Abstract
Autism spectrum disorder (ASD) is a group of neurodevelopmental conditions characterized by socio-communication impairments and repetitive behaviors or restricted interests. Autistic people with milder symptoms may receive a formal diagnosis only in adulthood. Autism can be accompanied by psychiatric comorbidities as well as self-injurious behaviors, aggressiveness, or irritability, which may hide different underlying causes. To date, only two antipsychotics (i.e., risperidone and aripiprazole) have been approved for the treatment of irritability in children and adolescents with autism by the Food and Drug Administration. However, the clinical management of problem behaviors can be arduous, especially in autistic adults. In this chapter, we present the case of a 30-year-old woman who referred to our psychiatric service for difficulties in socio-communication, emotional dysregulation, and aggressive behaviors. After a specialized diagnostic assessment, a diagnosis of ASD with co-occurrent unspecified mood disorder was performed, and an appropriate treatment was initiated.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Abbreviations
- ABA:
-
Applied behavior analysis
- ASD:
-
Autism spectrum disorder
- CBT:
-
Cognitive behavioral therapy
- DSM:
-
Diagnostic and Statistical Manual of Mental Disorders
- FDA:
-
Food and Drug Administration
- ID:
-
Intellectual disability
- IQ:
-
Intelligence quotient
- NSSI:
-
Non-suicidal self-injury
- PD:
-
Personality disorders
- SIB:
-
Self-injurious behaviors
References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM-5). American Psychiatric Publisher, Washington, DC
Bottema-Beutel K, Crowley S, Sandbank M et al (2021) Adverse event reporting in intervention research for young autistic children. Autism 25:322–335
Deb S, Roy M, Lee R et al (2021) Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder: systematic review and meta-analysis. BJPsych Open 7:e179
Feroe AG, Uppal N, Gutiérrez-Sacristán A et al (2021) Medication use in the management of comorbidities among individuals with autism spectrum disorder from a large nationwide insurance database. JAMA Pediatr 175:957–965
Fitzpatrick SE, Srivorakiat L, Wink LK et al (2016) Aggression in autism spectrum disorder: presentation and treatment options. Neuropsychiatr Dis Treat 12:1525–1538
Fuentes J, Hervás A, Howlin P (2021) ESCAP practice guidance for autism: a summary of evidence-based recommendations for diagnosis and treatment. Eur Child Adolesc Psychiatry 30:961–984
Fusar-Poli L, Brondino N, Politi P et al (2022) Missed diagnoses and misdiagnoses of adults with autism spectrum disorder. Eur Arch Psychiatry Clin Neurosci 272:187–198
Howes OD, Rogdaki M, Findon JL et al (2018) Autism spectrum disorder: consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology. J Psychopharmacol 32:3–29
Hull L, Petrides KV, Mandy W (2020) The female autism phenotype and camouflaging: a narrative review. Rev J Autism Dev Disord 7:306–317
Kentrou V, Oostervink M, Scheeren AM et al (2021) Stability of co-occurring psychiatric diagnoses in autistic men and women. Res Autism Spectr Disord 82:101736
Lai MC (2022) Clinical reflections on the intersections of autism and personality development. Autism 26:739–742
Lai MC, Kassee C, Besney R et al (2019) Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry 6:819–829
Licence L, Oliver C, Moss J et al (2020) Prevalence and risk-markers of self-harm in autistic children and adults. J Autism Dev Disord 50:3561–3574
Maenner MJ, Shaw KA, Bakian AV et al (2021) Prevalence and characteristics of autism spectrum disorder among children aged 8 years – autism and developmental disabilities monitoring network, 11 sites, United States, 2018. MMWR Surveill Summ 70:1–16
Moseley RL, Gregory NJ, Smith P et al (2019) A ‘choice’, an ‘addiction’, a way ‘out of the lost’: exploring self-injury in autistic people without intellectual disability. Mol Autism 10:18
Rydén G, Rydén E, Hetta J (2008) Borderline personality disorder and autism spectrum disorder in females: a cross-sectional study. Clin Neuropsychiatry 5:22–30
Salazar de Pablo G, Jordá CP, Vaquerizo-Serrano J et al (2022) Systematic review and meta-analysis: efficacy of pharmacological interventions for irritability and emotional dysregulation in autism spectrum disorder and predictors of response. J Am Acad Child Adolesc Psychiatry S0890-8567(22):00198–00198
Steenfeldt-Kristensen C, Jones CA, Richards C (2020) The prevalence of self-injurious behaviour in autism: a meta-analytic study. J Autism Dev Disord 50:3857–3873
van den Boogert F, Sizoo B, Spaan P et al (2021) Sensory processing and aggressive behavior in adults with autism spectrum disorder. Brain Sci 11:95
Acknowledgments
Dr. Fusar-Poli was co-funded by the European Union – FSE-REACT-EU, PON Research and Innovation 2014–2020 DM 1062/2021 (n. 08-I-17631-1).
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this entry
Cite this entry
Fusar-Poli, L., Concerto, C., Rodolico, A., Aguglia, E. (2023). Review and Case Study: Aggressive and Self-Injurious Behaviors in a Woman Who Received a Diagnosis of Autism in Adulthood. In: Martin, C.R., Preedy, V.R., Patel, V.B. (eds) Handbook of Anger, Aggression, and Violence. Springer, Cham. https://doi.org/10.1007/978-3-031-31547-3_161
Download citation
DOI: https://doi.org/10.1007/978-3-031-31547-3_161
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-31546-6
Online ISBN: 978-3-031-31547-3
eBook Packages: Behavioral Science and PsychologyReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences