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Serial Killers: A Bio-Psycho-Social PerspectiveMelina ZahalkaWestern Washington UniversitySerial Killers: A Bio-Psycho-Social PerspectiveSerial killers have held the fascination of the public; we question how and why they commit the acts they do. A serial killer is characterized by varied motivations, behaviors, and psychological characteristics (Brantley & Kosky, Jr., 2005). Identifying the “why’s” behind the behavior of these individuals has proved both intriguing and difficult: there are many shared traits, though non solely attributed to serial killers. For example, most serial killers were abused as children (Holmes & Holmes, 1998a, 1998b); however, most abused children do not become serial killers. In order to understand serial murderers, we must be willing to research and understand the variety of causes behind their heinous and troubled acts. Following this is a discussion investigating the many factors contributing to the makeup of a serial killer within their biological, psychological, and sociological realities. There are three identified types of “multicides”: mass murder, spree murder, and serial murder (Holmes & Holmes, 1998a, 1998b). Serial killers are as such due to the type of crime they commit—premeditated, ongoing, with three or more murders, with similarities in motivation and conduct between each, as well as periods of activity and “cooling off” over more than 30 days.BiologicalThough often blurred with psychological factors, the biology of serial killers is significant in predicting and influencing many aspects of their behavior. Our frontal lobe is responsible for much of our personality, ability to socialize, and how we relate to and construct our social reality. Traumatic Brain Injuries (TBI) often spark a significant change in behavior, such as personality, aggression, cognitive function, memory, and basic behavioral concepts (Fazel, Lichtenstein, Grann & Langstrom, 2011). In a recent study, 155 patients with penetrating TBI were examined, along with 42 controls, and run through genetic tests and childhood trauma assessments. Those with TBI were separated into two categories, one group with damage (defined as lesions) to the prefrontal cortex (PFC), and those with damage elsewhere. While there was some connection between those with Post-traumatic Stress Disorder (PTSD) and childhood trauma, those with TBI in the PFC were more likely to be more aggressive (Fazel & et. al, 2011). Studies of serial murderers’ brains have shown injuries or damage as well, such as a large blood clot in the left hemisphere of John Wayne Gacy, thought to have caused significant damage over its untreated existence. Dr. Lawrence Z. Freedman, who interviewed Gacy for over 50 hours, as well as his family members, reported that much of Gacy’s mental illness seemed influenced largely by the severe beatings he received as a child, creating not only emotional distress, but literally and physically inhibiting healthy brain function (Ewing, 2008). Serial killers have a very commonly shared trait—36% were physically abused as children, the majority regularly beaten, and often experiencing one or more losses of consciousness. The percentage of physical abuse does not include sexual or psychological abuse (Mitchell & Aamodt, 2005).Biology is not restricted to damage, however. In research conducted on the orbital frontal cortex, decreased ability to construct language and communication is also a correlating factor in the creation of social attitudes (Blair, 2004). Prenatal nutrition influences the makeup of the individual as well; in a study of 780 pregnant women in 18 primary care units, poor nutrition was one contributing factor to poor mental health (depression and anxiety most commonly) for the mother, also leading to low birth weight, frequent diarrhea, and cognitive underdevelopment in newborns (Nunes, Ferri, Manzolli, Soares, Drehmer, Buss, Giacomello, Hoffmann, Ozcariz, Melere, Manenti, Camey, Duncan & Schmidt, 2010). The vast majority of “disorganized” serial killers (those that have lower intellect, kill closer to home, defile the corpses, hunt at night, leave evidence, ect...) have mothers that consumed alcohol or other drugs during pregnancy (Mitchell & Aamodt, 2005).PsychologicalWhile the physical makeups of the brain and body have significant influence on development, intelligence, aggression, personality, impulse control, and other factors that are impaired in many serial killers, the psychological makeup of the brain is equally important. According to Brantley and Kosky, Jr. , the majority of serial killers have a diagnosable mental illness; surprisingly, they are not psychotic illnesses. Rather, the mental illnesses most common in serial murderers are personality and mood disorders, in which they display marked increases in aggression, violence, and antisocial behavior; there are significant decreases in social aptitude, impulse control, and behavior modulation (Brantley & Kosky, Jr., 2005).An overwhelming amount of research has been done over the years on the psychology behind serial killers, mainly concluding that severe and ongoing psychological disturbances in early childhood are responsible for a serial murderer’s behavior. In her articles on sexually motivated serial murderers, Zelda G. Knight repeatedly asserts that the contributing factors of creating a serial killer begin in the preoedipal stage. The preoedipal stage refers to Freud’s psychoanalytical concept of an Oedipus Complex, or the idea that a male can be attracted erotically (and detrimentally) to his mother; Knight