Personality Disorders and Violence: A Connection or Not?

Like everyone else, I have pondering what may have precipitated Adam Lanza's killing spree in Newtown. While most people assume he had a mental illness, we don't know that he did. (Asperger's is not a mental illness but a neurological disorder that is not associated with violent acts.) If he had a mental disorder, what might it have been? And which mental disorders, if any, are associated with higher risk of violence?

I haven't come to any conclusions, but after reading dozens or more articles in medical, psychiatric, and psychological journals, here are a few that at least increased my understanding of the topic and dispelled some myths: [More...]

  • Violence and personality disorders: clinical and forensic implications (2010)

    1) most of those suffering from PD (Personality Disorders) are not violent and never have been;
    2) many abnormal personalities are more likely to be victims then criminals
    3) no PD is necessarily associated to violent behavior permanently, and
    4) from a dynamic and motivational position, PD alone cannot explain violent behavior.

    The article is also helpful in discussing each type of personality disorder in the context of violent acts. In all, there are 10 personality disorders plus one unspecified. They are: Paranoid personality disorder (PPD); Schizoid personality disorder (SPD); Schizotypal personality disorder (STPD); Antisocial personality disorder (ASPD)/Psychopathy; Borderline personality disorder (BPD); Narcissistic personality disorder (NPD); Histrionic personality disorder (HPD); Obsessive-compulsive personality disorder (OCPD); Dependent personality disorder (DPD); Anxious-avoidant personality disorder (AAPD; Unspecified personality disorder (USPD)(includes sadistic personality disorder.)

    There are 6 types of personality disorders more prone to violent behaviors: antisocial, borderline, paranoiac, narcissistic, and to a lesser degree, dependent and anxious-avoidant.

  • Physician's Desk Reference: Personality Disorders

    Explains each type of personality disorder, and gives symptoms, risk factors, causes, and treatment for each, in language that is easy to understand (compared to the scientific journals.)

    Personality disorder is a major risk factor for attempted and completed suicides, as well as self-mutilation....Persons with borderline personality disorders have a higher risk for self-mutilation or cutting themselves. People may slash themselves to release built-up tension, to get attention, to punish themselves, or for symbolic reasons. Mutilation is most often seen during a time of perceived or actual loss, and is more often due to anger than depression.


    Many personality disorders run in families; however, whether this occurs as a result of genetics or learned behavior is still a subject of debate. Gender plays a role in one's likelihood of having a particular personality disorder. Certain personality disorders (such as antisocial personality disorder) are more frequent in males, whereas others (such as borderline, histrionic, and dependent personality disorders) are seen more often in women.


    Little is understood about the causes of personality disorders. Some disorders may be inheritable. Temperamental factors in childhood may also be associated with personality disorders as an adult. Certain personality disorders may occur because of temperamental differences between a child and the parents. Education, moral teachings, life experiences, and adolescent socialization may also play a role. None of these possibilities, however, have been proven in scientific studies. Other factors such as physical, verbal, and sexual abuse, neglect, loss or separation during childhood, and brain abnormalities have also been cited as possible causes for personality disorders.

    Although most personality disorders appear during the teenage years, others can appear later in life as a result of physical damage to the brain, psychiatric illness, or extreme stress.

    Treatment Prognosis:

    The prognosis is best for patients with borderline personality disorder, obsessive-compulsive personality disorder, dependent personality disorder, and avoidant personality disorder. The prognosis is worse for antisocial personality disorder, paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder.

  • Is Schizoid Personality a Forerunner of Homicidal or Suicidal Behavior? (2006)

    The crucial distinguishing features of schizoid personality disorder...are that the person appears to have a defect in the capacity to form social relationships and consequently is emotionally cold, aloof, or detached; has flattened affectivity; lacks close friends or confidants other than first degree family relatives; has little, if any, interest in having a sexual experience with another person; takes pleasure in few if any activities; and almost always chooses solitary activities....People with schizoid personality disorder are predisposed to develop brief psychotic episodes.

