In July 2012, a dozen people were killed and 70 more injured after a gunman opened fire in a movie theatre located in the Colorado city of Aurora. Around half a year later, a similar occurrence happened in Newtown, Connecticut where a lone gunman casually walked into an elementary school and killed 26 people in the process. The young man then turned the gun on himself and committed suicide. Although the two cases were ideally unrelated, it was later revealed that both gunmen had a history of mental illness (Vogel, 2014). In response, authorities began active searches for solutions that would ensure that mentally ill individuals were prevented from perpetrating such acts in the future. The topic of psychological disorders and their correlation to criminal behavior also began attracting extra attention. Today, psychologists deem it important to understand ways in which psychological disorders and their diagnostic traits may lead patients to commit various crimes such as assault, homicide, or theft. This paper primarily covers the diagnostic traits of bipolar disorder that may lead to homicide. The two traits of bipolar disorder that most positively correlate to homicide are paranoid delusional beliefs and impulsive behavior.
A mental disorder is defined as "...a syndrome characterized by a clinically significant disturbance in an individual's cognitive, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental process underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities" (Cherry, 2019, p. 1). The DSM-5 outlines several classifications of psychological disorders based on diagnosis and associated symptoms. Some of the most common mental disorders are eating disorders, anxiety disorders, and personality disorders.
Delegate your assignment to our experts and they will do the rest.
The classification provided by DSM-5 provides physicians and patients with guidelines on how mental disorders should be diagnosed and treated. The Diagnostic and Statistical Manual of Mental Disorders, as well as the International Classification of Diseases, helps explain to clinicians whether certain behaviors or symptoms in patients are those of mental disorders. For instance, the DSM-5 describes schizophrenia as a mental disorder characterized by breakdowns in thought, emotional, and behavioral processes in patients. The classification goes ahead to state that some of the symptoms of schizophrenia are hallucinations and delusions ( Remington, et al., 2016 ). Therefore, classifications such as those found in the DSM-5 enable clinicians to fully understand psychological disorders thereby allowing patients to access timely interventions.
Bipolar disorder is characterized by changes in moods, energy levels, and physical activities ( Grande, et al., 2016 ). Patients suffering from bipolar disorder will often have periods of elevated moods characterized by heightened physical and mental activity and periods of depression where they feel detached from their surroundings. According to Kaltenboeck, et al. (2016) , there are four major categories of bipolar disorder. They are Bipolar I Disorder characterized by manic episodes lasting for a week; Bipolar II Disorder characterized by hypomania and depressive episodes; Cyclothymic Disorder characterized by frequent periods of hypomania and depressive symptoms; while the other category contains disorders that do not fit into the afore-mentioned types pf bipolar disorder based on the predominant symptoms. The major risk factors of bipolar disorder are family history, genetics, and brain structure. Treatment for the disorder may shift from medication to psychotherapy based on the clinician’s diagnosis.
On the other hand, criminal behavior is defined as “any overt or covert law-breaking conduct in a given country or state, punishable upon conviction” (Coulacoglou & Saklofske, 2017, p. 384). There are two major categories of criminal behavior namely property crime and violent crimes. Examples of property crimes are theft and fraud while robbery and homicide are examples of violent crimes. To understand the relationship between bipolar disorder and criminal behavior, homicide has been deemed ideal for the current study. Homicide is a crime that involves a person killing another. The crime can occur at any time or place. Homicide can also either be premeditated or spontaneous, therefore revealing the importance of the current study.
The Link between Paranoia and Homicide
In the past, several studies have been carried out by researchers on the correlation between the diagnostic traits of bipolar disorder and criminal behavior. One of the studies carried out by Assareh, et al. (2016, p. 27) found that the main triggers of homicide amongst patients suffering from the bipolar disorder were “paranoid delusional beliefs (73.3%), excitement, impulsive behavior (20.0%), and auditory hallucinations (6.6%).” The study also shows that most of the affected patients were men. The tendency to commit suicide was aggravated by deep-lying sociocultural and emotional factors.