refers, then, to the preoedipal stage as a stage in which an infant or baby sees and interacts with its parent of the opposite sex (in this case a male to his mother) in a self-reflecting way, with no attraction or real division of self from the entity that is the mother. She asserts that it is in this stage (generally less than three years of age) that a male ‘would-be-serial-killer’ will have the beginnings of taint, and the pushes toward psychological malformation begin. Knight states that there are two main tasks every caretaker must accomplish to raise a psychologically healthy person. “The first task is for caretakers to delight in, and encourage, the infant’s interests and spontaneous enjoyment…The second task is for caretakers to provide sufficient support for the child when negative effects are experienced so that the child can learn to cope in the future with painful feelings (Knight, 2006).”Knight states that the first task of encouragement is an enormously important first step in a child feeling acceptance; as the child is in a stage of reflection, his acceptance of self is directly mirrored in the acceptance of his mother toward him. When this is not present, there is a marked deterioration of the ability to cope with inner thoughts, motivations, introspection, and general perception of self. She adds that when a male child does not find acceptance or encouragement, he becomes devalued. This devalued sense of self as a reflection from others can lead to anger, resentment, and interestingly, narcissism. Narcissism, in this case, is defined as an intense and unwavering obsession with the self, a trait that all serial killers arguably share. In addition to this first task, should the second task of providing support in the event of pain or trial go unbidden, the child suffers further devaluation and a marked lack of ability to manage a healthy, unafraid perception of the world. By creating obsessive, introspective doubt and constant trepidation and disconnect from a perceived dangerous world, children may develop contempt into their adult lives, and focus this on the population they perceive has targeted or affronted them (Toppo, 2009). Some of the “inability to cope” is initially manifested by those early feelings of inadequacy, helplessness, and fear; these are translated into behaviors of grandiosity, exhibitionism, and aggression. Knight mentions F. Summers’ idea of the fundamental self, in that defensive behaviors are the result of hiding a perceived defective self (Summers, 1999). This then feeds a perpetual lack of any self-esteem, creating within an individual an obsessive idea that they are inadequate, and that because they are negatively different from the rest of the world, the world is then at fault for their feelings of inferiority. Over 50% of serial killers were psychologically abused, almost always by one or both parents (Mitchell & Aamodt, 2005). Knight states that two factors that appear most concretely are early development deficiencies in the family construct, and childhood abuse. She says that the mothers of serial killers were often domineering, seductive, controlling, or demeaning; the fathers were in one way or another absent. She also states that most if not all serial killers are given to sexual sadism and fantasies, as well as a prevalence of drug and alcohol abuse and obsessions with gore, horror, blood, and death. “The addictive behaviors of serial killers (alcohol and drug abuse, delinquency, insatiable sex drive, preoccupation with death, horror, and gore) act to block out—or ward off—feelings of rejection and low self-esteem characteristic of narcissistic personality disturbances (Knight, 2006).”SociologicalWhile the ideas set forth by Knight appear primarily psychoanalytical and object-relations theory based (object-relations being the offshoot of psychoanalytical theory focusing primarily on relationships and familial ties), her findings and theories also serve to create further evidence for the influence of sociological factors on the creation of a serial killer. While most serial killers (68%) were abused as children (Mitchell & Aamodt, 2005), almost no children of abuse become serial killers: this indicates that there is more at play in their psychotic nature than biology or psychology alone. While innumerable factors account for why children of abuse continue to be abused into adolescence (indeed, even through their adult lives), one could be the isolation of the child from any networks of support. Without the care or concern of family or friends, a child can go abused for the duration of their home life; often a lack of education is a factor as well, and an inability to adjust to school or structured programs also leads to expulsion, social malady, few to no social networks, and increased time spent alone or in the company of abusive companions. Discrepancies arise in the social maladjustment theory when comparing “organized” and “disorganized” serial murderers. While “organized” murderers may have unsuspecting families or friends (such as “BTK” Denis Raider, the president of his church), “disorganized” serial killers are often alone, unemployable, and have little to no social support. The difference may also lie in the level of intelligence each killer possesses: “organized” killers, such as Ted Bundy, John Christie, Charles Manson, and Debora Green were enigmatic, and able to procure or maintain followers or friends through manipulation and charisma; their reported IQs were all over 121. Other “disorganized” serial murderers such as Clarence Victor and Jeffrey Dahmer were socially