    ...[Character traits are ]inability to form social and intimate relationships, inability to appropriately respond to social cues, depression, restricted range of emotions, disintegration of self based on incorrectly perceived threats or criticism, a drive to destroy themselves and others, and the difference between what occurs in the inner world and that which one displays in the outward appearance).

On genetic links: Most experts agree the search for a gene to predict violence or even severe mental illness is likely to be futile. Many argue it is a slippery slope, and one that could lead to unfair stigmatization.

"It is almost inconceivable that there is a common genetic factor’’ to be found in mass murders, said Dr. Robert C. Green, a geneticist and neurologist at Harvard Medical School. ‘‘I think it says more about us that we wish there was something like this. We wish there was an explanation."

Is a family history that includes suicide or depression relevant to anything? Most experts agree they are not indicators of violence.

On heredity and mental illness, Web MD says:

Many mental illnesses run in families, suggesting that people who have a family member with a mental illness are more likely to develop one themselves. Susceptibility is passed on in families through genes. Experts believe many mental illnesses are linked to abnormalities in many genes -- not just one. That is why a person inherits a susceptibility to a mental illness and doesn't necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors --such as stress, abuse, or a traumatic event -- which can influence, or trigger, an illness in a person who has an inherited susceptibility to it.

Similar here (on bi-polar disorder); here (schizophrenia and bipolar disorder); here and here.

On genetic testing and mental illness, here's a fact sheet from the National Institute of Mental Health.

On a genetic link to suicide -- more here.

None of these materials will tell us anything about Adam Lanza, particularly since we don't know whether he had a personality disorder or mental illness. And even if he did, it's still likely most people with that disorder don't commit violent acts.

I don't think anyone will ever know why Adam Lanza did what he did. The one person who knew him best, his mother, is gone. Even if he had a mental illness or personality disorder, it's unfair to stigmatize all people with that disorder, since so few of them commit violent acts.

Feel free to comment, but keep your comments on topic, which means no discussion of gun laws in this thread. Comments about gun control will be deleted. There are other threads, and open threads for that.

< Saturday Morning Open Thread | Gun Sales Continue to Surge, Fears of New Gun Laws Cited >
  • The Online Magazine with Liberal coverage of crime-related political and injustice news

  • Contribute To TalkLeft

  • Display: Sort:
    Thankfully upon first reading (5.00 / 1) (#1)
    by fishcamp on Sun Dec 30, 2012 at 12:34:41 PM EST
    I do not seem to fit into any of these Personality Disorders.  These are the kinds of medical statements I have to print and read about six times before I get it.  Tough reading.  Thanks.

    don't feel bad (none / 0) (#2)
    by Jeralyn on Sun Dec 30, 2012 at 12:45:50 PM EST
    it took me over three days to read them (and the dozens more I didn't find as helpful.) Some of their names are so similar (like Schizoid personality disorder (SPD) vs Schizotypal personality disorder (STPD.) Start with the Physician's Desk Reference one, I found that to be a really good primer and pretty easy to understand.

    This is such a complex subject (5.00 / 5) (#3)
    by Zorba on Sun Dec 30, 2012 at 01:16:02 PM EST
    I doubt that we're ever going to fully understand what causes what.  At least, not in my lifetime.

    I have been interested in psychology and in particular, abnormal psychology, since college.  I majored in psychology.  I did not think that psychology had all the answers (nowhere near), so I also took courses in human genetics, human development, neurobiology, anthropology, and sociology.  I went to graduate school in Special Education, and took more courses in human development and human genetics, and worked with, not just the developmentally disabled, but the severely emotionally disturbed, autistic children, and the behavior-disordered.

    And I have kept up with the field since I retired.  We may be getting closer to understanding human behavior and psychopathology in very many respects, but the answer to why mass killers do such things is still murky, and I don't care what all the pundits put forth as to "why" Adam Lanza did this.

    I don't think for a minute that his Asperger's had anything to do with it, and I don't want individuals on the autism spectrum stigmatized.

    Was he depressed?  Very possibly (actually, probably), and people who are depressed can have a lot of anger (usually turned inward, but not always).  Does this mean that this is the answer, and that we should stigmatize all depressed people?  Of course not.  Did he have a personality disorder?  Maybe.  But certainly, the vast majority of people with personality disorders do not commit mass murders.  

