Thursday, April 19, 2007

The Killer in the Lecture Hall

Professor Barbara Oakley in an op-ed in today's New York Times asks: Can administrators and deans really continue to leave professors and other college personnel to deal with deeply disturbed students on their own, with only pencils in their defense?

54 Comments:

Anonymous Anonymous said...

professor can only suggest, note, inform that a student seems to have a problem. There are or should be medical professionals, campus security people, etc who are responsible for addressing this sort of concern. Do you (NY Times) expect some chemnistry (say) prof to fix things on his or her own?

10:07 AM, April 19, 2007  
Anonymous Anonymous said...

College administrators are not smart enough, or competent enough, to be able to winnow out one murderer from among the hundreds or thousands of misfits, oddballs, psychos, toenail-pickers, introverts, obsessives, Asperger's patients, or loons who inhabit the typical college campus.

It. Cannot. Be. Done.

Pyschiatry is not an exact science.

If some administrators are dumb enough to try to find the one murderer and force him into therapy or off the campus, in the process they will pick out dozens if not hundreds of run-of-the-mill wackos, many of whom will sue immediately.

College administrators, not being known for their bravery, will NOT go down this path.

The "false positive" problem kills this notion before it starts.

Chester White

10:42 AM, April 19, 2007  
Anonymous Viola Jaynes said...

Professors are most likely not trained in these areas and should not have to deal with disturbed behaviour on their own. However, I also must say that my confidence in mental health professionals is not very high and has never been very high. I think it is such a subjective field and area of study that it is difficult to pin things down. Dr. Helen, this is certainly not a bad light on you...I so enjoy your thoughts and your blog...and your area as a "forensic psychologist" is a lot more specific, it seems. I am making a generalization in my statement about mental health professionals.

10:45 AM, April 19, 2007  
Blogger Allison said...

But it is worse than that. Even when they don't leave it to the professors, they leave it to psych staff that are not equipped to handle it. The counseling services on a college campus aren't even primarily to help adolescent and young adult students. Their services are to help the greater community, involving staff and depemdemts as much as students. They are expecting to deal with marital issues, eating disorders, stress, and some depression and anxiety, They are not looking for or equipped to treat dangerously mentally ill patients.

And there's still no single point of contact anyway. Housing issues go one place, academic another, conduct another. Other students won't break the silence out of fear that cops will run a dragnet through their dor, and find pot. There's no clearinghouse, and once confidentiality is invoked, all bets are off on how you inform anyone anyway. multiple deans refrain from discussing their charges by name with others. there's no way to cross reference the problems.

And this doesn't even get to administrators who want to deny the problem, or the inability to police the dorms. If a campus can't secure its dorms against theft, drug abuse, assault or rape, how are they going to handle violent mental illness?

10:55 AM, April 19, 2007  
Anonymous Sofasleeper said...

College administrators are not smart enough, or competent enough, to be able to winnow out one murderer from among the hundreds or thousands of misfits, oddballs, psychos, toenail-pickers, introverts, obsessives, Asperger's patients, or loons who inhabit the typical college campus

Hmm. As a borderline Aspberger's suffer, I'm not sure I'm happy being lumped with "misfits, oddballs, psychos, toenail-pickers, introverts, obsessives," and "loons", or any other sort of "run-of-the-mill wackos."

... Well, I'm probably okay being lumped with "introverts." But the introverts might not agree.

Do be careful of your sweeping generalizations.

11:00 AM, April 19, 2007  
Blogger Soccer Dad said...

Earlier you wrote
The violence-prone individual is more likely to have enduring personality pathology, such as a paranoid, schizoid, narcissistic, or antisocial personality, and a long history of difficult interpersonal relationships. He may ruminate about perceived slights or injustices for months or even years. Because he is often a loner, he has no circle of friends to correct his misinterpretations of other people’s intentions and behaviors. Because he looks at the world from a very egocentric point of view, he is unable to correctly perceive the effect of his behavior on other people. The emotion he feels is not everyday anger but profound and intense hatred of those who have allegedly demeaned or wronged him. His thinking is so faulty that he can justify assaultive behavior on the basis that he is the innocent victim (Beck, 1999).
I once knew someone like that at work. Like Prof Oakley, we all thought he'd go postal one day. Eventually he was fired, but to the best of our knowledge he never killed.
I suspect that there are many people who fit the description of what you wrote earlier, but how many of them actually end up becoming mass murderers. Just because anti-social people are more likely than the general population to go on a killing spree doesn't mean that they are likely to in absolute terms.

