Lockup Doc

Spree killing accounts for less than 1% of homicides in America, but when it occurs it always garners more than its share of media attention. Who are these killers, and why do they kill?

Demographically, those who kill in the context of domestic disputes, gang warfare, armed robbery, or even serial killing are different from those who commit mass murder. Spree killers are typically male and are more likely to be Caucasian, older, and better-educated than other murderers.  Also, they do not usually try to escape after the act, but instead either take their own lives or expect that police will do it for them. Many are ex-military, and many are unemployed. Around half may have serious mental health problems. They may suffer from a variety of conditions including psychosis, depression, or substance abuse problems. They may have been abused as children. The most common psychiatric diagnoses are typically personality disorders, especially narcissistic personality disorder.

Read more…

I’ve been following this tragic event both in the popular news media and in the blogs of fellow physicians. I have never examined the alleged killer and do not want to speculate about why he might have decided to what he is said to have done.

Having said that, though, I am finding some of the speculation to be rather bizarre. I was particularly surprised by a post by Kevin Pho (KevinMD.com): “Did Nidal Malik Hasan suffer from compassion fatigue or secondary traumatization?”

I’ve never heard of a mental health professional developing PTSD and killing people as a result of working with trauma victims.

I’m sure we’ll learn more about this case as the story unfolds. In the meantime, the speculation will continue…