Hasan Abder-Rahman MD, PhD, Imad Al-Abdallat MD, Lana N. Qaqish MD, Ameera Elqasass MD, Asma Al-Shaeb MD, Leen Abuzaid MD, Younes F. Samara MD
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However, forensic specialists noted inconsistencies with burn patterns, including the absence of blisters and redness around newer lesions. A review of the patient's psychiatric records revealed a history of repetitive self-harm, specifically aggressive scratching. Additional history from the family confirmed that the injuries were self-inflicted. Distinguishing between self-harming injuries and physical abuse in patients with ASD can be challenging, especially since both can coexist. This necessitates thorough assessment and experienced forensic consultation to avoid misdiagnosis, which can lead to significant legal and emotional consequences. To conclude, accurate diagnosis of self-harm versus abuse in patients with autism requires detailed investigation, consideration of psychiatric history, and forensic expertise. Moreover, early and correct diagnosis is crucial to prevent misattributed allegations of abuse and facilitate appropriate medical and psychiatric care for individuals with ASD.</p>","PeriodicalId":15743,"journal":{"name":"Journal of forensic sciences","volume":"70 3","pages":"1202-1207"},"PeriodicalIF":1.5000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Understanding the link between autism and self-harm from a forensic lens\",\"authors\":\"Hasan Abder-Rahman MD, PhD, Imad Al-Abdallat MD, Lana N. Qaqish MD, Ameera Elqasass MD, Asma Al-Shaeb MD, Leen Abuzaid MD, Younes F. Samara MD\",\"doi\":\"10.1111/1556-4029.70026\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication difficulties, restricted interests, and repetitive behaviors. Individuals with ASD, particularly females, are at an increased risk of self-injurious behavior (SIB), which can sometimes be misinterpreted as signs of physical abuse. This case report describes a 17-year-old female with ASD and ADHD and limited verbal language skills who presented to the emergency room with multiple skin lesions resembling second-degree burns, raising concerns of child abuse. Initial assessments by the emergency and dermatology teams were inconclusive, and plastic surgeons suggested the lesions were burns. However, forensic specialists noted inconsistencies with burn patterns, including the absence of blisters and redness around newer lesions. A review of the patient's psychiatric records revealed a history of repetitive self-harm, specifically aggressive scratching. Additional history from the family confirmed that the injuries were self-inflicted. Distinguishing between self-harming injuries and physical abuse in patients with ASD can be challenging, especially since both can coexist. This necessitates thorough assessment and experienced forensic consultation to avoid misdiagnosis, which can lead to significant legal and emotional consequences. To conclude, accurate diagnosis of self-harm versus abuse in patients with autism requires detailed investigation, consideration of psychiatric history, and forensic expertise. Moreover, early and correct diagnosis is crucial to prevent misattributed allegations of abuse and facilitate appropriate medical and psychiatric care for individuals with ASD.</p>\",\"PeriodicalId\":15743,\"journal\":{\"name\":\"Journal of forensic sciences\",\"volume\":\"70 3\",\"pages\":\"1202-1207\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-03-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of forensic sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/1556-4029.70026\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, LEGAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of forensic sciences","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1556-4029.70026","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, LEGAL","Score":null,"Total":0}
Understanding the link between autism and self-harm from a forensic lens
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication difficulties, restricted interests, and repetitive behaviors. Individuals with ASD, particularly females, are at an increased risk of self-injurious behavior (SIB), which can sometimes be misinterpreted as signs of physical abuse. This case report describes a 17-year-old female with ASD and ADHD and limited verbal language skills who presented to the emergency room with multiple skin lesions resembling second-degree burns, raising concerns of child abuse. Initial assessments by the emergency and dermatology teams were inconclusive, and plastic surgeons suggested the lesions were burns. However, forensic specialists noted inconsistencies with burn patterns, including the absence of blisters and redness around newer lesions. A review of the patient's psychiatric records revealed a history of repetitive self-harm, specifically aggressive scratching. Additional history from the family confirmed that the injuries were self-inflicted. Distinguishing between self-harming injuries and physical abuse in patients with ASD can be challenging, especially since both can coexist. This necessitates thorough assessment and experienced forensic consultation to avoid misdiagnosis, which can lead to significant legal and emotional consequences. To conclude, accurate diagnosis of self-harm versus abuse in patients with autism requires detailed investigation, consideration of psychiatric history, and forensic expertise. Moreover, early and correct diagnosis is crucial to prevent misattributed allegations of abuse and facilitate appropriate medical and psychiatric care for individuals with ASD.
期刊介绍:
The Journal of Forensic Sciences (JFS) is the official publication of the American Academy of Forensic Sciences (AAFS). It is devoted to the publication of original investigations, observations, scholarly inquiries and reviews in various branches of the forensic sciences. These include anthropology, criminalistics, digital and multimedia sciences, engineering and applied sciences, pathology/biology, psychiatry and behavioral science, jurisprudence, odontology, questioned documents, and toxicology. Similar submissions dealing with forensic aspects of other sciences and the social sciences are also accepted, as are submissions dealing with scientifically sound emerging science disciplines. The content and/or views expressed in the JFS are not necessarily those of the AAFS, the JFS Editorial Board, the organizations with which authors are affiliated, or the publisher of JFS. All manuscript submissions are double-blind peer-reviewed.