11:09 AM, April 19, 2007  
Anonymous Anonymous said...

Sofasleeper:

My point exactly.

To the average person, an Asperger's patient may display signs of odd behavior, to say the least, sometimes REALLY odd behavior. I assume you will not deny that.

Plenty of such patients have been hounded over the years, because it is impossible to accurately parse "odd" (or at least non-neurotypical) behavior.

I am on your side. My son is on the spectrum, so I know what I am talking about.

To elaborate on my first post, look what happened here. THEY HAD THE GUY. Then some magistrate essentially let him go.

So someone might say, well, we have to be tougher, harsher. But how many other folks have been hauled up before magistrates on pysch evaluations and DIDN'T kill people later? Almost all the time it works out fairly well, but once in a while it doesn't. Only with hindsight can we tell the difference. This is not foolproof science.

That's what no one looks at.

11:20 AM, April 19, 2007  
Blogger Maxine Weiss said...

One of the failures of the Mental Health Community, and psychiatry in general, is that they have never been able to predict, with any accuracy, who is going to commit murder, and who isn't.

After all, if Mental Health could predict who will kill, and who won't....we wouldn't have homicide in the first place.

Peace, Maxine

11:22 AM, April 19, 2007  
Blogger tomcal said...

Most of the university professors I know are on the verge o mental illness themselves...

11:22 AM, April 19, 2007  
Anonymous TMink said...

Hey Sofasleeper, I work with quite a few Asperger's patients and play with quite a few Asperger's friends. It is not that ASD folks are dangerous, it is that people with ASD look and present differently. I think the comment was made about false positives, not dangerous people. People with ASD present as different, and professors that are looking for axe murderers will confuse the two if they do not have training.

It is the difference between perception and reality, how someone looks and how someone acts. But it is my experience, professionally and personally, that people with ASD are some of the most interesting people and best friends a person could ever have.

Trey

11:27 AM, April 19, 2007  
Anonymous Sofasleeper said...

Anonymous 11:20,

Thanks for the clarification. I'm not sure I have a "side," but I'm glad you're on it.

Yes, Aspberger's patients display odd behavior. There's no point denying it. The heck of it is that I know certain behaviors seem odd to others, but they're so comfortable for me that it is a real effort to give them up. Doing so anyway has often been rewarding, but it's never been easy.

Making eye contact is still difficult. I'm not sure why. I can only tell you that it makes me feel naked and vulnerable. I've read various explanations for this particular AS symptom, but what is relevant here is that this is also a symptom on paranoid schizophrenia. I would hate to see the two confused.

Being interrupted while I am concentrating on something is almost physically painful. I don't know why, other than that it is another classic AS symptom. I'm aware of this and am teaching myself to change focus more gracefully, but my family still sometimes get snapped at when they interrupt me at the computer. I see the same behavior in one of my children, who has been diagnosed as PDD-NOS.

I have progressed to the point where I can function well with most people, yet most people flag me as a "nerd" about five minutes into a conversation. I doubt I'll ever get beyond that, and skeptical that I should make much effort to try. I have found it more productive to try to help people be more comfortable with my nerdiness; most people, most of the time, are willing to cut a little slack, to their credit.

And your point is well taken. An Aspberger's sufferer -- even one who is well over the borderline, and not highly functioning like myself -- is a very different fish from a paranoid schizophrenic. But both are behaviorally a few sigma off the mean, and most could be described as "loners."

Conclusion? "Oddball" and "loner" are grossly inappropriate as red flags for future mass killers.

This does not mean there are not useful red flags. I am no psychologist (though perforce I have learned a bit about the trade) but I would venture that stalking and arson are fairly reliable red flags. They also have the considerable merit of being antisocial acts in themselves -- unlike oddballedness or loneliness -- and therefore can justly be taken as grounds for a certain amount of coersion.

I expect Helen can shed useful and interesting light on which behavioral oddities are reliable red flags, and which are not.

11:48 AM, April 19, 2007  
Anonymous Anonymous said...

