Dual diagnosis in offenders with intellectual disability: setting research priorities: a review of research findings concerning psychiatric disorder (excluding personality disorder) among offenders with intellectual disability.
We still lack solid ways to spot autism and other mental health issues in offenders with intellectual disability.
01Research in Context
What this study did
The authors looked at every study they could find on mental health in offenders who also have intellectual disability.
They left out personality disorders and focused on autism, anxiety, ADHD, and other psychiatric conditions.
The goal was to see what tools we use to spot these conditions and where the big gaps in knowledge still sit.
What they found
Most studies were small and used different checklists, so the numbers don’t line up.
Hardly any work looked at autism inside prisons or secure units.
The paper ends with a clear call: we need better, bigger studies before we can help these clients well.
How this fits with other research
Feldman et al. (1999) already showed how to screen for autism in the general ID population. Cook (2002) pushes that same need into prisons and courts.
Kernahan et al. (2025) gives the next piece. They tested how autistic adults judge right from wrong in legal settings. Their data backs up the 2002 claim that we lack tools for this group.
JMWaldron et al. (2023) moved the spotlight again. They asked stakeholders to rank the top ten research questions for autism plus addiction. Their list updates the 2002 agenda from "what is missing" to "what to do first.
Lejuez et al. (2001) focused only on depression in autistic people with ID. Cook (2002) widens the lens to all psychiatric conditions, showing the problem is even bigger.
Why it matters
If you assess clients in forensic or court settings, know that current autism screens were not built for them. Push for full, multi-step evaluations instead of single checklists. Track any new behavior changes and share the gaps you see with your team so future tools can fit this real-world need.
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02At a glance
03Original abstract
Studies of so-called 'dual diagnosis', i.e. intellectual disability (ID) with an additional psychiatric disorder, are reviewed with particular reference to offending behaviour. Because of the paucity of studies of psychopathology in offenders with ID, the present paper opens with studies of broader issues of psychopathology among people with ID, notably those with depression, schizophrenia, mild depressive disorder, other major psychotic disorders, anxiety/neurotic disorder, autistic spectrum disorders and attention deficit hyperactivity disorder. There follows a review of the most established and commonly used measurement scales for dual diagnosis in ID. The review then focuses directly on those studies which have looked at the issues of dual diagnosis among offenders with ID. In keeping with other reviews in this series, the latter studies are classified according to the same criteria. Based on this review, it is apparent that there are high-priority research questions which concern the extent and nature of psychopathology among offenders with ID, most notably those with autistic spectrum disorders.
Journal of intellectual disability research : JIDR, 2002 · doi:10.1046/j.1365-2788.2002.00002.x