Dylann Roof: How to make a rampage murderer

As the penalty-phase trial of young white supremacist Dylann Roof gets underway this week, reporters have asked me to explain the psychological dynamics that trigger deadly rampages like Roof’s at the Emanuel African Methodist Episcopal Church in Charleston, South Carolina. My answer: Although the specifics such as locale and target shift, the broad contours of such spree killings remain remarkably constant. Here is my recipe of key ingredients:

1. Alienation

We humans are tribal animals. For millennia, we lived in tightly knit, cooperative societies where individuals were rarely alone. As author Sebastian Junger explores in Tribe: On Homecoming and Belonging, tribal identity motivates individuals to sacrifice for the collective good. In stark contrast, modern society deprives people of that essential sense of connection or belonging. Our current technological atomization is “deeply brutalizing to the human spirit,” writes Junger. Cast adrift, people feel meaningless and superfluous. Social alienation is producing epidemic rates of depression and suicide. But it is in spree killings that we see the ultimate expression of malignant alienation: Embracing nihilism, the killer finds meaning via symbolically destroying not just himself, but also the social order that rebuffed and humiliated him.

Mark Ames, author of the meticulously researched Going Postal, goes so far as to argue that mass shootings are a form of doomed rebellion against a toxic culture: Otherwise-normal people snap when pushed to the breaking point within decollectivized, militarized and ruthless settings. Workplace sprees occur in oppressive institutional settings rife with surveillance, mandatory unpaid overtime, and humiliating and degrading layoff rituals. Sites of school shootings, meanwhile, are often brutal places where students undergo chronic torment. The more endemic alienation becomes, the more people will snap.

2. Failure

This is perhaps obvious, but setting the stage for a spree killing is cataclysmic failure. Except in warfare, satisfied people don’t suddenly morph into killing machines. The killer has failed a life-stage transition, and his life has gone off track. Dylann Roof had a troubled childhood, marked by abuse, neglect, severe anxiety and academic failure, according to published accounts. He dropped out of high school. As a young adult, he couldn’t get a job or even a driver’s license. He coped by drinking heavily. The lives of other recent mass killers were similarly catastrophic, marked by failures on academic, vocational and/or relationship fronts. Adam Lanza (Sandy Hook) and Elliot Rodger (Isla Vista) had autism-spectrum conditions that left them incapable of forming intimate relationships. Omar Mateen (The Pulse nightclub) was a socially awkward loser: he flunked out of police training, got fired as a prison guard, and ended up doing lowly security work; his wife fled after he beat her.

3. Entitlement

Dylann Roof posing in his bedroom.

Failure alone is insufficient. The failure must be perceived as unfair. Like Roof, whose grandfather was a prominent attorney, the killer often has middle-class roots, inculcating the American mythology of success. Mass shooters often have higher aspirations than are realistic for their station in life. In Hunting Humans, pioneering anthropologist Elliott Leyton argues that the modern mass murderer tends to be especially socially conservative, class-conscious, and obsessed with power and status. Yet in our increasingly fragmented, alienating and high-stress world, a high-quality life is difficult for many a young American to achieve. Recognizing that he is on a dead-end trajectory and that his class aspirations will not be realized produces profound disappointment, personal shame and – ultimately - despair. To reduce cognitive dissonance, he needs someone to blame.

4. Projection

By the time he explodes, the spree killer has amassed an enormous reservoir of bitterness. He feels unfairly victimized. Through a scarcity lens, he perceives less deserving people as stealing away his opportunities and robbing him of his right to happiness. Those perceived as undeserving typically include lower-status or socially stigmatized groups such as people of color, women, sexual minorities or immigrants. This is the politics of resentment that Trump has milked so effectively.

Also feeding into the potent fury of many mass murderers are childhood histories of being bullied and socially rejected. In Rampage: The Social Roots of School Shootings, Katherine Newman and colleagues chronicle the tormented lives of infamous school shooters. Many were incessantly harassed, with antigay epithets a common refrain. In high school, Seung-Hui Cho (Virginia Tech) was relentlessly bullied over his social awkwardness, speech impediment and immigrant background. Dylann Roof was described as a “bug-eyed boy” with a bowl haircut who struggled academically; we can only guess at his social travails.

5. Masculinity

Spree killings are exceedingly rare (making them impossible to predict). Not every alienated, bitter loner picks up an assault rifle. But those who do are invariably male. Women are more likely to blame themselves for their misery. As journalist Jamie Bartlett reveals in The Dark Net, hundreds of thousands of young women ages 13-25 flock to the myriad “pro-cutting” and “pro-ana” (anorexia) Internet sites that have sprung up in response to demand from alienated young women.

In contrast to this turning inward, many young men regard violence against others as a way to gain status and respect. Our cultural glorification of male violence is evidenced by the enormous popularity of first-person shooter and warfare games. It is evidenced by the lack of meaningful protest over our government’s modeling of killing as a solution to problems: U.S. military drone strikes in the Middle East have ended the lives of many hundreds of civilians, with little fanfare. After all, we are the good guys, protecting the world against evil. As boys grow up, writes masculinity scholar Michael Kimmel, “they learn that they are entitled to feel like a real man, and that they have the right to annihilate anyone who challenges that sense of entitlement.”

Mass shootings are a quintessentially American theatrical production, the ultimate display of alienated hypermasculinity inside the world's leading imperial power. The production is carefully planned and staged, often accompanied by websites, online manifestos and photos that will help it propagate and endure in the cultural imagination. Embittered young men seize upon the restorative potential of violence, which enables them to extract vengeance for a litany of wrongs both real and imagined. Even more powerfully, violence offers the lure of immortality: Rack up enough dead bodies, and you become infamous. You are no longer a nobody; you are a warrior.

6. Ideology

To become a warrior, one needs a cause. There is no shortage of alienated young men like Roof, reared on a diet of masculine entitlement and believing that they have been treated unfairly. In another time, they might be like dying trees in a parched forest, standing alone and unnoticed until their eventual collapse. But in the age of the enchanted Internet, such men can simultaneously retreat from humanity yet plug into like-minded online communities where their diffuse rage can find a focus.