    Was he a sociopath?  Who knows?  He certainly didn't seem to have any feeling for his victims (which is one of the hallmarks of sociopaths), but on the other hand, someone can be so messed up mentally and emotionally that they are unable to get "outside themselves" because they feel overwhelming despair and helplessness, but this does not mean that they are sociopaths.

    As I said, this is complex, and we may never find out "why."  And we have come a long way in psychology, neurology, behavioral science, etc.  It is natural and human to want to know all the answers, but there are many things involving the human brain and human behavior that are still unknown.  

    The why probably exists deep... (5.00 / 3) (#4)
    by Dadler on Sun Dec 30, 2012 at 01:40:31 PM EST
    ...in the emotional life of a person. Many disorders and conditions exist, as J has discovered, but it is in the unique and often tormented emotional life of people where we will find their biggest wounds and needs for vengeance or whatever. It is where that difference in a violent person is triggered, IMO.  Human beings are, first and foremost, creatures who run on emotion. It rules us in many ways.  Modern medicine, however, treats human beings, for the most part, as nothing but machines with broken parts. Your doctor, be they a GP or a psychiatrist, is about as likely to delve into your emotional life to seek a connection to physical maladies as they are to offer you a hit of heroin.

    Which is where I might disagree with how far we've come in certain areas of medicine. As a person who was genuinely tormented by part of my brain for decades, to the point of being physically debilitated and having a nervous breakdown, and as a person whom modern medicine (save one doctor) completely failed from childhood on in this respect, because they refused to accept the profoundly initiating physical impact emotions can have, it makes me angry to understand just how much "influence" the pharmaceutical industry has had in areas is hasn't NEEDED to have any. IOW, when the pill-for-every-ill paradigm took over psychiatry starting in the 50s, the cure for my illness, and its further study and refinement in treating others, went out the door. Instead, I was left taking pills to treat symptoms, becoming zonked out and impotent, without addressing the actual illness. Finally, I found the old doctor who still had that old knowledge, who passed it on to me, and who in doing so largely cured me, because he gave me the tools to heal myself.  

    Not that this is applicable to this horrible case, but you hit a chord with me, that we tend to view people as things, not whole beings, and we really aren't comfortable talking about the ugly things that make all of us human, that we share with everyone, killer or saint.

    And, needless to say, I don't think this kid needed to be around guns as much as he was. Just a, um, hunch.


    Dadler (none / 0) (#13)
    by Jeralyn on Sun Dec 30, 2012 at 04:17:33 PM EST
    I specifically said no gun talk in this thread

    I'm glad to see that you recognize that (5.00 / 2) (#17)
    by Anne on Sun Dec 30, 2012 at 08:06:27 PM EST
    drawing any conclusions, no matter how much one reads or researches on the subject, is not just unwise, but probably also unfair - if not to Adam Lanza, then to the millions of people who suffer from mental illness, personality disorders and other conditions with a psychological component.

    The human mind is a fascinating thing; there is so much we don't know, so much that can't be learned from scans or other physical tests.

    I don't know what led Adam Lanza to do what he did, and I don't know that we ever will.  Maybe we'll be able to discern when or where things may have gone sideways, and whether "the system" - and all that that means - played a role, but I am less optimistic that whatever we do learn will result in changes or improvements that save the next Adam from himself and by extension, those on whom the next Adam would otherwise act out against.

    Thanks very much, Jeralyn (5.00 / 1) (#19)
    by Peter G on Sun Dec 30, 2012 at 09:38:51 PM EST
    for pulling this information together in one place.  As criminal defense lawyers, we encounter these disturbed personality types all the time (not only among our clients, but also in police, colleagues, prison officials and prosecutors, in fact). Some training in recognizing, interacting and dealing (relatively) effectively with folks manifesting these disorders should be a mandatory part of criminal defense/ public defender training.