maladjusted, alone, and both with IQs in the 65-75 range (Mitchell & Aamodt, 2005). Whether an intelligent murderer is able to mask his deviance or not, the ability to interact directly influences the creation and operation of the serial killer’s behavior.Whether charismatic or socially inept, a serial killer operates in terms of manipulation in order to maintain the lifestyle they create and live within. An “organized” killer may have superficial social ties, but they operate in their private lives alone—serial killing is a crime rarely committed in multiples and always in secret. As mentioned by Brantley and Kosky, mental illnesses associated with serial killers are not a psychotic nature—the knowledge that the killings are fundamentally wrong is present, forcing isolation in consideration of protection. Deviant and isolated behavior often creates or deepens social disturbance and mental illness, both of which effectively feed off of one another (2005). The cyclical effects of personal-intrapersonal-interpersonal maladjustment take tolls early on; Brantley and Kosky, Jr., state, “Depression and its collateral side effects are prominent in the histories of serial murderers (2005).” Many serial killers, such as Gary Ridgeway and Ted Bundy (two modularly different killers) sought companionship from their victims prior to killing them.Society holds its inhabitants in a structure, in hopes of creating accountability. When people operate outside or against society, accountability for the individual decreases. Within his brief article in The Journal of Forensic Psychiatry, Keith Soothill brings forth questions emphasizing the need to look at the how involved in the “who-what-why-when-where-how” method of investigation; knowing how something has happened is a viewpoint that will help to showcase the social aspects of serial killers. The location of the serial killing, the timing, the circumstances in which the killing was done—all of these factors are imperative in creating a clearer picture of circumstances regarding serial murder. When discussing the case of Dr. Harold Shipman (a serial killer and medical doctor), he asserts that the fact that Shipman worked in private practice, all but unsupervised; he even points to the poor record keeping of Dr. Shipman that was noticed but left unchecked—“ Thirty years ago Eliot Freidson stressed that the central issue in the analysis of work is the control of performance (Soothill, 2001).” This is related to the article by Brantely and Kosky, Jr., in regard to the female health care worker “Lucy” and her relatively unmonitored visitations and work with her patients/victims. Lucy was also left to her own devices, and was unable to keep appropriate records regarding medication distribution; this poor reporting continued unimpeded, until the victims’ toxicology reports began more frequently matching those medications which had been missing (Brantley and Kosky, Jr., 2005). Particular deviant or maladjusted traits in a person—specifically contempt and aggression—lead to isolation of the individual from society. These aggressive-type persons are often in combat in an effort to bat off belittlement as a result of a lack of self-esteem; or, as put by Summers, in a constant mode of defensiveness and isolation as a form of protection (Summers, 1999). Personalities that create distance from others socially often end up feeding the idea of isolated worthlessness; this can lead to a resentfully aggressive (or predatory) nature that is both unchecked and self-perpetuating (Hughes, 1997). Concluding ThoughtsAfter reviewing the literature available on the subject of serial killers and their creation, the idea of explaining their behaviors without addressing all three factors of being (biological, psychological, and sociological) would be akin to removing one or more legs of a three-legged stool. While biology is responsible for the chemical entity that is a person, that person’s psychology begins through behavior and interaction, and is especially influenced by the sociological aspects of the individual’s life. A knowledge of right or wrong is apparent in the deceptive and defensive nature of serial killers, indicating not only a consciousness internally, however skewed, but also a survivalist social awareness externally. All of these articles have served to illustrate the variety of ways a person may be sparked, formed, and molded—whether into a productive, caring individual; or into a terrified, angry, hurting and hurtful monster that is a serial murderer.Research Proposal The importance of finding one or more of the direct causes of the creation of a serial killer is of importance for the same reason it is fascinating: human lives are the ultimate cost, and to take them the ultimate corruption. As science grows, it is increasingly the only method in which to probe out logical and empirical truths. Through observation, we have identified some of major areas in which a serial killer differs from the rest of the human race—biologically, serial killers may have different development; psychologically, they are constructed and primed differently; socially, they are markedly different, with little lasting ability to maintain normalcy. The hypothesis is that there will be specific similarities between those with altered prefrontal cortexes and the behavior of disorganized serial killers--similarities that indicate disorganized serial murderers’ desire and willingness to kill lies in an alteration of the frontal lobe (specifically the PFC).Because of the near-impossibility of pin-pointing exactly what causes a serial killer, there is