Adam Lanza, the man the Associated Press has identified as the gunman in New Haven, CT’s mass shooting is reported to be responsible for the second worst mass shooting in U.S. history, exceeded only by the Virginia Tech massacre. Like the 1999 Columbine High School massacre, all of the individuals responsible for these tragedies were reported to have documented histories of mental illness. William Spengler, the gunman who ambushed firefighters in N.Y. killing two and injuring two others before killing himself had a criminal history of violence. Horrific events such as these draw widespread criticism of U.S. gun laws and spark intense debate about gaps in mental health care language and practices, privacy laws and loopholes that allow individuals adjudicated as mentally unsound to purchase and carry handguns without detection by the National Instant Criminal Background Check System (NICS). While the vast majority of individuals with mental illness are not prone to violence or anti-social behaviors, mental health professionals are aware that some psychiatric disorders are believed to be risk factors for violence. How can we know if and when there is a connection between mental illness and violence? This article serves to provide facts about relevant mental disorders in the case of Adam Lanza’s murder/suicide spree.
Did mental illness and/or a developmental disorder contribute to Adam Lanza’s violent behavior and callous disregard for human lives?
Adam Lanza’s brother, Ryan Lanza, told ABC news that Adam “is autistic, or has Asperger syndrome and a ‘personality disorder.’” Greater diagnostic clarity will likely emerge in the coming weeks as individuals familiar with Adam’s medical/mental health history come forward to aid law enforcement in their investigation. In the meantime, this article serves to clarify symptoms of the diagnoses that have been named in the case:
Personality Disorder: The Diagnostic and Statistical Manual (DSM-IV), psychiatry’s classification guide states “a personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture.” This pattern must appear inflexible and pervasive across a wide range of situations, and lead to clinically significant distress or impairment in important areas of functioning. While Adam Lanza’s particular diagnostic picture is currently unclear, some personality disorders appear to reflect symptoms consistent with Adam Lanza’s violent behavior and callous disregard for human life.
Antisocial Personality Disorder (ASPD): The DSM-IV‘s term for what is commonly known as psychopathy. Although there are behavioral similarities, ASPD and psychopathy are not synonymous. A diagnosis of ASPD using the DSM criteria is based on behavioral patterns, whereas psychopathy measurements also include more indirect personality characteristics. The psycho-diagnostic tool most commonly used to assess psychopathy is the Hare Psychopathy Checklist, which measures the following symptoms:
- Aggressive narcissism (which may include) glibness/superficial charm, grandiose sense of self-worth, pathological lying, manipulation of others, lack of remorse/guilt, shallow affect (genuine emotion is short-lived and egocentric), callousness/lack of empathy, failure to accept responsibility for own actions
- Socially deviant lifestyle (which may include) need for stimulation/proneness to boredom, parasitic lifestyle, poor behavioral control, lack of realistic long-term goals, impulsivity, irresponsibility, juvenile delinquency, early behavior problems, revocation of conditional release
Research studies report these symptoms are associated with reactive anger, impulsive and premeditated violence, and criminality. While the exact cause of personality disorders remains under debate, research studies point to both genetic and environmental contributions. Assessment and treatment of personality disorders are generally time consuming and challenging, and exacerbated by cutbacks in managed healthcare. Doctors and other health care professionals are seldom afforded adequate time to collect the detailed information necessary to diagnosis and treat someone with a personality disorder. Effective treatment includes long-term theraputic strategies that are firm yet fair, and teach individuals skills that can be used to live independently and productively within the rules and limits of society.
According to Dr. Janella Street, a clinical and forensic psychologist who works with individuals who’ve been accused of or convicted of criminal activity “One of the biggest challenges in providing preventive mental health care is overcoming the stigma attached to being diagnosed with a mental disorder. We have to make more effort to educate the public about various types of mental disorders, and remind them that only a very small percentage of individuals with a mental disorder act out violently.”
Schizoid Personality Disorder: These individuals avoid social intimacy, have little interest in relationships, and have limited emotional range – often manifest as blunted affect. Russ Hanoman, a friend of Lanza’s mother, earlier reported to CNN that Lanza was “very withdrawn emotionally.” Schizoid Personality Disorder is not the same as schizophrenia, although there is a familial association between the two. There is also a familial association between schizophrenia and insensitivity to pain, which Lanza reportedly experienced. Richard Novia served as an advisor to Newtown High School’s technology club, an organization to which Lanza belonged. Novia says he had meetings with Lanza’s mother, Nancy, and school administers about ensuring Lanza’s safety, considering his apparent inability to feel pain. “If that boy would’ve burned himself, he would not have known it or felt it physically.” It is currently still unknown if Adam Lanza was officially diagnosed with congenital insensitivity to pain, a rare neuropathic disorder that makes people unable to register painful stimuli and can lead to empathy problems.