A buildup of paranoid fear positively correlates with the likelihood of a bipolar patient killing another person. Paranoia is defined as a mental condition whereby the patient suffers from aberrations of persecution, unnecessary jealousy, or extreme feelings of self-importance ( Lawlor, et al., 2015 ). Paranoia is one of the most prevalent diagnostic traits of bipolar disorder. Although paranoia is accompanied by several other symptoms, it has been found that persecutory delusions are more likely to lead a person towards homicide than any other trait (Resnick, 2016). Motives for homicide here are mainly anchored on the need by patients to defend themselves or those around them from harm. For instance, a bipolar patient may feel threatened or persecuted by a close colleague either at work or at home. In the process of treatment for bipolar-related paranoia, it becomes difficult because the patients may often feel that the clinicians themselves have become part of the ‘conspiracies’ to harm them. Delusions of spousal infidelity can also lead bipolar patients to commit homicide. In the past various studies have been carried out on what causes bipolar patients to kill their spouses. According to Darrell-Berry, Berry, and Bucci (2016), most male patients often feel the urge to protect their manhood especially when they lose their jobs. When they can no longer provide for their families, they feel threatened to the extent of viewing their spouses as unfaithful or condescending. Such cases have in the past led to homicide due to an inability of patients to control their aggressive behavior.
It is also important to note that the paranoia in bipolar patients often builds up to a point where outward anger becomes uncontrollable. Darrell-Berry, Berry, and Bucci (2016) find that delusions of persecution, being spied, or conspired against are associated with severe aggression. This means that sometimes the paranoia may lead to premeditated murders after prolonged periods. Severe aggression may occur after the patient finally decides to take matters into their own hands. They may end up employing the use of blunt objects to attack their victims but it is important to note that premeditated murders do not always involve the use of such objects. Sometimes, patients may strangle their victims or suffocate them, depending on the situation.
Paranoia also causes aggression as a retaliatory response. Although most paranoia-related homicides occur as safety behaviors, studies indicate that some patients may have “attentional bias for threat cues and a proclivity to jump to conclusions” (Darrell-Berry, Berry, & Bucci, 2016, p. 6). For instance, paranoia may lead a patient to conclude that certain work colleagues are responsible for the lack of career progression. Instead of focusing on their output, the paranoia shifts attention to those around them. Studies indicate that just like other mammals, human beings can develop psychological aggression when dominance challenges become common or when threatened with violence. Roth (2014) gives an example of a 1980 discovery where young, wealthy white men living in the American south were bumped by a man walking in the opposite direction, they immediately became agitated and aggressive. The reason is that they often felt disrespected and also that they had to look manly. They also constantly thought about revenge missions. Their glands produced more testosterone and cortisol as a result. Ideally, all social animals have bipolar traits. According to Roth (2014), human beings are social animals and can instantly change behavior when circumstances change. We can be cooperative in one moment but aggressive the next. In reference to the theory of natural selection, it is common knowledge that the world favors organisms that can sense variations in their surroundings and act accordingly. It is a basic survival trait. However, patients suffering from bipolar disorder have shown that the paranoia trait may sometimes cause them to make false observations. They may either feel threatened or persecuted, and this may result in acts of homicide.
The Link between Impulsive Behavior and Homicide
Impulsivity also has a positive correlation with homicide tendencies. Impulsive behavior is defined as “a rash response in situations where considerate response is more appropriate” (Bakhshani, 2014, p. 2). Powers, et al. (2013, p. 1) further add that impulsive behavior is ‘an individual’s predisposition toward rapid, unplanned actions without regard to the negative consequences of these actions to [oneself] or others.” From both definitions, it can be seen that impulsivity often causes individuals to commit undesirable actions due to their inability to critically analyze the situations. This often leads to criminal behaviors such as homicide.