Elliot Rodger (Isla Vista) in pre-production selfie: "I am gorgeous"

Take Elliot Rodger, the Isla Vista killer. A flop with women despite his self-proclaimed “gorgeous” looks, he immersed himself in the misogynist realm of the “manosphere,” where “men’s rights” proponents and “pickup artists” rail against power-mad feminists who are denying men their natural-born right to supremacy (and sex). Such insular communities are like echo chambers, validating and amplifying warped ideologies. Within the manosphere, Rodger transformed himself from an invisible nobody -- a "beta male," in man-speak -- into a “true alpha male,” in his words, a heroic warrior standing up for oppressed “incels,” or involuntary celibates.

“Women are like a plague,” he repeats several times in an online manifesto. “The mere sight of them enjoying their happy lives was an insult to me, because I deserve it more than them…. They don’t deserve to have any rights. Their wickedness must be contained in order to prevent future generations from falling to degeneracy. Women are vicious, evil, barbaric animals, and they need to be treated as such.”

Like Rodger, Dylann Roof retreated into the Web. But instead of the manosphere, his search for meaning led him to the white supremacist channel. Specifically, the Council of Conservative Citizens, aka the “uptown Klan,” which devotes a lot of energy to disseminating propaganda about the menace of black-on-white crime. The atomization of culture into discreet identities has left many white men feeling abandoned and scapegoated, and racist ideology is quick to fill this vacuum. Roof eagerly soaked up the ideology of a white race under siege; like Rodger, he also grew frustrated with the preponderance of rhetoric over action. “[S]omeone has to have the bravery to take it to the real world, and I guess that has to be me,” he wrote. “I have no choice.”

Reducing the world to a stark black and white furthers the killer's self-image as a heroic warrior battling the forces of evil. In Terrorist’s Creed: Fanatical Violence and the Human Need for Meaning, fascism scholar Roger Griffin calls this “heroic doubling”: fanatics deploy violence as a call to arms to defend an idealized in-group against perceived threat by a demonized Other. Ideologically motivated killers like Roof, Rodger or the Norwegian mass murderer Anders Breivik may act alone in the moment, but they see themselves as soldiers in a larger movement. The growing popularity of online manifestos – Roof had one, too, although at four pages it paled in comparison to Rodger’s 141-page tome – attests to the narcissistic fervor with which spree killers cling to their adopted ideologies as rationale for bloodshed.

What makes the ascendancy of extremist rhetoric so dangerous is this capacity to activate the alienated loner. A direct cause-and-effect relationship is readily observable: Donald Trump spews anti-Muslim vitriol, and in short order attacks on U.S. Muslims spike. Public figures can produce random lone-wolf violence via repeatedly demonizing an out-group, while maintaining plausible disavowal of responsibility. This practice -- most well-known for its contribution to abortion clinic bombings -- has a scholarly term, "stochastic terrorism.” In Roof's case, the Council of Conservative Citizens whose ideology Roof parroted in his manifesto was quick to issue a statement deploring the massacre, even while defending Roof's racist belief system as correct.

7. Contagion

In late-18th century Germany, groups of young men could be seen strolling about in identical outfits of blue tailcoats, yellow trousers and high boots. They were imitating Werther, the romantic hero of the sensational novel The Sorrows of Young Werther, in which the idealistic protagonist kills himself over unrequited love. Blamed for a rash of copycat suicides among the impressionable and mentally ill, the novel was banned in Italy and Denmark.

This so-called Werther Fever is an early example of what we now refer to as a cultural meme – an idea, fashion or behavior transmitted like a virus from person to person, often via mass media, that takes on a life of its own as it propagates.

Seung-Hui Cho (Virginia Tech) poses in pre-production selfie

Spree killings seem to have morphed into just such a cultural meme. Especially with the spread of social media, they often go viral, tempting the next angry and alienated man with the tantalizing promise of infamy and immortality – especially if the body count is high enough.

In truth, however, this immortality is illusory, as the very ubiquity of the mass shooter meme is numbing the public; one killer’s fame lasts only for the brief interval until another pushes him aside. Dylann Roof will have his moment in the spotlight this week, and then it will be on to the next case.

Instead of just dissecting each individual act in this never-ending drama (and emphasizing singular elements such as untreated mental illness, gun accessibility, social media, violent video games, bad parenting, law enforcement failures of prediction, and the like), we might do well to regard young men like Roof as canaries in the coal mine. It is only when the air in the mine is poisonous that the canary will die.

In the award-winning TV show Mr. Robot, there are these ninja assassins who, when cornered, put a bullet in their own brain. A computer-crimes detective refers to this as “erasing their histories.” In orchestrating a dramatic last stand, mass shooters like Roof are doing precisely this, erasing their heretofore empty and meaningless lives and replacing them with a meme.

Related blog posts:

• Newtown, CT: Latest massacre brings more hand-wringing (Dec. 18, 2012) 
• Aurora massacre: To speak or not to speak? (July 22, 2012) 
• Arizona rampage: Analyzing the analyzers (Jan. 23, 2011) 
• Systems failure or black swan? New frame needed to stop memorial crime control frenzy (Oct. 19, 2010) 
• Virginia Tech: Can school shootings be prevented? (April 19, 2007) 

Dylann Roof's full manifesto is HERE; Elliot Rodger's is HERE.

Innovative international risk assessment service is expanding

Try your hand at answering these questions:

1. When evaluating Aboriginal offenders, how valid are standard risk assessment protocols? 


2. Among Canadian men, how well does the Danger Assessment (DA) predict domestic violence? 


3. For sex offenders in Vermont, what instrument is more accurate than the widely used Static-99 for predicting recidivism? 


4. In screening U.S. soldiers coming back from Afghanistan, is there a valid tool that would help allocate limited therapeutic resources in order to decrease violence risk? 


5. Finally, what the heck are the Y-ARAT, the CuRV, the START, and the VIO-SCAN, and what (if anything) are they good for?

With the frenetic pace of risk assessment research and practice developments, you couldn't be faulted for not knowing the correct answers to all of the above questions. Hardly anyone does.

That’s where the Executive Bulletin comes in.

Back in February, I told you about the launch of this service for clinicians, attorneys and researchers who want to stay abreast of developments in the field of risk assessment. The publishers scour more than 80 professional journals and create a one-page summary for each article relevant to violence and sex offending risk assessment among adults and juveniles. Using an appealing, easy-to-read format, each summary highlights the study's clinical implications and relevant legal questions, while minimizing statistical jargon. 

