January 4, 2013

"We can’t go out and lock up all the socially awkward young men in the world..."

"But we have to try to prevent the unpredicted."

Says a psychiatrist quoted in a WaPo article titled "Predicting violence is a work in progress."

The photos at the link — a line-up of Jared Lee Loughner, James Holmes and Adam Lanza — create the impression that you can tell by looking at them, especially at their eyes. But if you look long enough, you'll see the 3 men are quite different. Only Loughner is smiling. One may sense that madness radiates out of his face, but if you can exclude what you know — that's a photo taken after his shooting spree — he may seem like a fairly ordinary guy. Holmes's face, especially stuck between those other 2, looks open — even empathetic — and sad. Lanza looks abnormal, like an alien. The oddness is enhanced by knowing that this isn't a mug shot like the other 2. Is that his driver's license pic? It's hard to believe — in this age of digital photography — that a picture that came out that bad wouldn't be trashed. If I were diagnosing Lanza from that photograph, I'd say his problem was anorexia. What that boy needs is cheeseburger*... and a better haircut.
An analysis of 20 studies published three years ago found that schizophrenia increased the risk of acting violently fourfold in men and even more in women. The risk of schizophrenics committing homicide was 0.3 percent — more than 10 times greater than the average citizen.
What is the risk of serious violence — not just homicide — for schizophrenics who are also young and male? What is the risk for young, male schizophrenics of the paranoid subtype? If we're going to reason from statistics, we need to be able to look at the numbers in different ways. I suspect that the 0.3 figure — which screams you can't just institutionalize schizophrenics — is massively diluted by including large numbers of females, over 30s, and the nonparanoid subtypes (disorganized, catatonic, undifferentiated, and residual).

Back to the WaPo article:
John Monahan, a University of Virginia psychologist... and many others came up with a constellation of “risk factors” and “protective factors” for violent behavior.... [that] the presence of a mental disorder as only a small contributor to risk, outweighed by other factors such as age, previous violent acts, alcohol use, impulsivity, gang membership and lack of family support.
Gang membership? Now, you've got a list of factors that's off the subject of mental illness and more about a young male's social context.
“From our research, we could quickly distinguish between a patient whose chance of being violent was 1-in-10 from one whose was 1-in-2,” [Monahan] said.
Some statistics skepticism: he's saying "violent," not homicide or even serious violence.
[A British Medical Journal analysis found that of] the people predicted to “violently offend,” 41 percent did. Of those predicted to be nonviolent, 91 percent were. In practical terms, that meant that if authorities used the tools for the purposes of public health, they’d have to detain two people to prevent one from becoming violent.
That is patently defective reasoning. Where did they draw the line in scoring individuals using their set of factors? Show me how the factors were scored and who ended up being violent. Why have you simply divided people into 2 groups? Look at different subsets within the predicted-to-be-violent group with the highest scores. For example, if you break out 10% of them, the predicted-to-be-violent ones with the highest scores, what percentage of them went on to commit acts of serious violence? If that approaches 100%, then the "practical terms" about the fairness of detention would look entirely different.
________________________________

*Adam Lanza was a vegan — "He didn't want to hurt animals."

34 comments:

Surfed said...

I see those looks and eyes everyday that I've gone to work these last 35 years. One time we had a student in the category of spooky eyes and we would half joke in the teacher's lounge "how many people will Billy kill one day?' It turned out that he killed six. His wife, her father, the pizza delivery guy, his wifes best friend, his crack dealer and a fellow prisoner in Raiford where he was srving Life Without Parole.

AllenS said...

I've been on jury duty a bunch of times. I have an ability to just look at people and I'm able to tell if they are innocent or guilty before the trial even starts. I should be in charge of this.

Shouting Thomas said...

I was kinda hoping that the discussion of the massacre of the kids was over.

The chances of such an atrocity actually happening to your kid or to a kid you know are damned near zero. We can't (or I can't) obsess over every evil that strikes 26 people out of a population of 360 million. Nor is it a good idea to set public policy in response to such an isolated incident that affects such a micro-minute part of the populace.

Things were kinda dying down. Why stir them up again? My liberal FB friends have just about stopped screaming that the NRA really killed those kids. The fit seemed to have just about ended. Let it go.

Evil and madness touched the earth for a moment. That's it. Quit trying to figure it out beyond that.

Bob R said...

I teach in a math department. Lots of socially awkward loaners. Anyone who thinks you can tell by looking at their eyes is just kidding themselves. We DON"T have to try to prevent the unpredicted if we don't have any basis for prediction. The psychiatric profession has done far more harm than mass killers - any you can tell who they are by their degrees.

rhhardin said...

You can get any percentage you want if you don't have to give type I and type II error rates (missed cases and incorrect positives).

Just classify everybody as insane and you don't miss any cases. 100% good

Just classify everybody as sane and you don't lock up any sane people. 100% good

What you can't do is both at once.

dmoelling said...

There was a Canadian comedian who did a whole routing about "it's always the quiet guy who..." and played off Canada being a quiet country.

