WebMD Medical News
Brenda Goodman, MA
Laura J. Martin, MD
Dec. 19, 2012 -- Reports that Newtown shooter Adam Lanza had Asperger’s syndrome, a highly functioning form of autism, have led some to wonder whether that diagnosis could have played a role in the mass shooting, which killed 20 children and six adults at a Connecticut elementary school last week.
As with many cases such as this, the answer is complex. While experts are clear that Asperger's doesn’t make a person more likely to commit a violent crime, some say it may affect the way a crime is carried out.
Advocates for people with autism are more direct.
“Autism did not cause this crime,” says Peter Bell, MBA, executive vice president for programs and services at the nonprofit group Autism Speaks.
Bell, who also has a son with autism, says it’s important to understand that the condition is a developmental disorder that arises early in life. Children and adults with autism spectrum disorders struggle to communicate with others. They may feel socially isolated and have trouble feeling like part of a group. They may also have repetitive or restrictive behaviors, like rocking or shaking their hands.
“There’s absolutely nothing in that definition that talks about violence or committing aggressive acts,” Bell says.
Indeed, psychologists and psychiatrists agree that people with autism or Asperger’s are not more likely to commit violent crimes than members of the general population, but they say in very rare cases, it can happen.
In those isolated instances, forensic psychiatrists tell WebMD, a diagnosis of Asperger’s or autism may help explain some aspects of seemingly unfathomable acts.
“I think it does matter. I think that’s probably part of making sense of this horrible thing that happened. I think that’s part of the equation,” says Marc Hillbrand, PhD, a clinical psychologist at Yale University in New Haven, Conn.
Hillbrand has studied the psychology of mass shootings, but he had no direct knowledge of Adam Lanza’s medical history.
“What’s so unusual about this individual, if indeed he has Asperger’s, is the use of weapons. There are a few cases of people with high-functioning autism who have committed violent crimes using weapons, but it’s a very small number of people,” he says.
Marianne Kristiansson, PhD, professor of forensic psychiatry at Karolinska Institute in Stockholm, Sweden, has published one of the few studies looking at the characteristics of a small number of violent offenders who also had autism.
She said when she heard about the Connecticut shooting, her first thought was that the shooter might have had Asperger’s.
“That was just my diagnosis,” Kristiansson says. “This offender behavior that he has presented is quite typical of a subject with ... autistic traits.”
As head of the national board of forensic medicine in Sweden, it’s Kristiansson’s job to try to figure out why people sometimes act in violent ways.
She says most people who commit crimes do it for some kind of concrete reward -- money, for instance, or sex, or drugs. That’s not the case in people with autism spectrum disorders.
“In these cases, it’s very, very different. The motive for the crime is different. The motive of the crime is to communicate that you yourself are very offended. Other people have treated you in a very bad way and you want revenge. You want to communicate that on a very global level to lots of people,” she says.
“This behavior is completely impossible to understand because it’s so horrible. A psychopath would never commit such a crime,” she says “because a psychopath commits crimes that he receives some benefit from, and he would not commit suicide after a crime.”
“In Sweden we have had such offenders who really wanted to communicate to other authorities that they are very offended and very frustrated, but due to their autistic traits, they didn’t have the ability to communicate that verbally, so instead they take some kind of non-verbal communication,” she says, referring to the case of Peter Mangs, a 40-year-old with a diagnosis of Asperger’s who was charged with shooting more than a dozen people, most of them immigrants, from 2009 to 2010.
“Asperger’s subjects may have special interests. He had a special interest in shooting and guns and so on. So he had a license for lots of guns,” she says, referring to Mangs.
When people with Asperger’s become fixated on weapons, it can lead to violence, she says.
“It could be fires or fire-setting. We have even seen an interest in explosives that had very problematic effects and offending behavior,” Kristiansson says.
Amy Lutz doesn’t buy the idea that people with autism may turn to violence as a way to communicate. Lutz is the president of the EASI Foundation, which stands for Ending Aggression and Self-Injury in the Developmentally Disabled, a new nonprofit she started to help parents with violent children.
Lutz has a 13-year-old son with autism who was once so aggressive that he was admitted to a residential treatment program for a year so doctors could stabilize his rages.
“I didn’t want to become that mom who was beaten to death by her son,” she says, referring to the case of Trudy Steuernagel, who was killed by her teenage autistic son.
Lutz says that in her experience, her son’s rages were unpredictable. She says they happened in reaction to something in his environment or to some chemical imbalance in his brain. They were never predatory, as the shooting in Connecticut seemed to be.
“There was no intention behind the aggression,” Lutz says. “He would go off a cliff and there was no coming back until the storm had passed.”
But the storms were terrible. When her son was 9, they had him committed to the Kennedy Krieger Institute in Baltimore for a year, where he was given a diagnosis of bipolar disorder in addition to his autism.
A 2008 review found that 84% of violent offenders with autism also had co-existing psychiatric disorders at the time they committed the crime.
Lutz says that in her son’s case, electroshock therapy to control the bipolar disorder has helped.
“He’s still very autistic, but the rage is gone,” she says.
SOURCES:Peter Bell, MBA, executive vice president for programs and services, Autism Speaks, New York.Marc Hillbrand, PhD, assistant clinical professor of psychiatry, Yale School of Medicine, New Haven, Conn.Marianne Kristiansson, PhD, professor of forensic psychiatry, Karolinska Institute, Stockholm, Sweden.Amy S. F. Lutz, president, EASI Foundation.
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