VCU On Topic: Understanding Asperger’s Syndrome

By Sathya Achia Abraham

Violence is not typical of individuals with Asperger’s Syndrome, according to Bela Sood, M.D., professor and chair of child and adolescent psychiatry at the Virginia Commonwealth University School of Medicine, and a nationally recognized expert in children and adolescents with mental health problems.

When tragedies such as last week’s shooting in Newtown, Conn., occur people start to look for answers about what was wrong with the perpetrator of such a heinous crime. Media have been reporting that the shooter had the diagnosis of Asperger’s syndrome.

“It is an error to connect Asperger’s Syndrome and violence because that is not typical of individuals with this disorder,” said Sood. “There needs to get more information on his functioning through his life, have an in-depth psychological autopsy to see what can be attributed to any underlying mental illness.” 

“The danger of making attributions without knowing the facts is that it obfuscates what really happened, prompts value judgments not based on evidence and above all stigmatizes the diagnosis and other mental health issues,” said Sood.

Sood shared some information to clear any misconceptions about Asperger’s Syndrome.

What is Asperger's Syndrome? What are the signs and symptoms?

SOOD: Asperger’s syndrome is considered a type of autism (though there will be a change in nomenclature in 2013). It is considered milder than autism as individuals with Asperger’s Syndrome do not have the language deficits seen in autism. In this disorder, individuals have difficulty with social interaction and demonstrate repetitive and restrictive behaviors, but have no difficulty with communication.

Autism is a disorder characterized by difficulty with social interaction and poor or no language capabilities which affect communication, as well as repetitive (hand flapping, toe walking) and restrictive behaviors (focus on just one thing) and interests (oddness such as preferring inanimate objects to people). Eighty-five percent of individuals with autism have IQs that fall in the intellectual disability area and may also have seizures. It is currently estimated to affect 1 in 88 children born in America. Diagnosis is usually made between ages 2 and 6. While children with severe autism can have violent outbursts, there is no known link between autism and premeditated violence.

In general, what are people with Asperger's like?

SOOD: Often people with Asperger syndrome seem “quirky, shy or loners” because they appear to have difficulty negotiating social situations and relationships. They are also quite concrete in their understanding of spoken language and can often misinterpret idiomatic or metaphorical use of language without anyone ever guessing it. As a result their responses may be odd or off point to normal conversation. People with Asperger’s may lack interest in sharing experiences with others, or developing relationships.

Research indicates that is very likely that when an individual with autism or Asperger’s Syndrome looks at people all they see is a blank face and are not able to read facial expressions or body language cues of the other person (strong determinants of social behavior in humans), and therefore, their social responses may be completely inconsistent to the situation. This in turn causes them to misread people, misunderstand situations and not “fit in” and further feel isolated. Depression and anxiety may develop.

Is there a link between violence and Asperger's? Is there a link between lack of empathy and Asperger’s?  What is important for the general public to understand about Asperger’s syndrome?

SOOD: Though anger, rage may be seen with people who have Asperger’s syndrome it is no more than the general population. Traditionally, Asperger’s syndrome is not connected to violence. Although individuals with Asperger’s syndrome do not understand or read other people’s feelings, this is different from not having empathy. Empathy or lack thereof connotes a volitional lack of sensitivity to others feelings. While the lack of relatedness or “empathy” in Asperger’s syndrome is that they lack the language of emotionality and may be connecting with others but in a very odd or idiosyncratic way that may appear as a lack of empathy. 

How is a diagnosis for Autism/Asperger’s Syndrome made?

SOOD: Diagnosis is based on clinical interview, use of standardized rating scales developed for autism screening, obtaining multi-informant data on behavior from family/teachers, detailed developmental history and a mental status examination which allows a face to face evaluation of social connectedness, understanding of idiomatic language and metaphors, prosody of speech etc.

For more about stigma and social awareness of mental health illness read:

http://www.news.vcu.edu/experts/ontopic/Mental_Health/A_Crisis_in_Child_Mental_Health__Early_Intervention_Can_Make

About Bela Sood, M.D.:

Aradhana Bela Sood, M.D., professor and chair of the Division of Child and Adolescent Psychiatry in the VCU School of Medicine, and a nationally recognized expert in children and adolescents with mental health problems is frequently quoted by national media for her views on the use of medication in such disorders.

Sood, medical director of the Virginia Treatment Center for Children at the Children’s Hospital of Richmond at VCU, served on the panel reviewing the Virginia Tech shootings as a mental health expert. She is a dedicated teacher and lecturer and has taught a wide range of courses in pediatric psychopharmacology. Her current research examines the psychopharmacology of mood disorders in children and adolescents.

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