You can't go after every loner, but you can restrict known problems. The two recent subway pushers in NYC were both known risky people. Here in CT the two perps who raped an murdered a whole family several years back were just released on early parole. I just found out that CT also requires a patient's approval to remain in a mental ward if you are 14 or over! In NY they are going to close all the supervised homes for adults and move them to what's called supportive housing partly because the Obama administration is pushing this.

Pogo said...

The 'seeing it in their eyes test' is just modern phrenology.

End the family matriarchies in Chicago and watch their 500 annual murders plummet.



bpm4532 said...

Waay too many inexact descriptions of these people to be left to the modern, emotional political establishment that would create new laws or regulations to "help" us.

Old RPM Daddy said...

"But we have to try to prevent the unpredicted."

No, I didn't read the Washington Post article, but that's an interesting choice of words. Do you think he really meant "But we have to try to predict the unpredicted?"

The original wording makes me vaguely uneasy.

David Hampton said...

One of the problems I see is the sub-set of children from broken homes, single mothers, lack of father figure in the home, and their existence in a virtual world furnished by Hollywood and software. The willing suspension of disbelief and lack of exposure to morals, ethics and values seals their fate in a cocooned world of violence and self-destruction. Slaughter of innocents and themselves is just one example of the various examples of how socialpaths interact with a society they are incapable of healthy interaction.

Ann Althouse said...

"I've been on jury duty a bunch of times. I have an ability to just look at people and I'm able to tell if they are innocent or guilty before the trial even starts. I should be in charge of this."

So presumably you keep your special super-power to yourself or you'd never get on the jury in the first place.

Paul said...

It's not that the people are odd, lots of people are odd (but not me, I'm perfect.)

It's indicators like broken homes PLUS violence PLUS verbial expressioins of rage PLUS well it's all them together, and I mean together not separate cause lots of people grew up in broken homes or have some rage or such (but not me, I'm perfect!!)


Of course I'm kidding about being perfect, just check my spelling!

gerry said...

The 'seeing it in their eyes test' is just modern phrenology.

Perfectly expressed.

Didn't the Nazis and Communists develop ways to detect idiocy and false consciousness, respectively, from infallible measurements of skull size, distance between the eyes, psychological tests, gulag vacations, and torture?

Henry said...

Then there's this guy:

http://en.wikipedia.org/wiki/File:Whitman1963.jpg

Jay said...

Adam Lanza was a vegan — "He didn't want to hurt animals."

Of course!

See, animals are to be loved, treasured, and protected.

Children? Well, you can simply abort them or when you're that ghoul in Philly, induce live births and then throw them in the garbage. So why would he care about killing children?

Note: Vegans have killed more school children than Concealed Carry Permit holders.

Jay said...

We can’t go out and lock up all the socially awkward young men in the world

No, but we can simply get rid of "military style assault weapons"!!!!

Peter said...

“We can’t go out and lock up all the socially awkward young men in the world,” said Jeffrey W. Swanson, a professor of psychiatry and behavioral sciences at Duke University. “But we have to try to prevent the unpredicted.”

If "we" are going to start locking people up, could we start with Jeffrey W. Swanson? Because even if he's not violent himself, he's all too willing to use the force of government (i.e., violence, or credible threat of same) to take away the freedom of those who have not (and mostly are not likely to) commit violence?

Sure, the mentally ill should get treatment. And sometimes they're so far gone that they don't/can't realize this.

But psychiatrists have shown time and again that they're no better at predicting violence than those with no training.

Apparently it isn't enough to just force socially awkward kids, now they (at least some of them) need to be subject to pre-emptive confinement and/or treatment?

Perhaps the real scandal here is the absurd rise in autistic spectrum diagnoses- and the damage this is causing?

robinintn said...

"That is patently defective reasoning."

Please. He's a PSYCHIATRIST. There are no standards for reasoning, defective or otherwise. All his discipline requires is that he elicit a few nice feelings in his patients/readers.

Cedarford said...

Shouting Thomas said...
I was kinda hoping that the discussion of the massacre of the kids was over.


===================
No, the public wants this discussion on public policy, guns, and crazy people immersed in violence porn with access to guns.

Just as it did after 9/11. And the public was not put off wanting something done about Islamist extremism - by liberals saying tobacco, "misguided troubled youths from poverty" kill 70-250 times more people a year than terrorists.

Conservatives have to reconcile absolutist worship of the Sacred Parchment and Freedom!!!! for Psychotics!!
with expectations of public safety.

The nexus is mental disease-immersion in violence porn - access to guns - inability under HIPAA and other privacy laws to have doctors, parents be proactive and tell the public, police and gun shops this or that person is DANGEROUS and needs to be watched and kept from buying or otherwise accessing weaponry.

I add in the psycho category Muslim misfits like Nidal Hasan that are immersed in the violence porn of Holy Jihad imagery.

mikee said...

So gang membership is a stronger indicator of potential violent acts than schizophrenia?