In the months since my announcement, the Bulletin has been gaining traction around the world. It now reaches more than 11,000 practitioners, researchers, and policymakers in the United States, Australia, China, Hong Kong, Spain, Germany, Canada, the United Kingdom, Argentina, Israel, the Netherlands, Mexico, Lithuania, Norway and Denmark. Among its largest subscribers are the California Department of State Hospitals -- which requires that its forensic evaluators read each monthly issue in order to stay abreast of peer-reviewed research into evidence-based practice -- and the public-policy oriented Council of State Governments in the United States.

The newly rebranded Global Institute of Forensic Research (GIFR), with the ever-energetic forensic psychologist Jay Singh at its helm, is currently rolling out a new features and services, including a new website, a podcast version of the Bulletin for commuters, and expert risk assessment trainings (free to subscribers) that are eligible for continuing education credits from the American Psychological Association and the Canadian Psychological Association.

The service is subscription-based. At $35 per month (and $350 for group subscriptions) it isn’t cheap, but Dr. Singh points out that the alternatives are also costly. It’s both costly and time consuming to stay abreast of important risk-related articles from more than 80 journals, most of them fee-based. Thus, without a synthesizing service such as the Bulletin, practitioners risk falling behind and inadvertently violating relevant standards of practice.

Among my own main concerns if I am going to allow someone else to find and synthesize research for my consumption is the degree of fidelity and expertise that the reviewer brings to bear. Here, the field is fortunate to have someone upon whom we can confidently rely. What I find most valuable about the Bulletin is the level of critical analysis that the expert reviewers bring to bear on each of the 15 or 20 articles they summarize each month. (Indeed, my confidence is why I accepted an invitation a while back to serve on the Institute’s advisory board.)

Singh, an epidemiology professor at Molde University in Norway, has published more than 40 cutting-edge articles on violence prediction (a few of which I have featured in prior blog posts). Formerly a fellow of the Florida Mental Health Institute and a Senior Researcher in Forensic Psychiatry for the Swiss Department of Corrections in Zurich, he has also trained and lectured widely on mental illness and violence, including at Harvard, Yale, Columbia, Cornell, Brown, Dartmouth, and the University of Pennsylvania.

To date, his Institute has conducted exclusive interviews on tips and tricks in forensic assessment with leading practitioners and scholars including Jodi Viljoen, Nicholas Scurich, Annelies Vredeveldt and -- most recently -- Jennifer Lanterman of the University of Nevada at Reno. Next month’s featured expert is Seena Fazel of Oxford University. You can browse the website and find a sample issue HERE.

If you decide to sign up (or, better yet, get your institution to sign up), Singh is offering my blog readers and subscribers a special 10 percent discount. Just click on THIS LINK, and enter the discount code INTHENEWS.

Risk researchers launching premium literature service

The Alliance for International Risk Research (AIRR) is launching an excellent new risk assessment resource for mental health, correctional, and legal professionals. The AIRR Executive Bulletin is being called "an exceptional resource that lawyers on both sides, judges, examiners and the rest of us practitioners in these areas of forensic mental health, treatment and law should subscribe to in order to begin to implement a uniform body of current literature and ‘Best Practices’ that continually updates going forward to facilitate development of a legal and constitutional body of law."

The subscription-based service is designed for busy professionals who want to stay up to date but simply do not have the time to locate and read the voluminous literature published each month. It aggregates research on risk assessment for violence, sex offending and general recidivism among adults and juveniles.

AIRR researchers Jay Singh and Kevin Douglas

An expert team led by top risk assessment researchers Jay Singh and Kevin Douglas systematically searches more than 80 journals and identifies every new risk assessment article published each month. The average is around 20 articles. Doctors Singh and Douglas then purchase and read every article and write a one-page, easy-to-digest summary without statistical jargon.

In addition to the monthly summary of literature, subscribers also get four online risk assessment training seminars per year from top clinical researchers, and an exclusive monthly interview with an industry leader. It's a convenient way to get continuing education credits, because the trainings are eligible for American Psychological Association and Canadian Psychological Association credits.

A sample issue is available HERE. 

You can sign up for either an individual or a group subscription HERE.  For questions, contact lead reasearcher Jay Singh (HERE).

Documentary explores town's polarization over transgender murder

Forensic psychologist key element in gay panic defense

For 20 minutes, Brandon McInerney sat patiently behind Larry King in their junior high school computer classroom. Then, the budding white supremacist pulled out a handgun and shot his transgender classmate twice in the back of the head. Larry died two days later, on Valentine's Day.

The 2008 murder polarized the community of Oxnard, California. The chasm widened during the highly publicized trial three years later, when a pair of private defense attorneys managed to turn the homicide into a reverse civil rights case for beleaguered heterosexuals and white people. With the help of a forensic psychologist, they were able to convince seven out of 12 jurors that Larry King had provoked his own death through his gender transgression. After the mistrial, several jurors became outspoken advocates for Brandon, wearing "Save Brandon" bracelets and raising money for his retrial.

Director Marta Cunningham

"He [Brandon] was solving a problem," explained juror Diane Michaels, an OR nurse. “Where are the civil rights of the one being taunted by another person who’s cross-dressing? He had no one he could turn to because the school was so pro-Larry King’s civil rights, but where was Brandon’s civil rights?"

"It was the high heels, the makeup, the behavior," agreed Karen McElhaney, a fellow juror and a surgical nurse, as the jurors bonded over wine and hors d'oeuvres at one of their homes.

Through such candid interviews with family members, teachers, students (including two eyewitnesses), attorneys and jurors, first-time film director Marta Cunningham explores the conflicting ideologies regarding both gender diversity and social tolerance that Larry King’s murder graphically exposed. Cunningham spent four years and collected 350 hours of footage for Valentine Road (the name of the street on which Larry is buried), a Sundance award-winner debuting on HBO. She hopes that schools will use the film as an educational tool to promote tolerance. 

Forensic psychologist blames the victim

This blog's readers will be especially interested in the role of the forensic psychologist, who helped sell the victim-blaming theme at trial. The testimony of Donald Hoagland gave the jurors an "expert" imprimatur on which to hang their hat.

 ABC News trial coverage featuring voice of 

forensic psychologist Donald Hoagland as he testifies

"What Larry was doing was an extreme form of bullying, an extreme form of sexual harassment," Donald Hoagland told the filmmaker. "Guys don’t hit on guys. Brandon was thinking he needed to get rid of Larry. He needed to save everyone from this scourge that had come upon this school."

At the trial, Hoagland testified that the cross-dressing victim's flirtation threw 14-year-old Brandon into a fit of homicidal rage. He testified that King's declaration that he was changing his name to Leticia triggered a dissociative state in which Brandon temporarily lost track of reality, according to the Ventura County Star.

