Predictability of
dangerousness in association with mental disorders remains elusive, outside of
a few relatively well-established risk factors for the prognostication of
violence, such as male sex, the presence of a psychotic disorder, and comorbid
substance abuse.
In clinical practice, inquiry into the presence of aggressive
or violent ideation, in the form of ideas of homicide or suicide, is part of a
standard mental status examination. Nonetheless, fantasy life, when it concerns
harm toward others, may not be as reliable an indicator of imminent danger as
it may be in the case of self-harm. Five cases of young Italian men with
Asperger syndrome and recurrent and extremely violent femicide fantasies are
presented.
While there is no direct correlation between autism spectrum
conditions and violence, as other humans, persons with an autistic condition
are capable of committing crimes, including homicide. All five had in common a
number of characteristics and behaviors felt to be pathoplastic: All had been bullied,
all had been romantically rejected, all were long-standing First Person Shooter
(FPS) game players, and all were avid violent pornography consumers.
The
potential for an actual neurocognitive impact of violent video games, well
documented in the literature, and its combination with personal life history
and chronic habituation following long-standing violent pornography use is
discussed in the context of social and emotional vulnerabilities.
While
aggressive fantasies cannot and should not be underestimated, in countries
where duty to protect legislation does not exist, a clinical approach is
imperative, as, incidentally, should be anywhere.
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By:
- 1Medical College of Wisconsin, Milwaukee, USA The Law and Behavior Foundation, Amsterdam, The Netherlands mt.palermo@lawandbehavior.org.
- 2Tilburg University, The Netherlands.
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