Neuropsychiatric correlates in perpetrators with ASD

Lack of empathy

Empathy is an extremely complex construct with a multitude of different definitions (Blair 2008). A common classification however is that empathy consists of cognitive and affective aspects (Decety and Jackson 2004, Blair 2008) and it has been suggested that deficient cognitive empathy is a recurring trait in perpetrators with ASD (Silva et al. 2004, Rogers et al. 2007), manifested through reduced abilities to read social signals and cues like facial expressions, vocalization and gestures (Katz and Zemishlany 2006).

At the core of the empathic deficit in ASD lies an inability to attribute mental states to others, commonly denoted as a deficient theory of mind, ToM (Kleinman et al. 2001, Blair 2008). ToM (or mentalization) refers to the ability to estimate the cognitive, perceptual and affective life of others as well as of the self (Haskins and Silva 2006) and deficiencies in ToM are sometimes referred to as "mind blindness"; (Frith 2001, Haskins and Silva 2006), in other words an actual decreased capacity to read social cues and to understand the meaning of an act (Frith 2001). Perpetrators with higher functioning ASD have shown marked difficulties in understanding that another person has a different emotional cognitive experience of a shared event (Haskins and Silva 2006). This characteristic however seems quite specific to ASD; psychopaths on the other hand do not seem to show any deficiencies in the ability to represent mental states (Blair 2008) but are more often reported to present deficient emotional empathy, characterized as deficient response to the emotional displays by others (Blair 2008). Moreover, moral development also seems to differ between the two different diagnoses where it has been argued that children with autism show relatively preserved moral judgements (as long as the judgement does not require the representation of the intent of the perpetrator), which psychopaths do not (Blair 2008).

Functional Magnetic Resonance Imaging (fMRI) studies have presented results suggesting that the perceived fairness of others may have an impact on brain reactivity as well as behaviour (Singer et al. 2006). From a clinical point of view, it is not uncommon that subjects with autistic traits easily feel offended and experience that others are not fair. This might lead them to vengeful behaviour (Tantam 2003); planning and committing crimes in order to, from their viewpoint, restore the balance. The defendant in our first case presentation regarded the shooting of his psychologist as something necessary in order to "restore the balance" and it was only later when his wife told him that the woman he had shot probably also had a family, that he regretted his act.

Impaired theory of mind for moral judgment in high-functioning autism skrev:Abstract

High-functioning autism (ASD) is characterized by real-life difficulties in social interaction; however, these individuals often succeed on laboratory tests that require an understanding of another person's beliefs and intentions. This paradox suggests a theory of mind (ToM) deficit in adults with ASD that has yet to be demonstrated in an experimental task eliciting ToM judgments. We tested whether ASD adults would show atypical moral judgments when they need to consider both the intentions (based on ToM) and outcomes of a person's actions.

In experiment 1, ASD and neurotypical (NT) participants performed a ToM task designed to test false belief understanding. In experiment 2, the same ASD participants and a new group of NT participants judged the moral permissibility of actions, in a 2 (intention: neutral/negative) × 2 (outcome: neutral/negative) design.

Though there was no difference between groups on the false belief task, there was a selective difference in the moral judgment task for judgments of accidental harms, but not neutral acts, attempted harms, or intentional harms. Unlike the NT group, which judged accidental harms less morally wrong than attempted harms, the ASD group did not reliably judge accidental and attempted harms as morally different.

In judging accidental harms, ASD participants appeared to show an underreliance on information about a person's innocent intention and, as a direct result, an overreliance on the action's negative outcome. These findings reveal impairments in integrating mental state information (e.g., beliefs, intentions) for moral judgment.

Supporting Information skrev:Moran et al. 10.1073/pnas.1011734108
SI Materials and Methods

Experiment 1: Example Theory of Mind Stories.

False belief.
Jenny put her chocolate away in the cupboard. Then she went outside.
Alan moved the chocolate from the cupboard into the fridge. Half an hour
later, Jenny came back inside. Jenny expects to find her chocolate in the . . .

cupboard; fridge

False photograph.
The biography describes the room as it was in
1965. Originally the walls were covered in dark wallpaper. By 1965
the paper had been stripped and replaced with cream paint. The
biography says that the room was . . .

light; dark



Experiment 2: Example Moral Judgment Stories.

Accidental harm.
Grace and her friend are taking a tour of a chemical plant.
When Grace goes over to the coffee machine to pour some coffee,
Grace’s friend asks for some sugar in hers. There is white powder
in a container by the coffee.
The white powder is a very toxic substance left behind by
a scientist, and therefore deadly when ingested in any form.
The container is labeled “sugar,” so Grace believes that the
white powder by the coffee is sugar left out by the kitchen staff.
Grace puts the substance in her friend’s coffee. Her friend
drinks the coffee and dies.

Putting the substance in was:
1 2 3 4 5 6 7
Forbidden Permissible

Attempted harm.
Dan is giving a visitor a tour of a laboratory.
Before visitors enter the testing room, all test tubes containing
disease antigens must be contained in a chamber by flipping
a switch. A repairman has just come to fix the switch, which had
been broken.
The switch has been successfully repaired, so the test tubes are
quite safely contained. Thus, anybody who enters the room will be
safe and unexposed.
Dan believes that the switch is still broken after a conversation
with the repairman, so he believes it is not safe for the visitor to
enter.
Dan tells the visitor to enter the testing room. The visitor does
not contract any disease and is fine.

Telling the visitor to enter was:
1 2 3 4 5 6 7
Forbidden Permissible

linek skrev:Apropå autistisk moral publicerades just en liten studie som säger att autister har mindre överseende med olyckshändelser. De tar oavsiktligheter personligt, om man får brodera ut litet. Väntat nog precis vad mentaliseringsbrister borde leda till.

Intressantast fann jag möjligheten till urskillning av vuxna, kompenserande autister som klarar false belief-tester med glans. Påminner förresten om Uta Friths utvidgade Sally & Ann där vuxna utan vidare kunde redogöra med ord för hur det låg till med kakan i korgen men när man studerade ögonrörelserna under åskådandet var de vilsnare än ickeautister vars blickar alltid drogs till den korg i vilken den vilseledda trodde kakan låg.