ASD, OCD and violence – a forensic case study

The purpose of this paper is to illustrate the formulation and psychological treatment of a complex case whereby a combination of autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) has resulted in violent and aggressive behaviour.

This paper provides a brief summary of literature in relation to ASD, OCD and risk-offending behaviour followed by a case study of a man (referred to as “John”) with a diagnosis of ASD and OCD who has an extensive history of institutional violence and aggressive behaviour.

This paper highlights the complexity of a case that may support research suggesting that impaired theory of mind, poor emotional regulation and problems with moral reasoning increase the risk of an individual with ASD engaging in violence, in addition to a comorbidity of ASD and OCD resulting in a more severe and treatment-resistant form of OCD.

This paper highlights the challenges faced when working with a patient with Asperger’s syndrome and OCD with entrenched beliefs that lead to the use of violence as a compulsion to temporarily overcome unpleasant thoughts related to low self-esteem.