Troubling to me is the lack of clarity about the age group we are dealing with... as Steyn pointed out yesterday these are not children. They are certainly somone's child, as am I even at 42yrs old, but in society we don't look at them that way. They can vote, be sent to war, and drive 4000 pound projectiles called cars. These are adults, though young and inexperienced. The mental issues are complicated, as are what you can do about them, but calling their parents, doesn't necessarily help, because they are of an age where the parent may not exert much control... and the student must be taking responsibility for themselves. Perhaps that is the main provlem with this man to start with. He takes responsibility for nothing...
D

11:59 AM, April 19, 2007  
Anonymous Anonymous said...

Sofasleeper:

I agree with everything you have just said. Sorry for the misunderstanding.

I think I may have a touch of AS myself, but of course it was undescribed when I was growing up.

It's a lot more common that generally realized, as are related conditions such as hyperlexia (which is incredibly fascinating to study). My own theory (which believe me is as good as anyone's, as I have read them all) is that these syndromes are genetic to a large degree, and since it is more common for, let us say, unusual people to marry outside of their geographic location that it was maybe 50-60 years ago, they are becoming more prevalent.

To put it baldly, nerds are more likely now to congregate together on campuses and places like Palo Alto and therefore marry other nerds than they were before World War II. A couple generations later, here we are.

Not helping matters is the fact that bits of these syndromes seem to be mixed together in different people, making them impossible to tease apart. Lots of research to be done on these topics. If you ever get a chance to hear Tony Attwood talk on AS, or Temple Grandin on autism, try to go.

Chester White

12:07 PM, April 19, 2007  
Blogger alcatholic said...

I think psychology blogging will become more important after this tragedy.

I've learned so much already about different symptoms and red flags.

It won't be a bad thing if debates on societal violence start to focus less on guns and more on mental health, and blogs like this can make sure that perspective is raised responsibly.

12:53 PM, April 19, 2007  
Anonymous Anonymous said...

Well, I'm not much for monday morning quarterbacking. I think it would have been very hard for anyone to have caught this. People disappear into a crowd quickly in a large state university like this. Nor do I think much of gun control. But, I understand this young man had a psychiatric hospitalization. This man's name should have been on a hold list with the ATF and any gun purchases should have been subject to further investigation and evaluation.

1:00 PM, April 19, 2007  
Anonymous Sofasleeper said...

Chester,

I have never been formally diagnosed. I first suspected when I saw a quiz on Aspberger's in a popular science magazine, and found that I matched at least nine of the ten criteria. I also have three nephews with various forms of autism, but I didn't make the connection at once. Hard to see yourself in others sometimes.

Someone loaned my wife a book on "The Aspbergers Marriage" and she is absolutely convinced of the correctness of the diagnosis. Regrettably, she sometimes interprets this as "he's broke and can't be fixed." She also blames me for our PDD-NOS child: "Your genes." There are other issues as well. We have to work at holding the marriage together.

PDD-NOS is a catchall diagnosis. It has been suggested that the correct diagnosis for my son is hyperlexia. I am growing suspicious of labels.

I've heard some of Tony Attwood's talks, on tape. He is quite good. I just about stood up and cheered when he said, "Some people find teasing those who are different entertaining. I find it barbaric."

I have heard of, but not heard, Temple Grandin.

Back on the main topic, I do find it disheartening that Cho was ruled mentally defective by a court, but was still able to purchase a gun, in spite of laws that should have blocked the purchase. I believe owning a firearm is a right, but only for sane, law-abiding people. A free market can still be regulated.

1:16 PM, April 19, 2007  
Anonymous Anonymous said...

I understand the urge to better identify these individuals and make the colleges expell them, or whatever, but I think what's being missed in this debate is that usually the murderer whacko has already been expelled. This was the exception!

Many school shootings, or work shootings, are from disgruntled former students or employees. So even if the universities start expelling potentially violent people, they're not necessarily protecting their students. They may even make things worse.

I'm not sure what to say except that evil is always going to be among us, and we all better learn some good self-defense.

2:02 PM, April 19, 2007  
Anonymous Anonymous said...

This is kind of off-topic, and might be regarded a flame-bait by some, but I'd like to raise the question and see who else thinks it might be worth evaluating. It's not my idea; it belongs to a contributor to another forum. It summary, the question is: is it possible that the response by the VT police chief and the President of VT was delayed by their presumption that this a purely a case of domestic violence?

