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Clin Child Psychol Psychiatry. 2014 Jul;19(3):392-411. doi: 10.1177/1359104513503353. Epub 2013 Oct 11.

Narrative responses as an aid to understanding the presentation of maltreated children who meet criteria for autistic spectrum disorder and reactive attachment disorder: a case series study.

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University of Plymouth, Plymouth, UK
University of Plymouth, Plymouth, UK.


This paper offers research case studies of four severely maltreated children who had received a diagnosis of autistic spectrum disorder. A range of measures were employed to explore the children's psychological and emotional functioning, including Theory of Mind assessment (Sally-Anne Test), attachment measures (Story Stems Assessment Profile and Relationship Problems Questionnaire), along with measures to assess general psychological and emotional well-being. Contrary to the diagnosis, the children did not reveal a theory of mind deficit. However, they did indicate a profile of difficulties in mentalisation on the Story Stems. The findings are discussed in terms of the extent to which mentalisation and theory of mind are influenced by situational factors, especially the anxiety evoked by the Story Stem attachment scenarios. Clinical implications regarding mentalisation as a state vs. trait phenomenon are discussed.


Autistic spectrum disorder; Story Stems; attachment; mentalisation; qualitative research; theory of mind

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