Assessing Risk Without Assumptions: Neurodiversity and Threat Assessment
- Dr. Brian Van Brunt
- Jan 5
- 6 min read
Updated: Jan 6
If you’ve done threat assessment interviews long enough, you’ve asked some version of the classic question: “Have you thought about hurting yourself or someone else?”
It’s a reasonable question. It’s on the checklist. It’s part of the spine of almost every structured interview. And when someone says yes, our antennae do what they’re supposed to do; they stand up.
But here’s the catch, and it’s a big one: not everyone hears that question the same way. And when your interviewee is neurodiverse, that gap can quietly turn a well-intended question into a major source of misunderstanding.
Threat assessment is already a translation-heavy process. We’re translating emotion into data, narrative into risk indicators, and vague discomfort into actionable next steps. When neurodiversity is in the room, we also have to translate language itself, because the same words can mean different things depending on how someone’s brain sorts and labels internal experience.
The Hidden Fork in the Road: “Thought” Isn’t One Thing
For many people, “Have you thought about X?” lands the way the interviewer intends it to land. It’s shorthand for:
Are you considering doing this?
Do you want to do this?
Are you planning it?
But for many neurodiverse individuals, that same question can be interpreted more literally, more broadly, or more mechanically:
Has your brain generated the idea at any point?
Has the image or phrase popped into your mind, even if you hated it?
Have you been stuck on the concept, whether you want to be or not?
Those are wildly different questions. One is about intent. The other is about mental content. If we don’t know which question was answered, we can end up scoring the interview with the confidence of a GPS that thinks the ocean is a highway.
Neurodiversity Changes the Interview Terrain
“Neurodiverse” is an umbrella, not a diagnosis. It can include autism, ADHD, OCD, learning differences, tic disorders, sensory processing differences, and more. It can also overlap with trauma histories, anxiety, depression, and medical conditions. That means there is no single neurodiverse interview script. However, there are recurring interview dynamics that occur often enough to matter.
Literal language processing: Some neurodiverse individuals answer the words you said, not the meaning you hoped would be inferred. If you ask whether they’ve “thought about” harming someone, they may interpret that as: Has the concept ever crossed your mind in any form? The answer might be yes, even if there is zero desire, planning, or endorsement.
Intrusive thoughts and cognitive “noise”: Conditions like OCD (and sometimes PTSD, anxiety disorders, and other profiles) can involve intrusive thoughts: unwanted, distressing mental content that barges in like a pop-up you can’t close. The presence of a violent or suicidal thought can be a symptom rather than a signal of intent.
Rumination and “scenario looping”: Some people process uncertainty by running mental simulations. They rehearse possible outcomes, worst-case scenarios, social interactions, or conflict situations. That can sound like planning when it’s actually a form of cognitive regulation (or dysregulation). The content may be alarming, but the function of the thinking matters.
Differences in affect and delivery: A neurodiverse person may describe disturbing content with flat affect, mismatched humor, or unusual wording. That can throw interviewers off. Conversely, they may show intense distress when describing intrusive thoughts, which can look like “emotional escalation,” when it’s actually shame, panic, or fear of being misunderstood.
The point is not to pathologize. It’s to avoid assuming that our usual conversational shortcuts will translate cleanly.
Thoughts Are Not Always Desires
An important truth that threat assessment training sometimes glides past is that thought can be present without being wanted. A thought can be present without being a plan. A thought can even be present without being “about me,” in the way we usually mean it.
Imagine this moment in an interview: You ask, “Have you thought about hurting someone?” They pause. They say yes.
Your pen moves. Your risk meter ticks up. And it should tick up in the sense that we need to learn more. But what you haven’t heard yet is the person’s internal experience.
Maybe that “yes” means: My brain keeps throwing this horrible image at me, and I feel sick when it happens.
Maybe it means: I got stuck on a news story and couldn’t stop replaying it.
Maybe it means: Someone threatened me, and my brain keeps running defensive scenarios.
Those are not confessions of intent. They’re descriptions of cognition. If we stop at “yes,” we’ve collected a fact without collecting meaning. In threat assessment, the meaning is the payload.
The Follow-Up Is Everything
After someone endorses “thoughts,” the following questions are where the interview either becomes precise or misleading. Two follow-ups do an enormous amount of work:
“What does that thought mean to you?”
“How do you feel when it shows up?”
You’re not just checking whether a thought exists. You’re mapping its relationship to the person: endorsement vs. resistance, relief vs. disgust, rehearsal vs. intrusion.
Compare these two answers:
Answer A: “I’ve been thinking about it because they deserve it. They crossed a line. I’m done letting them get away with it.” This suggests narrative, justification, grievance energy, and potentially pathway formation.
Answer B: “I hate it. It pops into my head, and I feel panicked. I don’t want it there. I’ve tried to make it stop.” This suggests intrusive cognition and distress. Still clinically important. Not the same threat profile.
Both answers warrant intervention. But they don’t sit in the same place on a risk continuum, and they shouldn’t be scored the same way.
Ask About Planning Like You Mean Planning
If your real question concerns intent and preparation, ask directly about those. Neurodiverse interviewees may not “read between the lines” the way you expect, so don’t make subtext do the heavy lifting.
Instead of relying on “Have you thought about…,” consider adding clearer forks:
“Do you want to hurt anyone?”
“Have you ever felt relief or satisfaction imagining it?”
“Have you taken any steps to prepare or get closer to doing it?”
“When the thought appears, do you try to push it away or do you lean into it?”
“Do you find yourself rehearsing details like time, place, or method?”
These questions separate intrusion from intention without shaming the person for having a brain that generates unwanted content.
The Interview Is Translation Work
When you’re sitting across from a neurodiverse individual, part of your job is to learn their “operating manual” in real time. Not a full manual, just enough to interpret the data correctly.
That means slowing down where needed, checking meaning, and being curious about language. It also means recognizing that some people process threat and uncertainty by mentally mapping scenarios, exits, contingencies, and what-ifs. That cognitive style can look intense without being dangerous.
And yes, sometimes it is dangerous. That’s why we don’t dismiss it. We clarify it.
What This Means for Documentation and Scoring
Your notes can’t stop at “endorsed thoughts of harm.” That’s like writing “weather happened.” You need the type of weather.
Better documentation looks like:
“Reported intrusive thoughts of harm toward self/others. Described thoughts as unwanted and distressing, with immediate efforts to resist them. Reported shame/panic when thoughts appear. No evidence of rehearsal, planning, identification with violent ideation, or intent. Primary concerns include distress tolerance, support needs, and contextual stressors.”
Versus:
“Reported thoughts of harm toward coworker framed as justified retaliation. Described relief/satisfaction when imagining outcome. Discussed timing, access, and situational opportunity. Evidence of grievance narrative and potential movement along a pathway. Primary concerns include escalation, access to means, and targeted intervention.”
Same checkbox. Different universe.
Practical Takeaways
If there’s one upgrade to make when interviewing neurodiverse individuals in threat assessment, it’s this: Treat “thoughts present” as the beginning of inquiry, not the conclusion.
Ask what the thought does in their mind. Ask whether it’s wanted. Ask how they respond to it. Ask whether there is movement from thought to preparation. Listen for the difference between someone who is building a case for action and someone who is trying to escape their own mental noise.
The goal hasn’t changed: gather enough accurate information to score the rubric and match interventions to actual risk. Neurodiversity doesn’t make that goal harder. It makes precision more important.
Because in threat assessment, the most dangerous mistake isn’t asking the wrong question. It’s thinking you understood the answer when you didn’t.
Comments