In light of what many are calling the largest mass shooting in U.S. history, you will likely be hearing many reports about the clinical and psychological status of the shooter. At this time, there have been no reports about his clinical or psychological status but mental health professionals have been speculating about it in the news. Below is a list of clinical terms and information that you may be hearing about or may be wondering about, in relation to the Colorado shooter.

Schizophrenia: Schizophrenia is a severe and debilitating thought disorder that is diagnosed in less than 2% of the United States population. Symptoms of the disorder include: having a break with reality, illogical thoughts and extreme emotional and social dysregulation, among others. The probability of developing schizophrenia is relatively low compared to other mental health disorders.

The perception of individuals with schizophrenia being violent remains strong in our society. The facts do not match that perception. Individuals with schizophrenia are no more dangerous than the average person except under four conditions that increase the likelihood for violence. Those four conditions include:

1. Having a history of violence
2. Actively using drugs and alcohol
3. Off medication and actively psychotic
4. Lack of insight into one’s mental illness

Those conditions may increase the likelihood of violence but they do not guarantee violence. It is difficult (and in fact may not be possible) to accurately predict who is going to be violent and under which conditions.

The National Institute of Mental Health states the following about schizophrenia and violence:

“Most violent crimes are not committed by persons with schizophrenia and most persons with schizophrenia do not commit violent acts.”

Individuals with schizophrenia are more likely to be victims of violence rather than perpetrators of violence.

Schizophrenia is often confused with Dissociative Identity Disorder (DID), which was formerly called multiple personality disorder.

Dissociative Identity Disorder: DID symptoms include: the presence of two or more identities, at least two of these identities recurrently take control of the person’s behavior and having an inability to recall personal information. DID is very rare and is diagnosed in less than 1% of population.

The Bottom Line: Schizophrenia is not DID and multiple personality disorder is now called DID.

Psychosis: Psychosis is a break with reality. An individual who is psychotic might hear voices, see things that are not real or believe that someone is following them. The voices associated with psychosis are generally negative. The voices may be telling an individual to harm themselves or someone else. The voices can be very unpleasant and frightening.

Psychosis is associated with mental health disorders such as schizophrenia, schizoaffective disorder, bipolar disorder, psychotic disorder not otherwise specified (NOS), and several others.

An individual can have a psychotic break and never have another. In clinical terms, that is called Schizophreniform disorder.

Psychopath: According to research by Hare and Newman, psychopaths are:

• shallow,
• deceptive,
• grandiose,
• dominant,
• superficial,
• manipulative,
• are unable to establish emotional bonds,
• lack empathy, guilt, and remorse,
• are social deviants, impulsive and ignore the norms of society.

Many clinicians and researchers believe that psychopaths are untreatable.

Psychopath is a term used interchangeably with antisocial personality disorder (ASPD), sociopathy, and psychopathy but they are not same, at least technically (and according to Hare). Research shows, according to Hare, that most people with ASPD are not psychopathic but most psychopathic individuals meet the current diagnostic criteria for ASPD. Despite Hare’s contention that psychopaths and individuals with ASPD are very different, some researchers contend that both psychopaths and individuals with ASPD are virtually the same.

Antisocial Personality Disorder (ASPD): Antisocial personality disorder is characterized by difficulty interacting with others or lacking the desire to interact with others. Individuals with antisocial personality disorder are typically not shy. On some occasions, they can be charismatic. Ted Bundy, who is considered by many to be a “textbook” case of ASPD, was generally well-liked.

Individuals with ASPD lack empathy, tend to be arrogant, are excessively opinionated, can be charming, and engage in aggressive or criminal acts. There are also characteristically irresponsible, frequently manipulative, impulsive, and have no regard for others.

The aforementioned are some of the terms and phrases that you will likely hear discussed in reference to the Colorado shooter, and in other cases of a similar nature.

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