Why Can't Doctors Identify Killers?

[TygrBright]

This Op-Ed in the New York Times makes the points better than I ever could, about why fixating on "mental illness" in the case of horrific mass killings is pointless.

First:

While it is true that most mass killers have a psychiatric illness, the vast majority of violent people are not mentally ill and most mentally ill people are not violent. Indeed, only about 4 percent of overall violence in the United States can be attributed to those with mental illness. Most homicides in the United States are committed by people without mental illness who use guns.

Emphasizing the point:

...we have to acknowledge that our current ability to predict who is likely to be violent is no better than chance.

Large epidemiologic studies show that psychiatric illness is a risk factor for violent behavior, but the risk is small and linked only to a few serious mental disorders...

And then the author begins to point out the real issues:

...drug and alcohol abuse are far more powerful risk factors for violence than other psychiatric illnesses. Individuals who abuse drugs or alcohol but have no other psychiatric disorder are almost seven times more likely than those without substance abuse to act violently.

And, finally:

If we can’t reliably identify people who are at risk of committing violent acts, then how can we possibly prevent guns from falling into the hands of those who are likely to kill?

I think, too, that it's important to note that the author himself, a professor of clinical psychiatry, acknowldges that "As a psychiatrist, I welcome calls from our politicians to improve our mental health care system. But even the best mental health care is unlikely to prevent these tragedies."

If you factor in all of the things that contributed to this tragedy, in other words, what factors is it even possible, much less feasible or simple, to affect and control? I'll leave off here with the author's words, again:

We have always had — and always will have — Adam Lanzas and Elliot Rodgers. The sobering fact is that there is little we can do to predict or change human behavior, particularly violence; it is a lot easier to control its expression, and to limit deadly means of self-expression.

If pusillanimous pols, wholly cowed by the oligarchs getting rich from selling us the means to efficiently slaughter ourselves, are too blinkered to connect these dots, we must expect an endless and escalating stream of said slaughter.

To me, it's that simple.

sadly,
Bright

[TygrBright]

1. Thanks to those who rec'd this thread.

I'm always a little surprised by what does, or does not, evoke comment here.

nonplusedly,
Bright

[TreasonousBastard]

2. Once again easy answers never work...

but we never learn. Sure, there's mental illness involved, but here we see an expert tell us how wrong it would be to depend on that as a marker.

Pet theories abound on why these killings seem to be on the rise, but the causes are complex and there's no magic bullet out there to stop them.

When we do find the answer, I bet we don't like it one bit.

[dixiegrrrrl]

4. We have a neighbor child who stands a good chance of twisting off one day.

daddy is a fundie preacher.
Kid is oldest son.
Kid has been dressing in camo since age of 5.
Kid has a spitting repeated rage against ...get this....rabbits and squirrels. He "HATES" them and talks about shooting them all
if he had a gun. Vehemently so.He has not outgrown this thinking in four years.

Parents got a kitten and quickly gave it away 2 weeks later, Mommy and daddy both gave me different reasons as to why.

They pulled him out of 2nd grade and have been homeschooling him. Seems he was bullying the other kids.
he has NO friends. the other 3 kids ( 2 girls, one younger son) are pleasant outgoing kids who have friends who come over a lot.

His default expression is a scowl, appears to be most unhappy, enough so that neighbors have commented on it.
daddy laughs it off..says it is a stage he is going thru.
(Daddy is a doofus, btw, very much into being a leader in the community, and Mommy is a sweet woman, given to fits of anxiety over many things)

but on the every growing list of criteria for potential trouble, this kid has it all.

I expect his teenage years to be interesting.

[TreasonousBastard]

5. The obvious question is..

What to do about this kid?

The parents have rights.

The kid has rights.

The community has rights.

And everyone has obligations, understanding the danger of overreacting.

If the kid does go off later on, the handwringing and fingerpointing will be unbearable. There is some human insistance to assign guilt.

I have no ready answers, but maybe it's about time we openly get to work on the concept of a community and how parents alone aren't always all that great at dealing with things like this.

[dixiegrrrrl]

6. serious dilemma, indeed.

We have no workable system for those who are quite obviously a danger, much less for those who may be one.

Current laws of mandatory pysch admission emphasize "clear and present" danger, meaning imminent.
Meaning the person has to make specific, obvious statements of intent to harm self and/or others.
"I hate them and I wish they were dead..or..I want to kill them ...or.... I wish I were dead"
( but have no immediate plants,means) won't cut it, legally.

So what does one do with a possible future "probably" problem person?

and I speak as one who has worked in Mental Health and crisis work for a long long time.