As I understand the chronology of significant (not all) events, the following occurred:

1) Cho showed up at Emily’s room and shot her and her neighbor, then left and went back to his own room.
2) When the police arrived, they started questioning folks, and one of the folks that they questioned was Emily’s roommate, who told them that Emily’s (real) boyfriend had guns, and that she thought he was a little weird.
3) The police went off looking for the boyfriend, and did eventually find him, having previously identified him as “person of interest.”

At this point, there was no shooter apprehended, but a potential shooter had been identified.

I have to ask: Is it possible that the template of “domestic violence” was so deeply imprinted on the authorities that they didn’t even consider that the shooter might be an unknown third party, and that THIS is the real reason that the campus was not locked-down sooner?

Consider this: two people are shot and killed in in a college dormitory an apparent random act, the killer is unidentified and on the loose on a college campus, yet no lock-down is called for. I would think that an objective analysis of the situation would call for a lock-down immediately. The only way that not locking down the campus seems reasonable is based on some presumption of who the guilty party is and what their motivation was.

So I ask again, did the template for domestic violence cloud the judgment of the authorities in this case, and thereby contribute to the deaths of everyone who died in the second round of shootings?

Rusty

2:09 PM, April 19, 2007  
Blogger alcatholic said...

Good point, anon@2:02

Sending Cho home might not be optimal. He could snap and simply plan his rampage at home before returning to the campus.

As I posted in the previous thread, the only thing I can think of is that Cho needed followups by the mental institution that held him in 2005. The deterioration of his condition could(?) have been noticed and further measures taken, including medication(I would hope).

Universities should probably consider putting aside student privacy and inform parents of all counseling type events, and holding them partially responsible for continued observation, treatment, etc.

2:25 PM, April 19, 2007  
Anonymous Anonymous said...

Sofasleeper:

If you hit 9/10 of the Asperger traits, that's about as good as it gets.

"Aspies" are some of the most interesting people I have ever met. They are almost always intelligent and kind, and contribute a lot to society. Pardon me for saying it, but your wife need to read more on the topic.

A very high percentage of people at, say, a Star Trek convention have Asperger's.

You might want to check out www.hyperlexia.org. There is a lot of good info there, and links to more. Much can be done to help the hyperlexic child, and others with "PDD-NOS" ("Pervasive Developmental Disorder - Not Otherwise Specified," which of course means nothing). Possibly the best place in the world for treating and diagnosing hyperlexia is the Center for Speech and Language Disorders in Elmhurst, IL. People come there from all over the world.

Hyperlexia is fascinating. How can a 2-year old teach himself to read in a few weeks, when he can't even talk? How can he learn cursive by 4 without being taught? How can he figure out lower-case letters, having only been taught upper-case? How can he spontaneously read text upside-down at 4?

I have seen a kid do this and more. Universities are full of people like this.

Two last thoughts:

1. If the psychiatrists/psychologists can label something (or cram it into a box on a form), they will, regardless of whether it is relevant. This enables them to charge for diagnosing and treating the patient. A whole hell of a lot of this goes on.

2. Your instincts on Asperger's, hyperlexia, etc. are more likely to be accurate than anything a medical professional, especially a physician, tells you. Most of them are TOTALLY clueless on this stuff.

Chester White

2:39 PM, April 19, 2007  
Anonymous Anonymous said...

I am a university professor, and we are not left to deal with problem students on our own, so the question starts with an incorrect premise. The faculty at VA Tech also did not deal with Cho on their own, they referred him to counselors.

The counselors at colleges and universities are not there to provide long-term psychiatric care or services, they are meant to be a filter. They can provide short-term counseling to students who encounter typical college-age issues: break-ups with significant others, coping with academic stress, conflict resolution, homesickness, etc. When someone like Cho comes in, who is not in need of counseling, but professional psychiatric treatment, their job is to provide a referrral to the appropriate resource.

What people also don't seem to take into account is that once a referral is made to a psychiatrist, one has no way to verify whether the person in question has actually seen the psychiatrist or if care is ongoing. Doctor-patient confidentiality laws prevent a psychiatrist from answering any of those questions if someone were to call and inquire if a person was seeing them as a patient. Therefore, all that can be done is to make the referral and hope the psychiatrist is doing what they should be doing.