The fatal flaw with that gay panic theory of the crime is that McInerney made advance plans to kill King. He announced his plan to several people the day beforehand, according to testimony during the eight-week trial, and also acquired and loaded the gun and brought it with him to school. He shot King twice in the back of the head during a first-period class.

Jurors who voted against a murder conviction said that Larry King's request to be called by a girl's name gave Brandon a "green light" to execute him. One juror even wrote to the judge after the trial to protest the "witch hunt" against the killer, citing the victim’s "long history of deviant behavior."

"They made a murder victim the cause of his own murder," marvels Detective Dan Swanson, a hate crime expert who testified at the trial.

Prosecutor Maeve Fox, who ultimately agreed to a plea deal of 21 years for Brandon, said the case exposed the deep layer of intolerance in society, an intolerance that is even carried into the jury box.

Unfortunately, the documentary gives short shrift to another central factor in community support for Brandon. A decision by the prosecutor's office to try the 14-year-old suspect as an adult led to widespread public opposition. Brandon faced 51 years to life in prison if convicted in adult court. A coalition of dozens of gay and lesbian groups even joined the chorus of pleas to try the boy as a juvenile.

Cunningham's direction is understated. Rather than hitting the viewer over the head with a message or point of view, she allows the characters to speak for themselves, interspersing their dialogue with artful sketches, news footage and school surveillance video. The resulting nuanced tale forces audience members to think for themselves about the moral implications of the tragedy.

Ultimately, Valentine Road is a sad and haunting story about two lost boys struggling for identity in a violent world. For the two boys were alike in many ways, both of them abused, neglected and lacking competent adult mentorship as they navigated the perilous journey to adulthood. Larry had been bullied since the third grade for his effeminacy; Brandon was dependent on a bullying father who physically abused him, while his methamphetamine-abusing mother was homeless. 

Yet for all its pathos the film also shines a ray of hope. Even as the defense team vigorously promoted a victim-blaming narrative, youths from the local community came together to honor Larry King and to use his death to promote a message of tolerance. One can only hope that the film will be shown far and wide, and will contribute to that worthy endeavor.

VALENTINE ROAD WILL AIR OCTOBER 24 ON HBO. IT IS ALSO AVAILABLE ON DEMAND. CLICK HERE FOR THE FULL SCHEDULE.

RELATED STORY: "The Hidden War Against Gay Teens," Alex Morris, Rolling Stone, Oct. 10, 2013

* * * * *

My prior coverage of the case: 

• What caused middle school tragedy? 14-year-old Brandon McInerney to be arraigned Thursday (June 10, 2008) 
• More on the McInerney antigay murder case: Defense may use emerging science of adolescent brain development (June 11, 2008)  
• Gay panic defense: Slain boy accused of provocation (Aug. 10, 2011) 
• Jury deadlocks in gay panic trial (Sept. 2, 2011)  
• Gay panic defendant gets 21 years (Nov. 23, 2011) 

Hat tip: John Lewis

Study: Risk tools don't work with psychopaths

If you want to know whether that psychopathic fellow sitting across the table from you will commit a violent crime within the next three years, you might as well flip a coin as use a violence risk assessment tool.

Popular risk assessment instruments such as the HCR-20 and the VRAG perform no better than chance in predicting risk among prisoners high in psychopathy, according to a new study published in the British Journal of Psychiatry. The study followed a large, high-risk sample of released male prisoners in England and Wales.

Risk assessment tools performed fairly well for men with no mental disorder. Utility was decreased for men diagnosed with schizophrenia or depression, became worse yet for those with substance abuse, and ranged from poor to no better than chance for individuals with personality disorders. But the instruments bombed completely when it came to men with high scores on the Psychopathy Checklist-Revised (PCL-R) (which, as regular readers of this blog know, has real-world validity problems all its own). 

"Our findings have major implications for risk assessment in criminal populations," noted study authors Jeremy Coid, Simone Ullrich and Constantinos Kallis. "Routine use of these risk assessment instruments will have major limitations in settings with high prevalence of severe personality disorder, such as secure psychiatric hospitals and prisons."

The study, "Predicting future violence among individuals with psychopathy," may be requested from the first author, Jeremy Coid (click HERE).  

Free, one-stop shopping: Bulletin showcases new violence articles

The first monthly bulletin from the Alliance for International Risk Research just hit my email box, collating August's journal offerings on violence risk assessment and management. A quick sampling from the 17 articles listed:

• Large MM, Ryan CJ, Callaghan S, Paton MB, and Singh SP (2013) Can violence risk assessment really assist in clinical decisionmaking? Australian & New Zealand Journal of Psychiatry (online first Aug 2013)

• Rettenberger M, Haubner-Maclean T, and Eher R (2013) The contribution of age to the Static-99 Risk Assessment in a population-based Prison sample of sexual offenders. Criminal Justice & Behavior (online first June 2013)

• Lund C, Hofvander B, Forsman A, Anckarsater H, and Nilsson T (2013) Violent criminal recidivism in mentally disordered offenders: a follow-up study of 13-20 years through different sanctions. International Journal of Law and Psychiatry, 36, 250-257

• Caldwell MF (2013) Accuracy of Sexually Violent Person Assessments of Juveniles Adjudicated for Sexual Offenses Sexual Abuse (online first March 2013).

AIRR's goal is to make information about the latest research on violence risk assessment available to researchers, practitioners, and policymakers for free. I you don't have access to an academic database you still have to find a way to access the articles themselves, but that can generally be done through a request of the author.) If you haven't already signed up to receive your monthly email, you can do so by clicking HERE. 

'Authorship bias' plays role in research on risk assessment tools, study finds

Reported predictive validity higher in studies by an instrument's designers than by independent researchers

The use of actuarial risk assessment instruments to predict violence is becoming more and more central to forensic psychology practice. And clinicians and courts rely on published data to establish that the tools live up to their claims of accurately separating high-risk from low-risk offenders.

But as it turns out, the predictive validity of risk assessment instruments such as the Static-99 and the VRAG depends in part on the researcher's connection to the instrument in question.

Publication bias in pharmaceutical research
has been well documented

Published studies authored by tool designers reported predictive validity findings around two times higher than investigations by independent researchers, according to a systematic meta-analysis that included 30,165 participants in 104 samples from 83 independent studies.