So what does a parent, who has no clue about mental issues, do?
Esp. if they have no higher learning than high school?
Esp. if they are a fundie, who turns to their god for answers and help?
Esp. in a community/city/state where religion is considered more valuable and helpful than psychiatry?

In good substance abuse treatment programs, there is often requirement that families have meetings with counsellors, to better understand addiction and the addict, no matter how old the addict is.
That is rare in Mental Illness treatment.
( not as rare in Mental retardation programs, interestingly.)

[TreasonousBastard]

8. You've worked in the field? So you have...

some expertise and experience.

One big problem is too few listening to you and your colleagues, or helping you with a difficult job.

[dixiegrrrrl]

14. thank you.

Half of my patient/family contacts was education, about the diagnosis, the symptoms, the effects and side effects of meds, etc.
In the rural low income areas I usually worked, this was an interesting challenge, calling for much creativity to make abstract terms more understandable.
I worked in mandatory treatment states, worked with police, hospitals, courts, had a lot of crisis work, all of which showed me how hard it is to predict and treatment possible/probable future harm.
believe me,everyone in the system is frustrated about this.

[former9thward]

11. You are using this to slam religion and lack of education.

Where is the evidence of ANY of these supposed factors in the Santa Barbara case? The kid was in analysis from the age of 8. Which was probably the problem. They and their drugs screwed with his head big time.

[dixiegrrrrl]

12. No I am not, and you can't mind read someone's motivation.

Family Dynamics Sytem is one of the clinical tools I used, in my profession, in assessing troubled patients.

One of the findings of Family Dynamics is that there are 4 kinds of families which tend to create problems for offspring:
they fall into 2 categories:
Overly rigid and overly chaotic.

The Overly rigid family system are most often found in military families and fundamental religious families.
The chaotic family system are most often those with parents who have serious mental illness or chemical addiction.

Pls notice the words I use. they are "tend to", "most", "most often"
which are words pointing to strong correlations, not always causation.

The family I was speaking of, on topic of the OP question, falls into one of these patterns.

The Santa barbara guy, who I was NOT speaking of, is an example of not falling in the ctagories, as far as is known.

I would comment about your impression I am slamming education, but I do not see how you came to that conclusion.

[Ichingcarpenter]

3. If Mirror neurons do not form correctly by age 3

the subject as a very good chance of at least abnormal behavior as compared to others.

Scientists have been researching something called mirror neurons, located on both sides toward the front of the brain. They activate when people observe each other.


Mirror neurons can be much more difficult to emotionally process for many of these antisocial personalities, to the point where they can read faces and calculate others, even imitating acceptable social behavior for the sake of manipulation, but they don't feel for the person; they're one-way mirrors. They don't care about hurting another's feelings once they get what they want and they aren't looking in a vicarious mirror when looking you in the eyes.

The neurons may be something people can be born with a dissociation to, but apparently these neurons can also become less effective if they aren't used enough, which makes sense; it requires practice to learn something. Someone who doesn't or hasn't known a lot of people may not have worked out their mirror neurons as much as someone who's used to seeing people every day.

Maybe this empathy reaction retreats from years of abuse to avoid feeling pain caused by others. There's still a lot that needs to be researched, but scientists are coming closer to finding out what makes some more “human” than others.

With psychopaths, the phrase “stepping in their shoes” is completely literal and pointless.

Despite the presence of these particular neurons in the brain, they may not be a singular collection of cells to form their own system, but rather form the makeup of a larger portion of the brain in different areas. There's much debate as to whether empathy can be pinned down to one part of the brain or if it's part of a larger system. But it's these couple areas of the brain in these particular clusters where the reaction seems to take place, and may be the means to figuring out what went wrong with those who lack them. But to help people who lack empathy gain it? That's still a long way from being close to answerable, if it ever will be at all.

We do know that psychopaths can be inhibited, especially violent ones, but the only real way to convince someone such as Bernie Maddoff to somehow retreat from their manipulative behavior, it's a matter of getting them to understand the consequences they could have on themselves in the end.


Bernie Maddoff, one of the most successful (and ultimately unsuccessful) con artists, responsible for a Ponzi scheme that in the end resulted in bankrupting people out of billions, and even his son's suicide. He was able to switch on and off emphatic and sympathetic thought at will to do his con. Ted Bundy had this talent also

http://bengraves.hubpages.com/hub/Psychopaths-and-Mirror-Neurons-How-Empathy-can-be-Absent


http://www.psychologytoday.com/blog/the-empathic-brain/201307/inside-the-mind-psychopath-empathic-not-always


http://books.scientificamerican.com/fsg/books/the-wisdom-of-psychopaths/some-surprising-things-you-never-knew-about-psychopaths/


Maybe in the future there can be a test
in regards to mirror neurons and their functionality with regards to psychopathic determinations.