If someone is clearly an imminent threat to themselves or others, which is not always as easy to determine as the armchair psychologists would like to claim it is while pointing the finger of blame all over, then university faculty know to call the police, as do counselors. But, unless someone makes a clear and specific threat, there is little that can be done. Do we have any reason to believe this loner who spoke to nobody would have been walking around the day before telling people he was thinking about going over to the engineering building and shooting everyone inside and then killing himself? Or that he would have even said he was planning to shoot himself and that he already had the gun to do it? In order to have someone arrested or involuntarily committed for threat of harm to themself or others, they need to be that specific in their intentions.

So, no, faculty and administrators are not that stupid or clueless as some would like to point the blame finger that way. There are limits to what we can do as defined by law. And, there are limits to what anyone can predict. Mass murderers are not all that common, so it is hard to study them as a population to look for patterns that distinguish them from other troubled people who do not become mass murderers. It's really not as simple as saying, "Yeah, he was a sort of creepy loner who wrote violent essays in creative writing class, so we should lock him up because we know he's going to go on a shooting rampage." We don't know that until we have the perfect clarity of hindsight to help make that determination. There are plenty of people who are loners, who seem a bit creepy to others, who might write violent essays as an outlet for their frustrations and never would act out in any violent way in reality; there are a lot more of them than there are people who turn into mass murderers.

It's a lot easier to sit back at the computer in the aftermath and say they shoulda, woulda, coulda, but it doesn't mean that in the immediate panic and frenzy that any of that was really possible.

How does one even begin to lock down an entire campus, or notify everyone on that campus that something is happening when it happens during the time of day when most students are out and on the way to classes, not sitting in residence halls, or reading their email, or near a radio or TV? How do you lock down a campus when the shooter is already on that campus, and one of the students who is expected to be there? It's much easier to block roads on and off campus if something happens off-campus and doesn't involve a student, but when the violence is committed by a student and is already happening on campus, there just isn't any way to lock down a large campus. Indeed, a lock down of the engineering building may have done nothing but trap more students inside it when the shooting began. And, what would have stopped this kid from shooting his way past any security in place? University campuses are large places, with multiple roads in and out, multiple entrances to every building, thousands of students on the move at any given time.

I don't see any way this could have been prevented short of finding that the psychiatrist treating Cho was in some way negligent, and we don't know enough about that yet to make any determination if that happened or not.

It's a shame that someone who is claiming to be a forensic psychiatrist will sit around wagging her finger along with everyone else, as if psychiatry were an exact science in which one can easily make such determinations reliably in every case. Dr. Helen should know more than anyone else how much uncertainty remains in the field and how challenging it is to identify someone with such violent potential before they commit the first violent act.

2:41 PM, April 19, 2007  
Blogger Radish said...

How does one even begin to lock down an entire campus, or notify everyone on that campus that something is happening

Has it really been that long since the Cold War? Do you live in an area with no severe weather? Every building on every campus has an emergency warning system, probably with a recorded voice giving instructions and flashing lights for hearing-impaired students: continual noise for fire; three short blasts, a pause, then more short blasts for tornado approaching; devise a code for "shooter on the campus" and teach the faculty and staff how to lock down offices and classrooms the same way you teach them how to evacuate and shelter for other impending diasters. Stick some tornado warning sirens out on the drill field and inform students where the bomb shelters are.

Fiendishly easy, unless you're an administrator.

I can't blame VT for not having this in place since no one anticipated this sort of threat, but now there's no excuse for schools not preparing to deal with the inevitable copycats.

2:57 PM, April 19, 2007  
Anonymous Dave said...

One thing that I've been thinking about with all of the talking about psychiatric disorders and danger to the community is this seem to be a fairly new phenomenon.

It seems to me that until the 70's, most of the truly dangerous were involuntarily committed without much in the way of procedural limits. Was this a worse or better action?

2:58 PM, April 19, 2007  
Anonymous Anonymous said...

Why was this allowed to go on for so long? There's a magic phrase on many campuses: "full fee paying student." No loans, financial aid, or federal money to account for, paper work to go through or federal strings attached. No deep tuition discounts for local students or students who are citizens.


College students in general are coddled. Students paying full fees are bulletproof.

3:10 PM, April 19, 2007  
Anonymous TMink said...

I would say that 10% of my practice is with child and teen people with ASD. We can all learn new tricks, and grow, and so can folks with this particular challenge. Well, maybe I can never learn to spell, but that is another thread.