    Or maybe he had no prospects of reproduction... (1.00 / 4) (#11)
    by redwolf on Sun Dec 30, 2012 at 03:58:43 PM EST
    A social outcast like Adam has a zero chance to marry and have children in our sexual market place.  Males of almost every social aminal group without prospect of reproduction tend to be violent.   Most of the school attacks in china are done by men who have zero prosects of having a family.

    I'm confused why progressives want to help the disabled and down trodden but steadfastly ignore and belittle men who are unable to compeat in the sexual market place instead of helping them.

    is that comment a joke? (5.00 / 1) (#12)
    by Jeralyn on Sun Dec 30, 2012 at 04:16:02 PM EST
    Not only do you have no support for your theory, it's absurd in this case. I won't delete it but I'm not going to allow you to hijack the thread and lower the discourse. Please take this stuff to other sites.

    Most males... (1.00 / 3) (#18)
    by unitron on Sun Dec 30, 2012 at 08:08:43 PM EST
    ...have pretty strong sex drives (as a result of thousands of years of people with strong sex drives out-reproducing those who didn't), and if it's continually thwarted it's not going to contribute to making them more placid and at peace with themselves, so while it's a stretch to declare it the sole cause, it can't be disregarded as a possible component of what is no doubt a very complicated whole.

    Monks and nuns.. (none / 0) (#24)
    by jondee on Mon Dec 31, 2012 at 12:27:29 PM EST
    don't have a tradition of violent acting out that I'm aware of..

    The occasional ruler across the knuckles in parochial scool aside..


    My niece, who is completing a 5-yr. (none / 0) (#5)
    by oculus on Sun Dec 30, 2012 at 01:48:31 PM EST
    Ph.D. program in counseling observed the vast majority of mentally-ill mass murders are male.  No, I don't have a link.  

    Yes, in fact, she's right (none / 0) (#8)
    by Zorba on Sun Dec 30, 2012 at 02:51:39 PM EST
    The vast majority of mass killers are male.  See Link.
    And also, although few people seem to talk about  this,
    the fact remains that the overwhelming majority of mass shootings in the United States have been committed by men -- most of whom were white.

    The racial and gender dynamics of such crimes are rarely discussed or probed in the aftermath of these crimes. More attention is paid when the perpetrator doesn't fit the prevailing pattern.

    As I said before, it is just not in any way a simple thing to figure out why this happens.  It certainly does not mean that we should start looking at all white males as possible mass murderers, though, does it?  Any more than we should be looking at all people on the autism spectrum, or who are depressed, or who are bi-polar, or whatever, as possible mass murderers.

    The vast majority are... (none / 0) (#20)
    by unitron on Sun Dec 30, 2012 at 10:30:53 PM EST
    ...or see themselves as, to some degree, I would suspect, unempowered or dis-empowered males.

    I don't think you get many men thinking to themselves "I've got a great life. I'm handsome and successful, well respected and financially secure, and in a great relationship with a wonderful partner and the future looks fabulous.

    I think I'll celebrate by slaughtering a bunch of strangers and then take my own life when the cops show up."

    I don't think this sort of thing happens without some considerable amount of accumulated rage.


    A huge part of the problem (none / 0) (#25)
    by jondee on Mon Dec 31, 2012 at 12:32:56 PM EST
    also is the toxic societal mantra that a person is worthless if they're not "handsome and successful"..

    Gender roles and gender training (none / 0) (#21)
    by MyLeftMind on Mon Dec 31, 2012 at 07:24:11 AM EST
    could be responsible for the fact that so many mass murderers are men, as well as why other violent crimes are overwhelmingly committed by men. Some think that women are just more likely to turn their anger inward while men are more comfortable striking out.

    But I wonder if there's anther reason for that pattern. Are women are more likely than men to consider the consequences of breaking the law? Is legal deterrence more effective with women?


    Hmmm, that theory would accord (5.00 / 1) (#23)
    by Towanda on Mon Dec 31, 2012 at 12:12:27 PM EST
    with studies that find -- historically and today -- women serving far longer sentences than do men for the same crimes.  That's based on women being born evil and less able to be rehabilitated, according to the theories of those who framed penal policies.  