Conflicts of interest shrouded

Compounding the problem, in not a single case did instrument designers openly report this potential conflict of interest, even when a journal's policies mandated such disclosure.

As the study authors point out, an instrument’s designers have a vested interest in their procedure working well. Financial profits from manuals, coding sheets and training sessions depend in part on the perceived accuracy of a risk assessment tool. Indirectly, developers of successful instruments can be hired as expert witnesses, attract research funding, and achieve professional recognition and career advancement.

These potential rewards may make tool designers more reluctant to publish studies in which their instrument performs poorly. This "file drawer problem," well established in other scientific fields, has led to a call for researchers to publicly register intended studies in advance, before their outcomes are known.

The researchers found no evidence that the authorship effect was due to higher methodological rigor in studies carried out by instrument designers, such as better inter-rater reliability or more standardized training of instrument raters.

"The credibility of future research findings may be questioned in the absence of measures to tackle these issues," the authors warn. "To promote transparency in future research, tool authors and translators should routinely report their potential conflict of interest when publishing research investigating the predictive validity of their tool."

The meta-analysis examined all published and unpublished research on the nine most commonly used risk assessment tools over a 45-year period:

• Historical, Clinical, Risk Management-20 (HCR-20)
• Level of Service Inventory-Revised (LSI-R)
• Psychopathy Checklist-Revised (PCL-R)
• Spousal Assault Risk Assessment (SARA)
• Structured Assessment of Violence Risk in Youth (SAVRY)
• Sex Offender Risk Appraisal Guide (SORAG)
• Static-99
• Sexual Violence Risk-20 (SVR-20)
• Violence Risk Appraisal Guide (VRAG)

Although the researchers were not able to break down so-called "authorship bias" by instrument, the effect appeared more pronounced with actuarial instruments than with instruments that used structured professional judgment, such as the HCR-20. The majority of the samples in the study involved actuarial instruments. The three most common instruments studied were the Static-99 and VRAG, both actuarials, and the PCL-R, a structured professional judgment measure of psychopathy that has been criticized criticized for its vulnerability to partisan allegiance and other subjective examiner effects.

This is the latest important contribution by the hard-working team of Jay Singh of Molde University College in Norway and the Department of Justice in Switzerland, (the late) Martin Grann of the Centre for Violence Prevention at the Karolinska Institute, Stockholm, Sweden and Seena Fazel of Oxford University.

A goal was to settle once and for all a dispute over whether the authorship bias effect is real. The effect was first reported in 2008 by the team of Blair, Marcus and Boccaccini, in regard to the Static-99, VRAG and SORAG instruments. Two years later, the co-authors of two of those instruments, the VRAG and SORAG, fired back a rebuttal, disputing the allegiance effect finding. However, Singh and colleagues say the statistic they used, the receiver operating characteristic curve (AUC), may not have been up to the task, and they "provided no statistical tests to support their conclusions."

Prominent researcher Martin Grann dead at 44

Sadly, this will be the last contribution to the violence risk field by team member Martin Grann, who has just passed away at the young age of 44. His death is a tragedy for the field. Writing in the legal publication Das Juridik, editor Stefan Wahlberg noted Grann's "brilliant intellect" and "genuine humanism and curiosity":

Martin Grann came in the last decade to be one of the most influential voices in both academic circles and in the public debate on matters of forensic psychiatry, risk and hazard assessments of criminals and ... treatment within the prison system. His very broad knowledge in these areas ranged from the law on one hand to clinical therapies at the individual level on the other -- and everything in between. This week, he would also debut as a novelist with the book "The Nightingale."

The article, Authorship Bias in Violence Risk Assessment? A Systematic Review and Meta-Analysis, is freely available online via PloS ONE (HERE).

Related blog reports:

• Violence risk instruments overpredicting danger (Aug. 2, 2012) 
• Violence risk in schizophrenics: Are forensic tools reliable predictors? (Sept. 14, 2011) 
• Violence risk meta-meta: Instrument choice does matter (June 19, 2011)
• Psychology rife with inaccurate research findings (Nov. 20, 2011)
• International violence risk researchers launch free news service (June 13, 2013) 

Violence prevention: DC to host major collaborative venture

From U.S. Attorney General Eric Holder to legal scholar Barbara Bennett Woodhouse, the speakers at next month's APA-ABA collaborative conference read like a who's who in the field of violence prevention.

To give a flavor:

• Carl Hart, the neuroscientist whose memoir I recently featured, will speak on the contribution of U.S. drug policy to violence
• James Garbarino, author of the terrific book Lost Boys: Why Our Sons Turn Violent and How We Can Save Them, will address the developmental effects of violence -- a topic that forensic psychologists confront daily in our practices
• Mary Ann Dutton, a leading researcher on domestic violence, will discuss preventing intimate partner violence
• Patrick Tolan and Dewey Cornell will address youth violence in the schools 
• Judge Jay Blitzman and colleagues will talk about disrupting the 'cradle to prison pipeline' by implementing alternatives to school suspension and exclusion 
• Charlotte Patterson, a pioneer in LGBT research, will focus on reducing violence against sexual minorities 
• Mark Soler, an attorney who taught my media law class way back in journalism school, will speak on alternatives to incarceration in juvenile justice 
• Edward Mulvey will address mental illness and substance abuse in violence 

And that's just for starters. With more than 40 plenary and invited sessions, the lineup goes on and on, with a wide array of programming that should appeal to psychologists, attorneys, judges, legal and social science scholars, and anyone else interested in the roles of law and psychology in addressing the effects of violence:

• Intergenerational transmission of violence
• Violence in Native American communities
• Offender reentry
• Risk assessment and threat assessment
• Hate crimes
• Poverty and race in violence
• Sexually violent offenders
• Violence among military veterans
• Elder abuse
• and much more

A major goal of the conference, entitled "Addressing the Unspeakable: Confronting Family and Community Violence, The Intersection of Law and Psychology," is to build on the momentum of Eric Holder's Defending Childhood initiative, which aims to address the effects of violence on children, youth and families.

The conference is co-sponsored by the American Psychological Association and the American Bar Association, and continuation education credits will be provided for both legal and mental health professionals. Early registration ends this week, so register now if you're planning to attend.

The preliminary program is HERE; an overview of the event and its logistics is HERE; the online registration form is HERE. 