Take David Byrne from Talking Heads. His social skills and comfort grew till he got positively boring!! (Mostly a joke.) Camille Paglia does OK for herself, and she is not the most socially comfortable person in the world. Heck, the character Chloe on 24 is portrayed with ASD, and she is a favorite with the fans.

And nerds rule. Gates can buy and sell Michael Jordan, old DW, and Tiger Woods together several times. So could Steven Speilberg. Nerds have to wait longer to get their due, highschool is not kind to them, but the early 20s and 30s sure can be!

I embrace my inner nerd. I read too much, play an online MMPOG, comment on blogs, and have the worst haircuts in the world till my wife makes me get a good one. Tough! I am nerdy and proud of it.

And Sofa, you had no choice about your genes, but your wife CHOSE to marry and reproduce with you. Who is she mad at now?

Trey

3:25 PM, April 19, 2007  
Anonymous Sofasleeper said...

Chester,

Curiously, my wife is a moderately avid Star Trek fan, and she stuck with the franchise longer than I did. I gave up halfway through Voyager; she stuck with it well into Enterprise.

I've seen the hyperlexia site, and some things match. Others do not. Apparently my kid is an individual.

"I am a university professor:"

Much of what you say makes sense. However:

It's really not as simple as saying, "Yeah, he was a sort of creepy loner who wrote violent essays in creative writing class, so we should lock him up because we know he's going to go on a shooting rampage." We don't know that until we have the perfect clarity of hindsight to help make that determination. There are plenty of people who are loners, who seem a bit creepy to others, who might write violent essays as an outlet for their frustrations and never would act out in any violent way in reality; there are a lot more of them than there are people who turn into mass murderers.

Do we really know how predictive various red flags are? I'm guessing there have been at least a few empirical studies on this. I'm further guessing that Helen would know more them than almost anyone else here.

I suspect the percentage of loners who go on to mass murder is very low; I base this on the fact that I've known dozens of loners, and none became a mass murderer. The same is true of Oddball Behavior-Not Otherwise Specified.

But I'm guessing the percentage of stalkers who go on to more violent crimes -- perhaps not mass murder, but certainly rape or other felonious assault -- is high enough to warrant some attention from the law, particularly since stalking in itself is antisocial and criminal. And we know Cho was a stalker.

I'm likewise guessing the percentage of guys who set fire to their dorm rooms who go on to more violent crimes is high enough to warrant some attention from the law, yadda yadda yadda. And we have credible reports Cho set fire to his dorm room.

What other red flags can Helen offer that are sensitive enough and selective enough to be useful?

3:26 PM, April 19, 2007  
Blogger alcatholic said...

Professor Roy has expressed frustration that she couldn't do more. So, of course, she was not so stupid as to ignore the danger signs. I don't think the blame is one of stupidity.

Professor, are you saying that you don't think the public should discuss and debate the issue of mental health issues and public safety?

As a staff member, I think raised awareness and redoubled efforts to help troubled students would be a good outcome of a public debate. Policy changes, properly considered and evaluated by Administrations in response to public pressure, might be another.

Are you arguing for the status quo, or simply criticizing the comments on this thread?

3:58 PM, April 19, 2007  
Anonymous Sofasleeper said...

tmink,

I embrace my inner nerd. I read too much, play an online MMPOG, comment on blogs, and have the worst haircuts in the world till my wife makes me get a good one. Tough! I am nerdy and proud of it.

My Amazon book wish list is fifteen pages long, I program in C++, and I have a Linux workstation on my office desk. Neener neener neener.

Seriously, I concluded some time ago that an excellent predictor that a person is a geek is that he actually boasts of his geek credentials. I was positively disappointed when one of the online geek quizzes scored me as merely "Lord Geek Emperor" and an acquaintance as "Geek God." What this says is that AS have effectively generated a subculture of their own, in which they find social interactions reasonably comfortable.

Cho apparently had no such proclivities, so it's tempting to suggest that the oddballs who lack even a subcultural milieu are the dangerous ones. Unfortunately, I think this beautiful theory is wrecked by the ugly fact of the Columbine incident, since the Columbine shooters were reputedly heavily into Goth subculture.

... and I should make a brief disclaimer: Not all AS are geeks, and not all geeks are AS. There is, however, considerable overlap, as you and I are acknowledging here.