very little hope of predicting which child will grow to become one. In addition to this, the egregious nature of the crimes committed requires immediate and forceful stoppage: this makes longitudinal studies all but impossible. Interviews with serial killers have proved informative for the psychological and sociological influences, but often end up in self-gratification through reliving of the crimes, leading to exaggerated or edited recollections to preserve a specific sense of self by the killer. As with all humans, memory is fallible and the ego easily manipulated—making self-report or witness accounts less credible than desired. While one can look back and track the movements and actions of a serial killer (as has been done repeatedly with Bundy, Ridgeway, and Raider), there is the issue of relying on witness accounts to create a picture of the killer. While multiple accounts are informative and interesting, they are still subjective and relative to the person providing them.The purpose of this proposed study will not be sensationalized accounts of gore, and will endeavor to identify a solid characteristic that directly and reliably correlates to the motivation of a serial killer to kill. I propose an investigation into the realm of the brain, in an examination of individuals with damage or injury to the prefrontal cortex (PFC) of their brains and a cross-reference of their psychological and sociological characteristics to those of disorganized serial killers. Characteristics such as aggression, inability to cope, propensity toward isolation and perceptions of their social world will be taken into account. This study will be limited to disorganized serial killers only, as after reviewing the literature it is my thought that the differences between disorganized and organized serial killers is too great to place in the same category. The sampling frame of this study will be individuals that have sustained a traumatic brain injury (TBI) to the prefrontal cortex (PFC) of the their brain, as well as individuals that have had significant alteration (lesions, surgeries) to the PFC. These individuals will be approached for voluntary participation at their primary care physicians’ offices. The informed consent portion of the study will use verbiage specifically geared toward assuring the volunteers that the study is not attempting to correlate them personally to serial murderers. An example of the informed consent is as follows:This is a request for you to voluntarily participate in a study. The purpose of this study is to find the biological attributes that contribute to the behavior and pathology of serial killers. You have been selected because of your unique and specific attributes within your prefrontal cortex; this is thought to be an area affected in individuals that have committed serial murder. It is very important to stress that you as an individual are not being compared to a serial killer, but rather, that your biological constructs are relative to behaviors that may or may not contribute to alternate or deviant behaviors in others. It is possible that there is no correlation between injury to the PFC and nonstandard behavior—it is through your participation that this may be found more or less accurate. Should you agree to participate, you will undergo a series of non-invasive, painless scans to assess the exact makeup of your PFC, followed by a series of questions regarding your perceptions of the world around you. We will also gather ten character studies from ten different individuals that know you, with your approval of their selection, though without the written consent of those individuals, you will not be permitted to read the character evaluation, in an effort to protect the relationship between the two of you, as well as their privacy and right to opinion. The individuals providing a profile for you will be asked to fill out a multiple choice survey that does not relate you to serial murder, but rather, will be an assessment of characteristics any person could have. Your protection is our priority.Along with this, your medical and work history will be examined. All of this information will remain completely confidential. Any findings, conclusive or not, will be provided to you as a courtesy for your participation. Your travel expenses will be completely covered, and every effort exerted to maintain your health and peace of mind throughout the process. If you become distressed, upset, or unable to continue with any questioning or process, you are able to stop the process at any time. This includes but is not limited to taking a break, stopping all together, requesting food or water, ect…if you stop the study prior to its completion, your expenses for travel home are still covered in full. The information gained is still confidential. Your participation is important to the investigation of deviant and alternative behaviors of people, and much appreciated.The design of this study will be centered on the following principles of a disorganized serial killer, as mentioned above: aggression, inability to cope, propensity toward isolation and perceptions of their social world. Aggression, inability to cope, and frequency of isolation will be measured in a variety of ways: in the form of connected brain scan imaging while a series of questions and situations are posited; character evaluations with multiple choice questions asking how often the study participant yells, becomes enraged or significantly irritable, ect…; self-reports from the study participant regarding situations or people; and lastly, criminal and work history. Perceptions