[ck4829]

7. I don't think they seek treatment and that creates a barrier

If a person goes on a killing spree, I think that they A) view themselves as having nothing to live for and B) view themselves in the right and everyone else in the wrong.

Even if you could get these people committed or whatever, they'll never internalize what they're being given.

Now that's not to say we shouldn't do anything, I think a person going on a killing spree is doing something that is the end of a very long process, and we need to identify and see what we can do at every step of the process to mitigate it.

[951-Riverside]

9. Here's how to easily spot a potential mass killer

There are 5 groups of mass killers

1. Divorced dads who believe the court favors the wife
2. Employees who believe they were wrongly fired or terminated
3. Young people who believe they were bullied or picked on
4. Racists/Race Supremacists and Religious extremists
5. People who believe they are being "gang stalked" or watched by some by some mysterious government agency or believe the government is spraying chemicals in the air

If you run into these people and they own a firearm, chances are they have the potential of being mass killers. In a perfect world these people would have their weapons taken away and be banned from owning any in the future.

[whatthehey]

10. The trouble is the same arguments apply to gun owners

Even more so. A truly tiny number of gun owners cause gun violence, and it is similarly implausible to believe you can a priori predict which ones.

So if we cannot apply any broad solutions based on mental illness and allow them to work without trampling the rights of the mentally ill, a claim which makes sense to me, how can we do the same for gun owners?

Nothing short of absolute confiscation will do anything, and that will do little (splashy stories aside, look at UK homicide and even gun homicide statistics past 1996). Confiscation will also be much harder here than in Britain or Australia. They lacked the centuries of established precedent, the many thousands of competent gunsmiths who can make a fine firearm from stock steel, the huge and rather paranoid and militant gun lobby. To attempt it would be political suicide, hugely expensive, inciteful and ultimately uselss. Without Star Trek level scanning technology, there is no feasible way to even locate the things let alone grab them.

Guns are a large part of crime here, but to me it makes little sense that they are the cause of much of it, and they also are a large part of self-defense from crime too. Guns are simply the best tool for murderers, and will be the overwhelming choice for them. There are however likely few cases in which they are absolutely necessary for murderers, and I would predict minimal difference in homicide rates even if we could magically remove them all. For every criminal power struggle where a knife-wielding would be murderer could not get to or finish off his intended victim without a gun, how many homeowners would there be defenseless against younger and stronger invaders who would kill them with impunity? Our homicide rate has multiple causes, ranging from poverty/lack of opportunity to drug use to racism and race tension to failed social experiments to our perverted criminal justice system. The UK and Australian homicide rates changed very little after seeping gun bans far easier and likely far more effective than ours would be. Why would we be different?

[TygrBright]

13. A mentally ill homicidal individual with an overwhelming impulse to kill...

...who owns or has access to a gun, may be able to slaughter many people before they are stopped.

A mentally ill homicidal individual with such an impulse, but without a gun(s) or access thereto, is much less likely to succeed in wholesale slaughter.

A non-mentally ill individual who owns a gun(s) and who experiences an overwhelming impulse to kill may be able to slaughter many people before they are stopped.

A non-mentally ill individual who does not own/have access to a gun(s) and who experiences an overwhelming impulse to kill, is much less likely to succeed in wholesale slaughter.

What are the common factors related to each outcome?

patiently,
Bright

[whatthehey]

15. generalized hypotheticals belied by facts

There's very little even inductive arguments that people who want to kill sans guns are unable to do so (and also a strange focus on mass killings, whic represent a tiny fraction of homicides, but hey let's run with it).

The list of top mass killings is more non-gun than gun. Fires and explosions lead there, including impulse acts like Happy Land. The list of top serial killers likewise. Strangulation was the method of the runaway leader, and edged weapons are generally preferred among the rest, Guns are used in more US homicides without a doubt, but manifold times more often in individual cases among competing criminals.

Of course mass shootings exist, and get all the media attention, but if you look at the recent betes du jour you'll find few indeed who acted on anything like impulse. Detailed manifestos and long planning seem to be the norm. Which one of them with such forethought and long-simmering rage would not, in a magically gun-free world, have gone with poison or arson or bombs? Guns are used because they are simple to use, easily available and effective, not because there aren't alternatives

[backscatter712]

16. The gun-bunnies always demand to lock up everyone ever diagnosed with a mental illness...

...to distract from the idea that we could try implementing basic safety laws concerning deadly weapons. Why, a background check that could prevent a person with a history of violence from obtaining a weapon is such an invasion of their FREEEEEEEEEEEEDUMB!!!!

Nope. Better to keep the gun-sales flowing and violate the civil rights of one of America's most vulnerable groups.