Personal hygiene: This at least is an aspect of AS I can rationalize. I wash regularly, keep my hair fairly tidy (it appears to have a mind of its own) and shave and brush my teeth daily. It took effort to get in the habit of doing these things (I have an impressive amount of metal in my mouth.) Partly this is because, as an AS, I am just not as keenly aware of how others perceive me as a normal person would be. I had to consciously develop this awareness. But the other part is that many personal hygiene activities are produce what, for me, are unpleasant tactile sensations. I hate having stuff on my skin; I hate being touched. (I'm married because libido proved a more powerful drive than dislike of tactile sensations.) My child apparently is similar in this respect: He strips at times when it is socially inappropriate. So does one of my autistic nephews. I can relate even though I've socialized myself to know better.

Back to the main topic: What I've seen so far is entirely consistent with Cho being a paranoid schizophrenic. (Helen, is that a redundancy?) Unfortunately, AS was very frequently diagnosed as schizophrenia at least into the 1980s, when awareness skyrocketed; but I suspect it is still misdiagnosed as schizophrenia on occasion. I'm a bit of a loner; so are schizophrenics. I sometimes can be found staring into space and mumbling to myself; so can schizophrenics. The difference is that I'm trying to work out an indefinite integral in my head, whereas the schizophrenic is have a conversation with The Voices. I think Scott Adams ("Dilbert") did a very funny strip on this once.

Yet the two conditions are very different. Crime rates among AS are significantly lower than the background population (most of us are instinctively afraid of violating The Rules.) Schizophrenics, not so much (though I suspect most are not a danger to anyone but themselves.)

3:59 PM, April 19, 2007  
Anonymous Anonymous said...

It does seem like Cho wasn't just another troubled depressed student, but had heavy-duty mental illness like paranoid schizophrenia.

So my question is, should we go back to institutionalizing schizophrenics? Some subset of them?

They certainly shouldn't have guns. Is there a reasonable gun policy that would keep them from having guns while allowing law-abiding, sane folks to have guns?

Was Cho's problem moral rather than mental? Nikki Giovani called him "mean". Should schizophrenia + mean be the criterion for involuntary commitment?

Dr. Helen, I'm relying on you, since you actually know something about these issues.

5:38 PM, April 19, 2007  
Blogger Webutante said...

Helen, I believe that Israeli school teachers are allowed to be armed with handgunsin many schools. That certainly would cut down on the problems of violent students.

5:57 PM, April 19, 2007  
Blogger Jeff said...

Would the authorities have been able to deal with this man more effectively in the days prior to deinstitutionalization?

6:13 PM, April 19, 2007  
Anonymous Mr. Natural said...

I'm not really qualified anymore to comment on mental health issues. I was a clinical psychologist in the 70's, but got disillusioned with the field. Went back to grad school and retreaded myself in psychophysics (and no, that's not a physicist gone bad) and as an engineering psychologist. End of disclaimer.
However, I did work with a wonderful, experienced psychiatrist who would have diagnosed Cho (from the press accounts I read) as "spooky". That's good enough for me. If you ever meet someone like that, you'll know because they give you a really odd, disquieting feeling. The DSM-IV might give you a more scholarly description, but it won't really be any better. Psychiatric diagnostic categories are largely for third-party payers anyway, not for predictive purposes.
But you can't imprison someone for being spooky. Clinical psychology and/or psychiatry has very, very far to go before it is a science in the sense that its theories are reliably predictive. Even normative psychometric testing, which ain't bad in the prediction department as psychological tools go, gets lots of bad press and negative comment - often from the very people that criticize mental health folks when they can't predict violent lunacy.
What should have happened to Cho when he pulled that gun in a classroom and started shooting is the professor and a dozen or so students should have pulled a gun and shot him.
The reality of the situation is this: we are not going to eliminate either violent lunatics or guns in the foreseeable time horizon, no matter what we do. Laws, by definition, are irrelevant to criminals. If laws were the answer, crime would disappear. If treatment were the answer, crime would disappear. Gabbing for 50 minutes three days a week with a court ordered patient ain't treatment anyway. There are no magic words. Sorry. If someone doesn't want to change his/her behavior or thought patterns (assuming they could, of course) the remediation options are: (1) drug them into a stupor, (2) lock them in a cage, or (3) kill them.
Once you start locking up people for being weird, or even spooky, you start down a very dangerous road. We've been there, to some degree, and it was of course abused. I've seen people in Huntington and Weston State Hospitals (WV) that most definitely should never have been there, but someone wanted a divorce or their estate and got them involuntarily committed. Ken Kesey became famous writing a novel about committment abuse.
Sad as it is to contemplate, we're just going to need to kill guys like this when they loon out. Best case we can hope for is to be maximally ready to do that.