International violence risk researchers launch free news service

I don't know about you, but I find it incredibly hard to keep up with the burgeoning research in risk assessment. In this era of international fear and carceral control, disciplines from psychology to criminology to nursing to juvenile justice are cranking out more articles each month, and the deluge can feel overwhelming.

Fortunately, two prominent researchers are offering to help us stay organized and up to speed -- for free. The newly created Alliance for International Risk Research (AIRR) will send out a monthly email containing references to all new articles related to forensic risk assessment from over 80 scholarly journals. And all you have to do is sign up.

Jay Singh and Kevin Douglas, AIRR Editors-in-Chief

The AIRR is brought to you by Jay Singh and Kevin Douglas. Dr. Singh, a newly appointed professor and senior researcher for the Department of Justice in Switzerland, is one of the best and brightest around (I've featured his important research on violence risk assessment more than once on this blog); Dr. Douglas is an award-winning psychology professor at Simon Fraser University and co-author of the widely used HCR-20 violence risk assessment tool, among others. 

Their goal is to keep clinicians, policymakers, and researchers up to date in this rapidly evolving field, thus promoting evidence-based practices in the mental health and criminal justice systems. For articles published in languages other than English, the AIRR even boasts an "international coordinator" who will help disseminate the research to a global audience.

Signing up is easy: Just go to THIS LINK and provide your email contract information. The AIRR promises not to bother you with solicitations, survey participation requests or conference announcements -- "simply the latest risk-related research at your fingertips."

Don't delay! The first AIRR bulletin will be arriving in inboxes on Sept. 1.

Study links childhood trauma and adult aggression

Call for trauma-focused treatment of offenders

Children who experience abuse, neglect and family dysfunction have a heightened risk of developing health problems such as obesity, drug addiction, depression and heart disease in adulthood. That common-sense notion is widely accepted, and has been proven in a series of studies funded by the US Centers for Disease Control and Prevention (CDC) and Kaiser Permanente. The Kaiser-CDC project has amassed a large database of the life histories and health trajectories of middle-class residents of San Diego, California.

Now, a San Diego psychologist has deployed that project's Adverse Childhood Experiences (ACE) survey to link these negative childhood experiences with adult aggression and criminality, including domestic violence, sexual assault, stalking and child abuse.

In fact, the correlation is additive, the new study found: The more types of adversities a man underwent in childhood, the higher his likelihood of engaging in criminal aggression as an adult.

Men in the study who were referred to outpatient treatment following convictions for domestic violence, sexual offending, nonsexual child abuse or stalking reported about four times as many adverse childhood events as men in the general population. Men convicted of sex offenses and child abuse were especially likely to report being sexually abused as children.

The link between early damage and later aggression explains why treatment programs that focus primarily on criminal acts are not very effective, say psychologist James Reavis of San Diego, California and his colleagues.

"To reduce criminal behavior one must go back to the past in treatment, as Freud admonished us nearly 100 years ago," wrote Reavis and co-authors Jan Looman, Kristina Franco and Briana Rojas in an article slated for the Spring 2013 issue of The Permanente Journal. "Fortunately, evidence exists in support of both attachment-based interventions designed to normalize brain functioning and in the efficacy of psychoanalytic treatment."

Why the link between abuse and aggression?

Cumulative experiences of abuse and neglect disrupt both a child's ability to form secure attachments to others and his ability to regulate his emotions, the researchers posit. Thus, men abused as youngsters tend to either avoid intimacy altogether or are at risk to become violent in intimate relationships, due to a "bleeding out" of their suppressed inner rage.


Not only must treatment of offenders focus on healing their "neurobiological" wounds, the researchers say, but the findings also point to the need for more early childhood interventions to stop child abuse before its victims grow up to victimize others.

Stay tuned: A second article being prepared for publication will explore the link between early adversity and dysregulation in the hypothalamic-pituitary-adrenal axis that modulates stress responses.

The article, "Adverse Childhood Experiences and Adult Criminality: How Long Must We Live before We Possess Our Own Lives?" can be requested from the first author, psychologist James Reavis of San Diego (HERE). The article includes a copy of the ACE questionnaire, which is potentially useful in forensic cases as a means of quantifying experiences of child abuse and neglect.

Showdown looming over predictive accuracy of actuarials

Large error rates thwart individual risk prediction

Brett Jordan David Macdonald (Creative Commons license)

If you are involved in risk assessments in any way (and what psychology-law professional is not, given the current cultural landscape?), now is the time to get up to speed on a major challenge that's fast gaining recognition.

At issue is whether the margins of error around scores are so wide as to prevent reliable prediction of an individual's risk, even as risk instruments show some (albeit weak) predictive accuracy on a group level. If the problem is unsolvable, as critics maintain, then actuarial tools such as the Static-99 and VRAG should be barred from court, where they can literally make the difference between life and death.

The debate has been gaining steam since 2007, with a series of back-and-forth articles in academic journals (see below). Now, the preeminent journal Behavioral Sciences and the Law has published findings by two leading forensic psychologists from Canada and Scotland that purport to demonstrate once and for all that the problem is "an accurate characterization of reality" rather than a statistical artifact as the actuarials' defenders had argued.

So-called actuarial tools have become increasingly popular over the last couple of decades in response to legal demand. Instruments such as the Static-99 (for sexual risk) and the VRAG (for general violence risk) provide quick-and-dirty ways to guess at an individual's risk of violent or sexual recidivism. Offenders are scored on a set of easy-to-collect variables, such as age and number of prior convictions. The assumption is that an offender who attains a certain score resembles the larger group of offenders in that score range, and therefore is likely to reoffend at the same rate as the collective.

Responding to criticisms of the statistical techniques they used in their previous critiques, Stephen Hart of Simon Fraser University and David Cooke of Glasgow Caledonian University developed an experimental actuarial tool that worked on par with existing actuarials to separate offenders into high- and low-risk groups.* The odds of sexual recidivism for subjects in the high-risk group averaged 4.5 times that of those in the low-risk group. But despite this large average difference, the researchers established through a traditional statistical procedure, logistic regression, that the margins of error around individual scores were so large as to make risk distinctions between individuals "virtually impossible." In only one out of 90 cases was it possible to say that a subject's predicted risk of failure was significantly higher than the overall baseline of 18 percent. (See figure.)

Vertical lines show confidence intervals for individual risk estimates;
these large ranges would be required in order to reach the traditional 95 percent level of certainty.

