Barcelona snapshots

Prof. Mara Parellada

Mara Parellada psiquiatra Controversias Psiquiatría Barcelona
University of California San Francisco, EE.UU. & Universidad Complutense de Madrid, España
Ponencia Violencia y agresividad en los trastornos del espectro autista
Fechas 31 Agosto - 2 Septiembre, 2020
Mesa redonda 2 Violencia y Agresión en los Trastornos del Neurodesarrollo y Psicóticos

BIOGRAFÍA

Dr Parellada received her medical degree from the University Autonoma (Madrid), her Psychiatry Specialty from the University Complutense, and her Specialization in Child and Adolescent Psychiatry from the Institute of Psychiatry, London. Her PhD in Medicine (European Doctorate) was conducted in the University of Alcalá.

She joined the Department of Psychiatry, University Complutense, Madrid, as Assistant Professor, in 2008 and she joined the faculty of the Department of Psychiatry, University of California in San Francisco (UCSF) as Adjunct Professor in 2015.

She has been consultant psychiatrist at the Department of Child and Adolescent Psychiatrist, University Hospital Gregorio Marañón (HGUGM) since 2000 and Head of the Specialty Care Programme for autism spectrum disorders (ASD), recognized as Best Practices Programme by the Spanish Health System since 2009 and Head of the Complex Diagnosis Unit since 2016. Both clinical programmes are based in the HGUGM and have a catchment population of 6.000,000 (whole Region of Madrid). She co-authored www.doctortea.org, a web for the desensitization for medical environment in ASD. Clinically, in addition to treating patients with ASD, she has focused on the improvement of services for this population within the public health system.

She has served as the principal investigator in autism for the HGUGM since 2007 and the HGUGM site within the Spanish Biomedical Research Center for Mental Health Network (CIBERSAM), studying, mainly, the neurobiology of ASD, the overlap between ASD and psychotic disorders and the identification of distinct biotypes withinof ASD. Recently, she started leading the conduct of clinical trials for the core symptoms of ASD in Spain and is principal investigator of a multi-site clinical trial funded by Horizon 2020. She has received multiple research grants in competitive calls and her research has been funded by both public and private institutions.

She has published multiple scientific articles in international peer-review journals in the field of neurodevelopmental disorders (https://scholar.google.es/citations?user=gbuSdmkAAAAJ), and has contributed to multiple national and international conferences.

RESUMEN

The relationship between autism, aggressive behaviour, and violent acts is a complex one. Behavioural disorder is a common comorbid condition in autism, and it particularly takes the form of aggressive outbursts in ASD patients with intellectual disability and explosive behaviours in high functioning ASD. Autistic people do not often become involved in violent crime. However, the prevalence of autism is high among inmates in high security hospitals and prisons. Autistic people are much more frequently victims of violent behaviours perpetrated by parents and peers than matched controls. In addition, the prevalence of bullying and peer rejection is particularly high.

Autistic people are characterized by distinctive features that may have a direct association with the specific ways in which some violent behaviours present, such as rigidity and repetitive and restrictive interests. The range of the communicative repertoire is narrow in many autistic people, and different behaviour manifestations may substitute communication gaps. Autistic features also impact the way autistic people describe the aggressive acts that they may commit and the most appropriate way for the community to manage them.

A developmental perspective on social and antisocial behaviour helps understand the large number of risk factors that may aggregate to increase the possibility of being an agent or victim of aggressive acts. These include trouble developing appropriate parent-child attachment bonds, parental misbehaviours related to frustrating and overwhelming parenting experiences, difficulty establishing an appropriate social network that promotes prosocial behaviour, problems understanding the intentions and perspectives of others, emotional breakdowns secondary to lack of successful life transitions, and experiences of rejection, isolation, etc. Some of the risk factors are innate characteristics of ASD (sensory hypersensitivity, lack of social understanding, or repetitive behaviours and inflexibility) while others are nonspecific factors associated with being different from the norm.

Treatment of aggressive behaviours needs to take into account the biological and social context in which they occur. More importantly, prevention of added social risk factors and promotion of the most adaptive possible social development are the most pivotal preventive measures for diminishing aggressive events in people with ASD.