will be measured by asking the participant a variety of questions in which their point of view is explained, such as, “Do you feel positive about your place in the world? Do you feel understood by the people around you? Do you feel you understand other points of view?” Other questions such as, “Do you initiate calls to friends or family, or do they initiate?” “Do you have difficulty concentrating?” will serve to generalize the line of questioning, as well as show any markers of cognitive dysfunction relevant to the study. The design of this study will be a comparison study, where known facts and consistent findings about the characteristics of serial murderers are compared to the behaviors and personality traits, social and psychological profiles of the sample frame (persons with damage or alteration to the prefrontal cortex). This study will also incorporate survey questions, from which persons close to the individuals with TBI taking the survey can identify traits that might otherwise go unreported. In addition to this, case notes from doctors and other professionals that the individual already sees on a consistent basis will be examined. The independent variable will be the known attributes of disorganized serial murderers and the dependent variables will be the findings from the sample frame regarding aggression, inability to cope, propensity toward isolation and perceptions of their social world.The materials needed for this study will be extensive: two professional psychologists well-versed in deviant human behavior, two neurologists to conduct the brain scans and interpret them, ten individuals for each of the participants that regularly interact with them (their PCP, nurse, or caretaker; a friend, family, or co-worker), and the ten individuals with TBI or other significant alteration to the PFC’s cost of travel, lodging, food, and care. A companion is suggested for the participants to encourage them to stay through the entire study. Also needed are the facilities to conduct the study in—a medical lab, with CAT and PET scanners, technicians to operate them, and facilities to review the results in. Rooms for interviewing are necessary, private and secluded, as well as areas for analysis and discussion by those conducting the study. The reports from the neurologists, medical doctors (if present, for example, because of a physical need or impairment), psychologists, and interviewers (if different than the psychologists) will be compiled and sorted into the previously mentioned categories. The surveys from each of the cohorts of the study will be compiled and analyzed. Procedure: the volunteers will arrive in the morning of Day One. They will be given accommodations, an orientation as to what will be happening, and a list telling what each day holds. Every effort will be made to create the feeling of an interview/seminar, as to put the participants at ease and retrieve the best possible results. Day One will begin with meeting those proctoring each test, and the beginning of the profile building. The surveys will have been collected (as a pre-procedure measure, due to the need of approval by the subjects), and the data collected from them. There will be ten volunteers, each being tested for three days. Day One will involve a psychological exam and a physical. Day Two will involve extensive PET/CAT scans. Day Three will culminate in questioning each subject while connected to active PET scanners to monitor activity in each area of the brain, specifically the PFC. Keeping the active scans and questioning at the end of the study will hopefully encourage completion, as this is the portion of the study most likely to create an emotional reaction. To reduce emotional harm to the participants, their companion will be allowed in the room. Each test will serve to create a profile of the characteristics of a person with an alteration to the PFC, and the comparison of these characteristics to known traits of disorganized serial killers.The results are predicted to be comparable, allowing for differences in socioeconomic status, reasoning behind voluntary participation, male-female differences, and other factors. Female participants will be especially valuable in that increased aggression will be especially unusual given female biology, compared to the male makeup that is more likely to exhibit aggression. Traits expected to be comparable to disorganized serial killers are: easy aggravation, rapidly increasing aggression when aggravated, difficulty calming, increased activity in the frontal lobe when confronted with shocking images ,not necessarily gore, but images with possibly stark red contrasts, and perceived but not apparent pain (such as a cat catching a bird, or a leopard downing a gazelle). I predict higher levels of anxiety and frustration when asked to complete puzzles of moderate difficulty with multiple steps, as well as increased heart rate and blood pressure when stimulated by multiple sounds while trying to accomplish various tasks. Also predicted from the surveys collected would be serious alterations of task-performance pre-and post-injury or trauma for those who sustained mid-life injuries; increased propensity to shouting or hitting when angry or frustrated; decreased ability and joy within social realms; decreased ability to critically problem-solve; decreased ability to accept criticism; as well as hyperawareness in perceptions of others (i.e., they don’t like me, they don’t understand me, or paranoia). The results of the full study of the subjects compared to the full studies available on the traits of disorganized serial