Thursday, April 19, 2007

I talked with a local news station about mental health issues and the Virginia Tech case. You can see it here--click on the camera icon on the right to see video.


Anonymous Anonymous said...

You describe the killer as narcissistic. An AP story I just read contains this quote:

"'Cho was clearly psychotic and delusional,' said Dr. Louis Kraus, chief of child and adolescent psychiatry at Chicago's Rush University Medical Center."

Narcissistic and psychotic are pretty different! I find it hard to see psychosis anywhere here, in spite of Dr. Kraus, but I'd be interested in your comments, Dr. Helen.

One noteworthy point the article made (though I'm not sure it was deliberate) was about the prevalence of bullying in school. My own conclusion, from various observations, is that bullying is far too common, and that schools ignore the problem, or blame the victim, because they lack the backbone to deal with the bullies. This I see as a serious problem, whether or not the victims become criminals later.

1:54 AM, April 20, 2007  
Blogger Helen said...

Nom dePlume, Ph.D. said:

I said the killer wanted notoriety--given the diatribe he sent to NBC News--it seemed he did!

7:01 AM, April 20, 2007  
Blogger knox said...

Iroff says 15 percent of Knox County's students are dealing with depression and 10 percent have attempted suicide.

10 percent?!?!? That seems awfully high. Could his numbers be off?

9:48 AM, April 20, 2007  
Anonymous Anonymous said...

Have this many young people always suffered depression and withdrawl like this or is and has this number gone up?

10:04 AM, April 20, 2007  
Blogger Helen said...


I thought the same thing--10% of Knox County's students have attempted suicide? Can that really be correct? If so, what is going on?

Viola Jaynes,

The number of depressed young people has gone up in recent years with 5.5 million in therapy. Speculation ranges from too much infantilization of kids that leads to depression and psychopathology to earlier puberty and subsequnet mental health problems to just more identification of those who are depressed.

10:36 AM, April 20, 2007  
Anonymous Anonymous said...

The Daily Mirror supposedly interviewed some of Cho's relatives in Korea, who provided background on the family and their situation before and after they came to the U.S. If you believe the Mirror, the relatives said Cho had always been more or less the way his college acquaintances described him. They also said he was diagnosed as autistic by someone in the U.S., but that his parents were too poor and overworked to give him the specialized care and attention he required.

I've never heard of an autistic person devolving into a mass murderer. Maybe the exact term for his condition got lost in translation. Or else the Mirror is full of it - always a possibility.

Helen - does this sound like even a remote possibility to you?

10:49 AM, April 20, 2007  
Anonymous Anonymous said...

Historically, autism has often been misdiagnosed as schizophrenia. Sounds to me like this was a case of schizophrenia being misdiagnosed as autism.

If this is in fact the case, I'm not surprised. Autism has become something of a fashion. When we took my child to be evaluated for autism (the one who was eventually "diagnosed" as PDD-NOS) the leader of the evaluation team mentioned that they reverse many more diagnoses of autism by the family doc than they confirm.

And ask yourself this: Would you rather your child was diagnosed as autistic or as schizophrenic? Neither is pleasant, but I'm guessing many parents would rather hear "autism." After all, there has been speculation in the popular media that certain oddball historical figures, such as Jefferson or Einstein, may have had Aspberger's or other forms of high-function autistic spectrum disorders.

As I've mentioned before, autism and schizophrenia have a superficial resemblance, but are fundamentally different conditions.

Another article here:,2933,266921,00.html

seems to confirm that Cho was a bit of an oddball in middle and high school. Apparently he got picked on a lot, which is inexcusable and barbaric, but one does not become schizophrenic as a result of schoolyard taunts. There are indications the schizophrenia was already there, possibly overlooked because it was mistaken for an immigrant's poor language skills.

11:22 AM, April 20, 2007  
Anonymous Anonymous said...


As you can tell, I don't know much about schizophrenia or autism. But my layman's undersanding is that autism is something you're likely born with, while schizophrenia develops over time with most onsets during adolescence or later. Is that incorrect? If not, Cho seems to fit both scenarios and neither.

I also don't picture a schizophrenic as someone patience or planning skills to attempt something like this. That's probably not accurate, either.

Somehow, NPD still seems like the best fit for his described behavior. It all sounds very familiar.

But again - I'm not a pro.

11:52 AM, April 20, 2007  
Blogger Helen said...

SofaSleeper and Bugs,

It is hard to speculate a diagnosis for Cho, it sounds like there were a lot of problems from the get go. In general, however, Schizophrenia with childhood onset usually developes after years of normal development. An additional diagnosis of Schizophrenia can be made if an individual with Autistic Disorder developes the characteristic features of Schizophrenia with symptoms such as prominent hallucinations or delusions that last for at least one month. I have wondered (again this is speculation on my part) if Cho had an additional diagnosis of Schizoid disorder--that is a personality disorder characterized by choosing solitary activities, lacking close friends, emotional flatness, detachment, or flattened affectivity. In one study of mass murderers, it was found that personality quirks were common--especially those of paranoid, schizoid, narcissitic and antisocial traits and mass murderers were a curious blending of all these traits.

There are a number of questions about Cho's mental state that we may never know.

12:33 PM, April 20, 2007  
Anonymous Anonymous said...

Liked the interview, by the way. You have an intensity that must serve you well in your profession.

12:53 PM, April 20, 2007  
Anonymous Anonymous said...

Hmm, interesting. I have wondered myself how a schizophrenic could have planned this incident as well as Cho did. Mind you, it wasn't a masterpiece of planning, but it showed more foresight than I would have expected of a schizophrenic. Nevertheless, "paranoid schizophrenic" seemed as plausible a label as any.

So I went and looked up both NPD and schizoid disorder in Wikipedia, with the usual caution (caveat utilis Wiki). NPD doesn't quite fit, because there is no hint that Cho every sought the admiration of others. Schizoid disorder doesn't quite fit, either, because Cho was certainly trying to get the attention of others.

Perhaps the best diagnosis we'll ever come up with is "crazy, mean SOB."

12:57 PM, April 20, 2007  
Anonymous Anonymous said...

I think that there are narcissists who turn inward if they don't get what they feel is sufficient respect and admiration. They might be socially awkward, without the basic social skills they'd need to seek affection from others. So they simply give up trying and treat everyone else as a real of potential enemy.

If a narcissist is frightened of the world and determined to keep it out, it seems like he might lose the ability to get feedback from his environment - information about how he's doing and how other people see him. His narrative about himself might become more real to him than the real world. He might be the hero in his own story, or the anti-hero, but other people are definitely the villains.

I don't know - this just seems familiar somehow. Cho seems familiar. He reminds me of Harris & Klebold. Sounds like he reminded himself of them, too. But as people have said - nobody knows but Cho.

6:30 PM, April 20, 2007  
Anonymous Anonymous said...

Do comments like these help our understanding?
Mental case [Houston Chronicle]
"National Alliance on Mental Illness released a statement saying that Cho might not have been suffering from serious mental illness. The statement pointed out that people without mental illness are more prone to violence than people suffering from schizophrenia."

Is this true?
mental health professionals have exploded another assumption about Cho, that he was a loner. Subsequent analysis of his experience in college showed that Cho was instead a "failed joiner,"

5:43 PM, April 21, 2007  
Anonymous Anonymous said...

Yep, he was sound as a pound until he "just snapped." And isn't a "failed joiner" by definition a loner?

I think this organization is just trying to prevent backlash against the mentally ill. (Think about it - some of the comments on this and other blogs probably sound a bit scary to them.) Not sure how much insight it'll give us into Cho's condition.

6:39 PM, April 21, 2007  
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