The brick wall limiting predictive accuracy at the individual level is not specific to violence risk. Researchers in more established fields, such as medical pathology, have also hit it. Many of you will know of someone diagnosed with a cancer and given six months to live who managed to soldier on for years (or, conversely, who bit the dust in a matter of weeks). Such cases are not flukes: They owe to the fact the six-month figure is just a group average, and cannot be accurately applied to any individual cancer patient.

Attempts to resolve this problem via new technical procedures are "a waste of time," according to Hart and Cooke, because the problem is due to the "fundamental uncertainty in individual-level violence risk assessment, one that cannot be overcome." In other words, trying to precisely predict the future using "a small number of risk factors selected primarily on pragmatic grounds" is futile; all the analyses in the world "will not change reality."

Legal admissibility questionable 

The current study has grave implications for the legal admissibility of actuarial instruments in court. Jurisdictions that rely upon the Daubert evidentiary standard should not be allowing procedures for which the margins of error are "large, unknown, or incalculable," Hart and Cooke warn.

By offering risk estimates in the form of precise odds of a new crime within a specific period of time, actuarial methods present an image of certitude. This is especially dangerous when that accuracy is illusory. Being told that an offender "belongs to a group with a 78 percent likelihood of committing another violent offense within seven years" is highly prejudicial and may poison the judgment of triers of fact. More covertly, it influences the judgment of the clinician as well, who -- through a process known as "anchoring bias" -- may tend to judge other information in a case in light of the individual's actuarial risk score.

Classic '56 Chevy in Cuba. Photo credit: Franciscovies

With professional awareness of this issue growing, it is not only irresponsible but ethically indefensible not to inform the courts or others who retain our services about the limitations of actuarial risk assessment. The Ethics Code of the American Psychological Association, for example, requires informing clients of "any significant limitations of [our] interpretations." Unfortunately, I rarely (if ever) see limitations adequately disclosed, either in written reports or court testimony, by evaluators who rely upon the Static-99, VRAG, Psychopathy Checklist-Revised (which Cooke and statistician Christine Michie of Glasgow University tackled in a 2010 study) and similar instruments in forming opinions about individual risk.

In fact, more often than not I see the opposite: Evaluators tout the actuarial du jour as being far more accurate than "unstructured clinical judgment." That's like an auto dealer telling you, in response to your query about a vehicle's gas mileage, that it gets far more miles per gallon than your old 1956 Chevy. Leaving aside Cuba (where a long-running U.S. embargo hampers imports), there are about as many gas-guzzling '56 Chevys on the roads in 2013 as there are forensic psychologists relying on unstructured clinical judgment to perform risk assessments. 

Time to give up the ghost? 

Hart and Cooke recommend that forensic evaluators stop the practice of using these statistical algorithms to make "mechanistic" and "formulaic" predictions. They are especially critical of the practice of providing specific probabilities of recidivism, which are highly prejudicial and likely to be inaccurate.

"This actually isn’t a radical idea; until quite recently, leading figures in the field of forensic mental health [such as Tom Grisso and Paul Appelbaum] argued that making probabilistic predictions was questionable or even ill advised," they point out. “Even in fields where the state of knowledge is arguably more advanced, such as medicine, it is not routine to make individual predictions.”

They propose instead a return to evidence-based approaches that more wholistically consider the individual and his or her circumstances:

From both clinical and legal perspectives, it is arbitrary and therefore inappropriate to rely solely on a statistical algorithm developed a priori - and therefore developed without any reference to the facts of the case at hand - to make decisions about an individual, especially when the decision may result in deprivation of liberties. Instead, good practice requires a flexible approach, one in which professionals are aware of and rely on knowledge of the scientific literature, but also recognize that their decisions ultimately require consideration of the totality of circumstances - not just the items of a particular test. 

In the short run, I am skeptical that this proposal will be accepted. The foundation underlying actuarial risk assessment may be hollow, but too much construction has occurred atop it. Civil commitment schemes rely upon actuarial tools to lend an imprimatur of science, and statutes in an increasing number of U.S. states mandate use of the Static-99 and related statistical algorithms in institutional decision-making.

The long-term picture is more difficult to predict. We may look back sheepishly on today's technocratic approaches, seeing them as emblematic of overzealous and ignorant pandering to public fear. Or -- more bleakly -- we may end up with a rigidly controlled society like that depicted in the sci-fi drama Gattaca, in which supposedly infallible scientific tests determine (and limit) the future of each citizen.

* * * * *

I recommend the article, "Another Look at the (Im-)Precision of IndividualRisk Estimates Made Using Actuarial RiskAssessment Instruments." It's part of an upcoming special issue on violence risk assessment, and it provides a detailed discussion of the history and parameters of the debate. (Click HERE to request it from Dr. Hart.) Other articles in the debate include the following (in rough chronological order): 

• Hart, S. D., Michie, C. and Cooke, D. J. (2007a). Precision of actuarial risk assessment instruments: Evaluating the "margins of error" of group v. individual predictions of violence.  British Journal of Psychiatry, 190, s60–s65. 

• Mossman, D. and Sellke, T. (2007). Avoiding errors about "margins of error" [Letter]. British Journal of Psychiatry, 191, 561. 

• Harris, G. T., Rice, M. E. and Quinsey, V. L. (2008). Shall evidence-based risk assessment be abandoned? [Letter]. British Journal of Psychiatry, 192, 154. 

• Cooke, D. J. and Michie, C. (2010). Limitations of diagnostic precision and predictive utility in the individual case: A challenge for forensic practice. Law and Human Behavior, 34, 259–274. 

• Hanson, R. K. and Howard, P. D. (2010). Individual confidence intervals do not inform decision makers about the accuracy of risk assessment evaluations. Law and Human Behavior, 34, 275–281. 

*The experimental instrument used for this study was derived from the SVR-20, a structured professional judgment tool. The average recidivism rate among the total sample was 18 percent, with 10 percent of offenders in the low-risk group and 33 percent of those in the high-risk group reoffending. The instrument's Area Under the Curve, a measure of predictive validity, was .72, which is in line with that of other actuarial instruments.

"The best predictor of future behavior is …

… past behavior."


Past as prelude. So neat, so clean. So full of certitude. Like a fortune cookie Confucianism. Something you might hear on CSI: Special Victims Unit. A maxim cited by pop psychologist "Dr. Phil" McGraw, in one of his many self-help books.

I'm sure you have heard the mantra. It's creeping into risk assessment reports and court testimony by forensic psychologists. Sometimes, it's augmented with incendiary metaphors: The subject is "a ticking time bomb"; he is "carrying a hand grenade and it's just a matter of when he pulls the pin."

