes the explanation for violence may be similar to that given by Raskolnikov in Dosteyevsky’s Crime and Punishment: that is it is of an experimental nature. It is often a wish to experience a sense of mastery and control over another person.  They may also do it to test their predictions about how others would behave in such extreme circumstances.

 

It is worth noting that Asperger’s syndrome can occur in people of talent like Casal, Kierkegaard, E. Hopper, A. J. P. Taylor, Goethe, van der Post, Columbus, O. Wells, and ‘H. G.’.