The contributory role of psychopathology and inhibitory control in the case of mass shooter James Holmes

• In this article, the case of Mr. Holmes is discussed in detail with a particular focus on the treatment he received when he was at graduate school in the months leading up to the shooting and, primarily, the findings from the sanity evaluation carried out by Dr. Metzner. In this article the I-3 model is applied to the case of Mr. Holmes. His attack can be seen as resulting from an increase in dispositional and situational impelling factors, presence of instigation factors and a decrease in inhibiting factors, based on a detailed review of available information. The instigation, impellance and inhibition factors potentially present during the lead up to the shooting (approximately five months) and present at the time of the shooting are explored in this article. Instigation factors included a breakup with his girlfriend and academic failure at graduate school. Impellance factors included chronic (i.e., persistent) and severe mental illness associated with psychotic features (e.g., delusions, hallucinations and disordered thinking); social anxiety disorder (and trichotillomania); chronic suicidal thinking; chronic homicidal thinking and his perceived biological shortcomings. Inhibition factors included experiencing a "loss of fear" or "overcoming fear" of the consequences of killing people (in other words, he was becoming disinhibited); prescription medication which may have decreased his inhibition (specifically, antidepressant medication, sertraline - he was eventually prescribed 150 mg of sertraline) and individuals with ASD may be `more readier' compared to others to act on psychotic impulses. This may have been what was happening in the case of Mr. Holmes. Specifically, why he was potentially more vulnerable to acting on his psychotic ideas and beliefs. Also, disinhibition caused by his severe mental illness associated with psychotic features (later diagnosed by the four psychiatrists before the trial as either schizophrenia, schizoaffective disorder or schizotypal personality disorder) may also have been an important contributory factor.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

Nyckelord

Mass shootings

James Holmes

Psychosis

Schizophrenia spectrum

disorders

I-3 model

schizophrenia spectrum disorders

pervasive developmental disorder

response-inhibition

early intervention

asperger syndrome

self-control

autism

psychosis

pathways

violence

Criminology & Penology

Psychology

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