killers will, hypothetically, reveal traits that would not be similar if not for brain injury. In further discussion, it should be noted that there is a level of risk involved for the participants. As subjects with brains that may be injured, impaired, or altered, they are a more vulnerable population. Though specifically selected as self-determinant individuals, it is important to keep in mind that their ability to process and deal with emotions and situations is more delicate than others who have not sustained brain injury, and that they should be treated with respect as people with basic human rights. In addition to this, all proctors of the tests must be well-versed in the effects of traumatic brain injury, and know that confusion, upset, irritability, fear, and other debilitating emotions and reactions may be more apparent and more problematic for the individual with TBI. This study should be started in the full knowledge that the subject has a right to self-determination, and that they may terminate the study at any time to avoid psychological or emotional damage. The limitations in this study will be the obvious issue that the subjects are not serial killers. The effort to compare traits is to illustrate the effects of injury to the PFC, and show the relationship between injury and aggression, devaluation of others through altered perception, and the fear added to daily living in a state with depleted coping and communication skills. It is an effort to use exact science to formulate an abstract concept, and so while the results are conclusive in their observation, they may or may not be conclusive in their application. Along with this, the information gathered on known traits of disorganized serial killers is often sensationalized and misrepresented; much information has been gathered, though due to the heinousness of the crime is difficult to extract pure fact from emotional recollection or revelation. The best way to circumvent the issues of subjectivity surrounding the traits of serial murderers would be to pull case files and medical records, which may be difficult to obtain. In addition to this, given the vulnerability of the population being studied, it should be noted that many may not complete the study, or may have an adverse reaction. The importance of this study is to illustrate the significant alteration of the biological makeup of the disorganized serial killer, and to show that while both organized and disorganized killers have similar drives and “lusts”, the disorganized killer is at the significant disadvantage of the aforementioned characteristics, and that those debilitations should be taken into account when interacting with or assessing the functioning of them. In addition to this, results may help in all matters of violent offenses; again, if we know the cause, we can work for a solution. This study is not meant to excuse any crime or action, but rather, explain the reasons motivating the behavior. It is important to note that organized serial killers are aware of the right-wrong paradigm associated with killing; disorganized killers often know it is wrong but lack the ability to cover up, plan, or prevent further killings. This study will, hopefully, show that some acts are the result of altered functioning of the brain.ReferencesBlair, R.J.R. (2004). The Roles of Orbital Frontal Cortex in the Modulation of Antisocial Behavior. Brain and Cognition, 55, 198-208.Brantley, R. H., & Kosky, R. H. Federal Bureau of Investigation, Law Enforcement Bulletin. (2005). Serial murder in the Netherlands: a look at motivation, behavior, and characteristics. U.S. Government Printing.DeFronzo, J., Ditta, A., Hannon, L., Prochnow, J. (2007). Male serial homicide: The influence of cultural and structural variables. Homicide Studies, 11 (1), 3-14.Ewing, C.P. Insanity: Murder, Madness, and the Law. Oxford University Press. 2008.Fazel S, Lichtenstein P, Grann M, Langstrom N (2011) Risk of violent crime in individuals with epilepsyand traumatic brain injury: A 35-Year Swedish Population Study. PLoS Med 8: e1001150. doi:10.1371/journal.pmed.1001150.Grohol, J. (2011). The Differences Between Bipolar Disorder, Schizophrenia and Multiple Personality Disorder. Psych Central. Retrieved on February 6, 2012, from , E. (1997). Serial murderers and their victims. (2nd ed., pp.45-58). Pacific Grove, CA: Brooks/Cole.Holmes, R. M., & Holmes, S. T. (1998). Contemporary perspecitives on serial murder. (2 ed., pp. 7-38). Thousand Oaks, CA: Sage Publishing.Hughes, J.M. (Ed.).(1997). Oxford Concise Australian Dictionary (2nd ed.). Melbourne: Oxford University Press.Knight, Z. G. (2006). Some thoughts on the psychological roots of the behavior of serial killers as narcissists: An object relations perspective. Social Behavior and Personality, 34(10), 1189-1206.Mitchell, H., & Aamodt, M. D. (2005). The incidence of child abuse in serial killers. Journal of Police and Criminal Psychology, 20(1), 40-47.Nunes, M., Ferri, C., Manzolli, P., Soares, R., Drehmer, M., Buss, C., Giacomello, A., Hoffmann, S., Ozcariz, C., Melere, C., Manenti, C., Camey, S., Duncan, B., Schmidt, M. (2010). Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil. BMC Psychiatry, 10 (8).Soothill, K. (2001). The harold shipman case: A sociological perspective. Journal of Forensic Psychiatry, 12(2), 260-261.Summers, F. (1999). Transcending the self: An object relations model of psychoanalytic theory. (pp. 37-43). Hillsdale, NJ: Analytic po, G. (April 13, 2009). 10 years later, the real story behind Columbine. USA Today. ................
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