Impulsivity is associated with undesirable outcomes because actions are often carried out without foresight. For instance, a patient suffering from bipolar disorder may kill their victim in the middle of a heated argument due to their inability to control their emotions. Patients with impulsive behavior also tend to undertake actions that are more risky with little or no prior consideration. In considering the aforementioned example, the most ideal outcome of such an argument would be to make peace and come to a long-lasting conclusion. However, an impulsive subject may instead choose to kill as a way of silencing their tormentor.
Impulsive behavior can be divided into three broad sub-scales. These sub-scales are attentional impulsivity, motoric impulsivity, and non-planning impulsiveness (Powers, et al., 2013). Attentional impulsiveness ideally occurs when a subject focuses on a specific outcome through keen assessment and an inability to control intrusive and racing thoughts. This type of impulsiveness dominates their minds and may potentially lead to premeditated murder. On the other hand, motoric impulsivity alludes to the tendency to act on the spur of a moment with little or no awareness of the normal thought process. Finally, non-planning impulsiveness is the lack of future planning or analyzing the consequences of one’s actions.
In clinical circles, the Barratt Impulsiveness Scale (BIS) is used to diagnose impulsive behavior in patients. The scale is a form of self-report where individuals can answer questions about how they behave on a day-to-day basis (Stahl, et al., 2014). For instance, users can be asked whether they tend to become restless or whether they normally make negative comments during arguments. Although there are other methods of measuring impulsive behaviors such as the Eysenck Impulsiveness Scale (EIS) and the Dickman Impulsivity Inventory, the use of the Barratt Impulsiveness Scale remains a top priority for most clinicians.
Recent studies indicate that sexual homicide is the most common form of correlation between impulsive behavior and homicide. Sexual homicide is a crime that integrates sexual assault and actual murder. Victims of sexual homicide, therefore, are mostly raped before they are killed. According to DeLisi and Wright (2014), sexual homicide lies on a sexual violence continuum where lesser crimes like sexual assault gradually graduate into sexual homicide over extended periods. During instances of sexual assault, the perpetrator uses instrumental violence while sexual homicide involves the use of expressive violence.
The difference between a sexual murderer and a non-homicidal sex offender lies in their levels of impulsivity. According to Healey and Beauregard (2017), sex offenders with high levels of impulsivity are more likely to commit sexual homicide. Therefore, impulsivity is a noteworthy predictor of sexual homicide. In most cases where impulsivity leads to sexual homicide, there are specific situational factors that can specifically lead to acts of violent murder. For instance, it has been found that low self-control can lead individuals to commit sexual homicide. The correlation between low self-control and sexual homicide is also backed up by the fact that it has been linked to violence in the past. When an individual cannot control their actions, then they are more likely to make bad decisions. Sometimes, these decisions may involve other people such as their spouses or close associates.
DeLisi and Wright (2014) further explain that disorders such as low self-control often lead to sexual homicide because the crime acts as a way of ending the frustration. Mostly, the frustration is caused by another person such as a parent or a boss. In the context of sexual homicide, the perpetrators could seek gratification by murdering a woman who has denied them sexual favors in the past. It can be seen that sexual homicide, in this case, is often caused by unrelated factors that motivate the killer to take matters into their own hands. However, in such situations, researchers have found that low self-esteem by itself does not primarily lead to acts of sexual homicide and, thus, needs to be accompanied by impulsivity as a trait. Therefore, impulsive behavior provides the crucial link between bipolar patients and their tendencies to commit murder.
Conclusion
In the past, scientists have strived to establish the relationship between mental disorders and criminal activity. The urge has been as a result of several high-profile acts of violence where the perpetrators have been found to have suffered from mental illnesses. It has been found that mental disorders are disturbances in a person’s rational, emotional, and behavioral compositions. These disturbances negatively affect the patients in that their psychological, biological, or developmental processes become dysfunctional. The Diagnostic and Statistical Manual of Mental Disorders classifies bipolar disorder as a mental illness. Bipolar disorder is characterized by changes in moods, physical activity, and energy levels. Patients suffering from bipolar disorder will often have periods of elevated moods characterized by heightened physical and mental activity and periods of depression where they feel detached from their surroundings.