6:38 PM, April 19, 2007  
Blogger Maxine Weiss said...

Yes, look at what Joe Kennedy did to Rosemary. Rosemary Kennedy was not violent. Look at Frances Farmer and Jean Tierney....and the abuses. In California, it's still very easy to get someone detained on a 5150 observation hold...the question is what happens after that....and there aren't enough beds in Los Angeles for all the crazy people who are annoying me right now as I speak.

You can't 5150 the world, everytime I'm uncomfortable, or don't like the way someone looks. For years, that's what happened in California.

Poor Rosemary Kennedy. Is she still alive? Lots of innocent people have been abused in the name of "mental health".

Peace, Maxine

7:40 PM, April 19, 2007  
Blogger alcatholic said...

I really value the words of caution about the use of psychiatry to protect the public from the mentally ill. Sober minds are definitely needed and appreciated.

Assuming no negligence is found, and I don't think any has surfaced in the story of this tragedy, are tragedies like this just an evil to be prevented, or not, by circumstances beyond explicit control?

8:37 PM, April 19, 2007  
Anonymous BigAl said...

Any attempt to see the NYT as being more reasoned in their editorials is hogwash. In this case, they have "reasoned" that a re-ignition of the old gun control debates is a sure-fire loser for their friends and might lead to a debacle in 2008. No more, no less.

7:55 AM, April 20, 2007  
Blogger Purple Avenger said...

Do you (NY Times) expect some chemnistry (say) prof to fix things on his or her own?

Once shooting starts, yes. The cops will come and sponge up your dead carcass, and take lots of pictures, but they're not going to be stopping too many nuts from wasting you in the next few minutes.

12:15 PM, April 20, 2007  
Anonymous TMink said...

Sofasleeper wrote: "My Amazon book wish list is fifteen pages long, I program in C++, and I have a Linux workstation on my office desk."

OK, I was not trying to out nerd you. And that is a good thing, as I am not worthy to carry your slide rule or translate your Klingon. I am not worthy, but at least I know!

Trey

4:14 PM, April 20, 2007  
Anonymous Sofasleeper said...

Heh. I don't speak Klingon. Even I have limits.

I do know how to use a slide rule, but I prefer a good RPN calculator.

5:56 PM, April 20, 2007  
Anonymous Bugs said...

Anybody heard "White and Nerdy" by Weird Al Yankovic?

6:40 PM, April 20, 2007  
Anonymous Anonymous said...

I have a child with Aspberger's and saw on Fox that Cho's parents said he had a form of autism. Geraldo aldo did a feature on a related story where a young man with Aspberger's killed two people. This frightens me because part of the problem with Aspberger's is how the child is misunderstood, isolated and taunted to begin with...

That being said, I feel sorrow for all involved and do not think it could have been prevented. Most of the time, violent people don't seek mental health counseling (Ted Bundy, OJ Simpson, Scott Peterson etc.), so I don't believe mental health treatment is an accurate way to "flag" potential killers. However, it would prevent many people from seeking support, counseling and treatment. I don't own any guns and am against guns in general, but I think if someone is hell-bent on getting a weapon, they probably would find an illegal way to do so.

The Viginia Tech incident was a human tsunami and no one was responsible except for the gunman. We like to think we can control eveything and we simply can't. Blaming people (the school, the teachers, parents) only causes more pain. The best defense we have aginst violence in this country is compassion, acceptance and intolerance for bullying and isolating people from the group because they are different.

1:35 AM, April 22, 2007  
Anonymous Sofasleeper said...

" Anybody heard "White and Nerdy" by Weird Al Yankovic?"

Hilarious. Absolutely side-splitting hilarious. I have a new fondness for Donny Osmond.

And, yes, I've engaged in most of the behaviors depicted. Except that I've never liked Pascal, and the Star Wars Holiday Special really stank.

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