    As are... (none / 0) (#9)
    by Abdul Abulbul Amir on Sun Dec 30, 2012 at 03:07:55 PM EST

    As are the vast majority of single victim murderers, serial killers, rapists, armed robbers, et al.

    IIRC, women make up about 3.8% of prison inmates serving time for violent crime.



    Ban men! (5.00 / 4) (#10)
    by oculus on Sun Dec 30, 2012 at 03:25:52 PM EST
    What about social isolation as (none / 0) (#6)
    by observed on Sun Dec 30, 2012 at 01:54:23 PM EST
    a factor, whatever its cause?

    I wonder if the "cause" is more (none / 0) (#7)
    by observed on Sun Dec 30, 2012 at 02:13:24 PM EST
    specific---i.e., that a person who begins fantasizing about using guns (or other weapons) to commit mass violence may become drawn into a feedback look where he thinks about it more and more, and in more unrealistic terms. It's like not thinking about an elephant, or not reaching to grab the brownie in front of you, in principle.

    On the Schizoid type, (none / 0) (#14)
    by Jeralyn on Sun Dec 30, 2012 at 04:29:19 PM EST
    I thought this was interesting from the article Violence and Personality Disorders:

    Persons with [Scizoid] PD act alone and may commit violent behaviors against other persons ...Normally, schizoids are not violent, but they have serious anger attacks if their personal space is invaded or they are disturbed.

    ....In the study by Stone on serial killers, up to 47% met the criteria of SPD. Violence in persons with this disorder is unlikely, but may be extreme. It is an expressive violence, that is mediated by fantasies and lack of feelings towards the persons. There is frequently an absence of clear external precipitating causes, so that the aggressions, as they are responding to the imaginary world of the subject, are unexpected and consequently unpredictable.

    These individuals have very low self-esteem and serious difficulties for interpersonal relationships. As they are resentful with society, they have negative emotions of anger and revenge. Their isolation and absence of social skills generate rejection, which precipitates the violent act, that may be an isolated, serial or mass one. When dealing with multiple assassinations, final suicide is frequent.

    People with schizoid personality disorder show little emotion, and appear to be detached from interpersonal relationships. People with schizoid disorder are often the loners of society, occupying solitary jobs and generally avoiding interactions whenever possible. Despite the similar name, these people do not have the thought disorders (hallucinations, delusions, etc.) seen in schizophrenia.

    Not everyone is violent but all need treatment (none / 0) (#15)
    by terraformer on Sun Dec 30, 2012 at 05:45:32 PM EST
    I can tell you that pro gun people don't want to stigmatize mental illness. When we discuss this issue, it's in the context of evaluation, treatment and continued monitoring of individuals who may be dangerous without stigma. The evaluations, monitoring and treatment needs to conform with due process principles and no person should be forced to prove their sanity without first having someone provide at a minimum compelling evidence that they are not sane. The federal courts have decent process or this and should be the basis for a model of something uniform around the country. I can tell you that most states don't get this right.

    Spirituality (none / 0) (#16)
    by P3P3P3P3 on Sun Dec 30, 2012 at 05:56:23 PM EST
    folks sometimes in life tend to go through a time period of depression or down cycle, in the religious sphere you might say "they were in their Job", a time of crisis for them

    there are bumps in the road on the way to maturity, and some are more tempted by evil desires then others, consequently the extremes are more publicized

    So What's Gonna Happen? (none / 0) (#22)
    by RickyJim on Mon Dec 31, 2012 at 12:01:02 PM EST
    Does anybody have an opinion about likely law changes in an attempt to prevent recurrences?  Is there a movement to return to more institutionalization of people with psychiatric problems rather than trying to treat most of them with drugs?

    that's not really the topic here (none / 0) (#26)
    by Jeralyn on Mon Dec 31, 2012 at 01:00:05 PM EST
    Please stay on the topic of Adam Lanza and his mental state and whether it's likely medicine or science can determine what caused him to kill people.

    Somebody Help (none / 0) (#27)
    by RickyJim on Mon Dec 31, 2012 at 01:26:54 PM EST
    I am pretty sure I have read there have been some autopsy results of people who have done wicked things that have shown abnormalities but have no references.