The two traits of bipolar disorder that most positively correlate to homicide are paranoid delusional beliefs and impulsive behavior. Paranoia is defined as a mental condition whereby the patient suffers from aberrations of persecution, unnecessary jealousy, or extreme feelings of self-importance. A bipolar patient often becomes paranoid when faced with persecution or when they feel the urge to be protective of themselves and those around them. However, such feelings of insecurity are often unwarranted and come around as a result of their inability to make proper observations. On the other hand, impulsive behavior alludes to the tendency of an individual to be quick to action with little or no consideration of the outcomes. Bipolar patients have been found to vent out their frustrations on underserving victims of sexual homicide.
The information found in this paper can be used by various stakeholders in their bid to understand the relationship between impulsive behavior, paranoia, and homicide. It is hoped that this research will help clinicians understand the nature of the bipolar disorder and how it can lead to a homicide. Politicians, policy-makers, and authorities too may find the information provides important insights regarding how best the rates of homicide can be reduced.
References
Assareh, M., Rakhshani, T., Kashfi, S. M., & Rai, A. R. (2016). Homicide offending and its main determinants in patients with schizophrenia or bipolar mood disorders. Archives of Psychiatry and Psychotherapy , 18 (3), 27-31.
Bakhshani, N. M. (2014). Impulsivity: a predisposition toward risky behaviors. International journal of high risk behaviors & addiction , 3 (2).
Coulacoglou, C., & Saklofske, D. (2017). Psychometrics and Psychological Assessment: Principles and Applications.
Cherry, K. (2019, February 26). Overview of Psychological Disorders and How They Are Diagnosed. Retrieved from https://www.verywellmind.com/what-is-a-psychological-disorder-2795767
Darrell-Berry, H., Berry, K., & Bucci, S. (2016). The relationship between paranoia and aggression in psychosis: A systematic review. Schizophrenia research , 172 (1-3), 169-176.
DeLisi, M., & Wright, J. (2014). Social control theory of sexual homicide offending. In G.Bruinsma, & D. Weisburd (Eds.), Encyclopedia of criminology and criminal justice (pp. 4916–4922). New York: Springer.
Grande, I., Berk, M., Birmaher, B., & Vieta, E. (2016). Bipolar disorder. The Lancet , 387 (10027), 1561-1572.
Healey, J., & Beauregard, E. (2017). Impulsivity as an etiological factor in sexual homicide. Journal of Criminal Justice , 48 , 30-36.
Kaltenboeck, A., Winkler, D., & Kasper, S. (2016). Bipolar and related disorders in DSM-5 and ICD-10. CNS spectrums , 21 (4), 318-323.
Lawlor, C., Hall, K., & Ellett, L. (2015). Paranoia in the therapeutic relationship in cognitive behavioral therapy for psychosis. Behavioural and cognitive psychotherapy , 43 (4), 490-501.
Powers, R. L., Russo, M., Mahon, K., Brand, J., Braga, R. J., Malhotra, A. K., & Burdick, K. E. (2013). Impulsivity in bipolar disorder: relationships with neurocognitive dysfunction and substance use history. Bipolar disorders , 15 (8), 876-884.
Remington, G., Foussias, G., Fervaha, G., Agid, O., Takeuchi, H., Lee, J., & Hahn, M. (2016). Treating negative symptoms in schizophrenia: an update. Current treatment options in psychiatry , 3 (2), 133-150.
Resnick, P. J. (2016). From paranoid fear to completed homicide. Current Psychiatry , 15 (2), 24-25.
Roth, R. (2014). Emotions, Facultative Adaptation, and the History of Homicide. The American Historical Review , 119 (5), 1529-1546.
Stahl, C., Voss, A., Schmitz, F., Nuszbaum, M., Tüscher, O., Lieb, K., & Klauer, K. C. (2014). Behavioral components of impulsivity. Journal of Experimental Psychology: General , 143 (2), 850.
Vogel, Matt. (2014). Mental Illness and Criminal Behavior. Sociology Compass. 8. 10.1111/soc4.12140.
