Don't assume school shooters are mentally ill
There is a lot of mumbo-jumbo psych talk circulating around the dead bodies in Uvalde, a town I knew pretty well because I consulted frequently with their hospital administrator.
I want to remind readers of the problem of personality disorders (P.D.) and distinguish P.D. from mental illness.
P.D. is a pattern of anti-social or dysfunctional behavior caused not by mental illness, but by bad manners and bad social adaptation. There are three groups of personality disorders. In the emergency medicine part of my life, I taught residents that P.D.s are the weird, the wild, and the withdrawn.
The killers and criminals are usually in the wild group, who are the most anti-social and disruptive.
Here is a typical listing available from a search at https://psychone.net/list-of-personality-disorders.php.
Class A (The Weird)
Odd or eccentric disorders
· Paranoid personality disorder
Characterized by suspiciousness and a deep mistrust of people, paranoid personalities often think of others as manipulative, cunning or dishonest. This kind of a person may appear guarded, secretive, and excessively critical. More..
· Schizoid personality disorder
People with schizoid personalities are emotionally distant and tend to prefer to be alone. They are generally immersed in their own thoughts and have little interest in bonding and intimacy with others. More..
· Schizotypal personality disorder
This disorder is characterized by odd and unusual �magical� beliefs. These individuals may have an eccentric way of behaving or dressing. They also tend to display outlandish beliefs such as believing that they can see the future or travel to other dimensions.
People with this condition often have difficulty connecting with others and establishing long term relationships. Overtime, they may develop a fear of social gatherings. More..
Class B (The Wild)
Dramatic, emotional or erratic disorders (wild)
· Antisocial/psychopath personality disorder
Individuals with this disorder are known to be manipulative, irresponsible, and have a history of legal difficulties. They show little respect for the rights of others and feel no remorse for their actions. They also leave a trail of unfulfilled promises and broken hearts.
Antisocial personalities are also at high risk for drug abuse (e.g., alcoholism; meth) since many are rush seekers. While they seldom suffer from depression or anxiety, they often use drugs to relieve boredom and irritability. More.. (Dunn note--this PD is male dominant)
· Borderline personality disorder
Borderline personalities are impulsive and have extreme views of people as either all good or bad.
These people are unstable in relationships and have a strong fear of abandonment. They may form an intense personal attachment with someone they barely know and end it without no apparent reason. They might also engage in a pull and push behavior that usually ends with their partner leaving permanently.
Self-mutilation, suicidal gestures or attention-seeking destructive behaviors are not uncommon. Borderline personalities are three times more likely to be female. More..
· Histrionic personality disorder
People with this condition engage in persistent attention-seeking behaviors that include innapropriate sexual behavior and exaggerated emotions. They can be oversensitive about themselves and constantly seek reasurrance or approval from others.
Excessive need to be the center of attention, low tolerance for frustration, blaming others for failures are also characteristics of the histrionic personality. More..
· Narcissistic personality disorder
Narcissistic personalities have a blown up perception of themselves and an excessive desire for attention and admiration. Individuals with this disorder have a false sense of entitlement and little respect for other people's feelings. They are oversensitive to criticism and often blame others for their failures.
Prone to outbursts of anger and irritability, the narcissistic personality tends to be manipulative in interspersonal relationships. But deep beneath the surface lies a vulnerable self-esteem, susceptible to depression and feelings of inferiority. More..
Class C (The Withdrawn)
Anxious or fearful disorders
· Avoidant personality disorder
This disorder is described by chronic social withdrawal, feelings of inferiority, over-sensitivity and social withdrawal.
People with avoidant personality disorder are constantly fearful of rejection and ridicule. They form relationships only with people that they trust. The pain of rejection is so strong that these individuals prefer to isolate rather than risk disappointment. More..
· Dependent personality disorder
Individuals with this condition have an abnormal desire to be nurtured that leads to submissive and clinging behavior. Dependent personalities have difficulty making their own decisions and seek others to take over most important areas in their lives.
They will often go to great length to obtain nurturance from others, have separation anxiety when alone and desperately seek another partner when a close relationship ends. More..
· Obsessive-compulsive personality disorder (OCPD)
Not to be confused with OCD. People with OCPD are perceived as strict and demanding by others. They have a persistent preoccupation with perfectionism, orderliness, and efficiency, at the expense of interpersonal relationships. They also show an excessive devotion to work, productivity and exhibit rigidness and stubbornness.
People with OCPD usually have a negative view of life and often become withdrawn and depressed.
I was a corrections physician for almost thirty years as a contribution to our hometown and local law enforcement/incarceration services. I know a little about criminals. Here are three essays, two short and one long, on the issue of criminality and mental disorders.
Consider my warning: P.D.s are not a mental illness; they are a culturally dysfunctional behavior problem. P.D. individuals are not psychotic or out of touch with reality — they just have a bad set of behavior and social controls. They got messed up on the way to adulthood and functional good behavior.
John Dale Dunn: emergency physician, retired; inactive attorney; resident of Brownwood, Texas.