One current case of mine involves a guy with a cluster of several violent offenses a few years ago, when he was in his 20s. He was using drugs back then, and hanging around with a bad crowd. Plus, he is chronically psychotic. Not a good combination.

But if you predict future violence based on a set of risk factors like his, you will be wrong more often than not. Only about four out of ten of those individuals judged to be at moderate to high risk of future violence go on to reoffend violently, according to research. The low base rates of violent recidivism will be working against you.

Birth of a legend

So where does this idea that "the best predictor of future behavior is past behavior" come from, and does it hold any water?

Perusing psychology texts, it appears that the principle has circulated for decades. But as it gained traction, some boiled it down into a simpler, one-size-fits-all mantra. So, for example, the 2003 Complete Idiot's Guide to Psychology claims as an established "psychological fact of life" that, "when it comes to human beings, the best predictor of future behavior is past behavior." Period. End of story.

But this is a gross oversimplification. Psychological scientists who study human behavior agree that past behavior is a useful marker for future behavior. But only under certain specific conditions:

1. High-frequency, habitual behaviors are more predictive than infrequent behaviors.
2. Predictions work best over short time intervals.
3. The anticipated situation must be essentially the same as the past situation that activated the behavior.
4. The behavior must not have been extinguished by corrective or negative feedback. 
5. The person must remain essentially unchanged.
6. The person must be fairly consistent in his or her behaviors.

Here, by way of illustration, is a typical study of the phenomenon, involving college students' class attendance habits:

In a semester-long course, researcher Icek Ajzen found that a student's attendance rate for the first eight sessions correlated 0.46 with his or her attendance rate for the second eight sessions. As you can see, all the conditions are in place: Class attendance is a habitual and routinized behavior, the prediction span is very short, and there is little likelihood of meaningful changes in either the situation or the person. Yet still, the correlation is far from perfect.

Other examples from the classic studies: Frequency of exercise during a given time period is a pretty good indicator of exercise habits in the near future. Ditto for cigarette smoking and drug use.

But over longer time periods, even high frequency, habitual behaviors may undergo dramatic change. A smoker or heavy drinker might successfully quit the habit. A chronic thief might land a decent job, start a family and settle down.

As this last example suggests, researchers have also determined that the situation plays a critical role in behavior. The situation is often more determinative than individual character traits. Personality theorist Walter Mischel - frequently cited in connection with the "best predictor" maxim - suggests that behavioral consistency is best described through if-then relationships between situations and behaviors, as in: "She does A when X, but B when Y." So, a person may engage in heavy drug use when in the company of drug-using peers, but may stop using when she gets a fulfilling job and moves to the suburbs, or when she is staying with her strict grandmother.

Forensic psychologists jump aboard

It’s one thing to find a simplistic maxim where one would expect to - in an "Idiot’s Guide" or on Dr. Phil. But it is troubling to see it incorporated in forensic contexts, where the stakes are much higher.

Confusion creeps in when a risk marker is mistaken for an inevitability. It is true that people with a history of violence have a higher likelihood of committing violence in the future than do people who habitually turn the other cheek. Risk is especially acute for those with very extensive histories of violence across a range of situations. But this does not mean that everyone who has committed past acts of violence will continue to aggress forever (any more than someone with no prior violence is guaranteed to remain peaceable forever).

It's like claiming to know that because your teenage neighbor had a fender bender (or two) when he was first learning to drive, he will definitely crash his car again. He is probably at a higher risk of another collision than is his middle-aged mother, with her clean driving record. But he may or may not crash again. There are many intervening variables - whether he learned from his mistakes, the frequency and locations and times of day of his future driving, his choice of companions, the actions of other drivers on the road, the weather conditions, and so on.

The maxim also conflates all types of violence, and all types of offenders. For example, with detected recidivism among sex offenders falling somewhere between a low of about 3 percent and a high of no more than 15 percent, it's pretty hard to argue past as prelude. And if we apply the mantra to murderers, as did "Dr. Death" in Texas, we will be even further off the mark. In California over the past two decades, about 1,000 people have been paroled from prison after serving time for first- or second-degree murder. Their recidivism rate for murder?

Precisely zero, according to Nancy Mullane's Life After Murder.

The best-predictor axiom ignores such base rates, which are essential to accurate prediction. If we know the base rate of the criminal behavior we are trying to predict - whether murder or sex offending or general violence - and we know the frequency with which a person has engaged in that behavior, we can use a mathematical formula called Bayes's theorem to calculate a rough likelihood of the behavior's reoccurrence. (I recommend Nate Silver's The Signal and the Noise for great examples of the applications of this theory across a range of contexts, from poker to climatology.)

The maxim also snubs its nose at the age-crime curve, perhaps the most universal finding of a century of criminology research. As they reach their mid-30s or so, criminal offenders begin to slow down. Some mature naturally, some go through successful mentorship or treatment programs, some settle down and have families, some form mellower friendships, some simply burn out. Whatever the reasons, as research by Shadd Maruna and Sampson and Laub drives home, desistance is a virtual inevitability for all but the most die-hard minority of offenders.

This is not to say that the maxim is entirely useless. It may work fairly well under certain limited circumstances, if all of the following hold true:

1. We are predicting over a relatively short time frame.
2. The individual has a high frequency of violence.
3. The violence occurs in a variety of situations.
4. The person is faced with the same or similar situations.
5. He or she has not been deterred by negative feedback.
6. He or she has not changed in any other significant way.

But given lengthier time frames of prediction, our subject and his circumstances both undergo inevitable and often unpredictable changes, and we lose fidelity.

A ticking time bomb fails to ignite

In the case of the report I was reading this week, the mantra was a complete bust. The guy got out of jail and did great. He voluntarily sought treatment and cooperated with all terms of his supervision. By the time I saw him, he was leading a life as peaceable as a newborn lamb's. In his spare time, he even volunteered to help the needy at his local church.

If the evaluator had heeded the literature on criminal desistance, she might have seen this coming. The fellow had reached the age at which desistance becomes more the rule than the exception. He no longer associated with his old criminal peers. Perhaps most importantly, he had stopped using the drugs that had exacerbated his psychosis.

The past-as-prelude mantra fits with today's dominant, dark view of offenders as a bundle of perpetual risk factors, ticking time bombs just waiting to explode.

What it doesn't fit so well with is reality.