Reminds me of the well-debunked study by Kellerman, et al., in JAMA in the 1990s which correlated gun ownership to an increased risk of death by gun violence. One problem (of many) with the study was that renting an apartment was much better correlated with dying from a gunshot than owning a gun, as were half a dozen other fairly common lifestyle choices, such as drug use or having a felon for a friend or family member.

In other words, life is dangerous.

edutcher said...

You're talking about locking up at least 50% of young males.

Which would suit the feminazis and Democrats just fine.

But it's interesting to note Mom had no illusions about her son. She saw a time bomb getting ready to go off.

Pianoman said...

Someday there will be brain scanners that can predict a Lanza or Loughner. We'll have brain scans that show our "general mental health" in the same way that the "full body scanners" can show general physical health.

In the meantime, it's best to allow citizens to arm themselves so as to minimize the damage these crazies can cause. And yes, that means allowing teachers and school administrators to conceal carry.

Pianoman said...

@ST: "Things were kinda dying down. Why stir them up again? My liberal FB friends have just about stopped screaming that the NRA really killed those kids. The fit seemed to have just about ended. Let it go."

The President assigned Joe Biden to a task force (or something like that), auto-pen signed the fiscal cliff deal, and then went off to Hawaii for golf. As far as I'm concerned, that means that this issue is over. The gun control nuts aren't getting any new legislation out of this.

Your FB friends can rage all they want to, but they're not getting their way this time.

Althouse isn't focusing on the guns anyway, although the commentariat are probably going to nudge the discussion in that direction (myself included). Her point is to illustrate the difficulty of preventing the next Lanza from harming people.

Is it worth it to incarcerate 9999 innocent men in order to prevent the one crazy guy from shooting up a school, or a mall, or a sporting event? Can we get better at predicting when crazy people like Lanza are about to "snap"? Should we direct resources at trying to solve this problem rather than trying to convince Americans to allow their guns to be confiscated?

If we're serious about this, then how about taking some of the money being spent on AGW research and spending it on trying to prevent the next Lanza from happening? Would that be a reasonable redirection of Federal money?

Seeing Red said...

"But we have to try to prevent the unpredicted."



Known knowns, known unknowns & unknown unknowns.

OTOH, those nutty psychiatrists think that 3 year olds saying "no" indicite future loonyness.

No, morons, they're being 3.

Left Bank of the Charles said...

I don't buy it. I think we know who these mentally ill individuals are, and the average person meeting a stranger could tell in a 10 minute conversation whether someone was too crazy to be allowed to buy a gun.

Now trying to predict who is actually going to become violent, that's a fool's errand.

ambienisevil said...
This comment has been removed by the author.
Mitchell the Bat said...

Are we still worried about XYY males or has the War on Men® taken care of that?

Kirk Parker said...

Althouse,

"Lanza looks abnormal, like an alien"

You haven't hung around many middle schools or high schools recently, have you? Clearly the fellow is not an outgoing social leader, but nothing about the picture looks either unusual or (more importantly) dangerous to me.

"What that boy needs is cheeseburger"

Your way's not very kosher.

Peter said...

'edutcher' said, "You're talking about locking up at least 50% of young males."

But that would cost to much, and civil libertarians would complain.

Better they should be drugged and "treated."

Better for the so-called "helping professions," anyway.

Sinnamon Buns said...

This is not a case of "defective reasoning," Ann, you are confusing the true positive rate (the sensitivity of the test) and the true negative rate (the specificity of the test) with positive predictive value and negative predictive value.
The numbers reported (41% and 91%) are, respectively, the sensitivity and specificity. It is a fact (though a counter-intuitive one) that for disease states with very low prevalence, the positive predictive value of a test (i.e. the fraction of all positive tests that are really positive and not false positives) is also very low. So a test can be very sensitive but with a low prevalence most of the positive test results are false positives. Without knowing the prevalence of the disease state in the population it is impossible to determine from the numbers provided whether the test is an efficient (with high PPV) or not. If it's any consolation, many (if not most) MDs make this same error. How frightening is that?

Scott M said...

Legalize prostitution.

Done.

Next?

Rusty said...

Wasn't there a movie about this?

Starring Tom Cruise.

Palladian said...

If "we" are going to start locking people up, could we start with Jeffrey W. Swanson? Because even if he's not violent himself, he's all too willing to use the force of government (i.e., violence, or credible threat of same) to take away the freedom of those who have not (and mostly are not likely to) commit violence?

Exactly right. As if the gun-grabbers yammering in the wake of the crime at Sandy Hook Elementary wasn't distasteful enough, the "lock up weird males" talk has been even worse.

mtrobertsattorney said...

If it is true that there is no way to identify these psychopaths before they commit some atrocity, then it follows that there will always be a number of these characters walking around out there with a motive and intent to kill as many innocent adults and children as they possibly can.

Assuming all firearms are banned and destroyed, is there any reason to believe that these psychopaths wont gravitate to much more lethal means to carry out their evil intent?

(In 1927, 38 school children and six adults were killed by one individual in Bath Township, Michigan. No firearm was used.)