Avoidant Personality Disorder: These individuals are socially inhibited, feel inadequate, avoid social interaction, and are hypersensitive to criticism. Many who’ve come forward to offer their accounts of Lanza in his youth describe him as socially withdrawn and awkward. Alan Diaz who reportedly knew Lanza several years ago said “He was a shy kid, quiet. He would sometimes stand in the corner. We knew he was socially awkward and we just accepted it. But he was never threatening.” Marsha Moskowitz, 52, drove Lanza to school for three years and said about Lanza “He didn’t sit with the other kids and didn’t seem to have any friends.”
Autism: Autism is a disorder characterized by difficulty with social interaction and communication, as well as repetitive and restrictive behaviors and interests. It is currently estimated to affect 1 in 88 children born in America. Diagnosis is usually made between ages 2 and 6. While children with severe autism can have violent outbursts, there is no known link between autism and premeditated violence. According to UCLA psychologist Elizabeth Laugeson, autism spectrum disorders can sometimes correspond with a reduced sensitivity to pain. Lanza’s classmates claim to have been told that he had Asperger’s.
Asperger’s Syndrome is considered a type of autism (with anticipated change in nomenclature in the DSM-V in 2013). In this disorder, individuals have difficulty with social interaction and judgement, lack non-verbal communication skills, demonstrate repetitive and restrictive behaviors. Odd speech patterns and physical clumisness can also be common traits. People with Asperger’s may lack interest in sharing experiences with others, or developing relationships. Asperger’s is also associated with an insensitivity to pain as well as social deficits such as impoverished ability for empathy. Individuals with Asperger’s tend to have a theoretical understanding of people’s emotions, but often struggle with acting socially appropriate in real-life situations. The cause of Asperger’s Syndrome appears to result from developmental factors that affect many or all functional brain systems. The mainstay of treatment for Asperger’s is behavioral therapy, focusing on specific deficits to address poor communication skills, obsessive or repetitive routines, and physical clumsiness. Most children improve as they mature to adulthood, but social and communication difficulties may persist.
News source CNN has been unable to independently confirm whether Lanza was diagnosed with autism or Asperger’s. Both are developmental disorders, not mental illnesses. The Autism Society has released the following statement “There is absolutely no evidence or any reliable research that suggests a linkage between autism and planned violence. To imply or suggest that some linkage exists is wrong and is harmful to more than 1.5 million law-abiding, nonviolent and wonderful individuals who live with autism each day.”
Judith Warner, a health journalist of Time Magazine writes “We don’t know that Lanza’s crime represents a failure of our “system” of mental health care in America, as has been said countless times this week, because we don’t know what, if any, mental health care he was receiving in recent years at all. We don’t know what the Lanzas’ attitude toward mental health care was. Did Nancy, who home schooled Adam for years, reject the mainstream beliefs of child psychiatry, as many in the home-schooling community do?”
In the aftermath of the New Haven, CT shooting, The Interdisciplinary Group on Preventing School and Community Violence has asked for “a renewed nationwide effort to address the problem of mass shootings that have occurred repeatedly in our schools and communities. Now is the time for our political leaders to take meaningful action to address the need for improved mental health services and protection from gun violence. At the same time, concerned citizens in every community should engage in comprehensive planning and coordination to prevent violence in our schools and communities. These plans should include access to mental health services for youth and adults who are showing signs of psychological distress, including depression, anxiety, withdrawal, anger, and aggression as well as assistance for the families that support them. The bottom line is that we must all work together toward the common goal of keeping our schools and communities safe.”
The complete position paper and a list of endorsing organizations is available at curry.virginia.edu/articles/sandyhookshooting.
Read more at: http://phys.org/news/2012-12-aftermath-newtown-meaningful-action.html#jCp
The complete position paper and a list of endorsing organizations is available at curry.virginia.edu/articles/sandyhookshooting.
Read more at: http://phys.org/news/2012-12-aftermath-newtown-meaningful-action.html#jCp
The complete position paper and a list of endorsing organizations is available at curry.virginia.edu/articles/sandyhookshooting.
Read more at: http://phys.org/news/2012-12-aftermath-newtown-meaningful-action.html#jCp
The complete position paper and a list of endorsing organizations is available at curry.virginia.edu/articles/sandyhookshooting.
Read more at: http://phys.org/news/2012-12-aftermath-newtown-meaningful-action.html#jCp
The complete position paper can be reached at http://curry.virginia.edu/articles/sandyhookshooting
Dr. Christina Villarreal is a clinical and forensic psychologist in private practice in Oakland, CA. Professional inquiries please direct to christina.villarreal@gmail.com
drchristinavillarreal
I welcome your comments!