Serial Murder: A Forensic Psychiatric Perspective

W hen law enforcement apprehends a serial murderer, the event is consistently the focus of unswerving media coverage. For local communities, the ordeal can be particularly shocking and upsetting. Residents living in a community that is exposed to serial murder may even experience posttraumatic stress disorder symptoms for varying periods of time (Herkov and Beirnat, 1997). Over the past three decades, our society has become fascinated by the phenomenon of serial murder as evidenced by the numerous books, movies and television shows on the subject. Yet, despite the high level of interest, there is no current theory that adequately explains the etiology of serial murder (Holmes et al., 2002). This is primarily due to the fact that serial murder is an event with an extremely low base rate and therefore is difficult to study via rigorous scientific methods (Dietz, 1986). While serial murder is a universally terrifying concept, it is an extraordinarily rare event. In a study of the frequency of serial sexual homicide, McNamara and Morton (2004) found that it accounted for only 0.5% of all homicides over a 10-year period in Vi rginia. In contrast to the sensationalized perception that serial murder is a growing epidemic, there is no solid evidence that this is the case. An analysis of homicide victims from 1960 to 1998 indicated that the percentages of female homicide victims have actually decreased (Schlesinger, 2001a). Because the victims of serial murderers are overwhelmingly female, these data fail to support the notion that serial murder is increasing in frequency. Historically, the term serial murder may be relatively new, but its occurrence is not. In the United States alone there have been documented cases as far back as the 1800s. In 16th-century France, it is likely that myths such as “werewolves” were used to explain the deeds of serial murderers that were too horrifying to attribute to human beings (Everitt, 1993). In all likelihood, serial murderers have always been among us. In 1886, psychiatry professor Richard von Krafft-Ebing wrote the classic Psychopathia Sexualis , in which he described the characteristics of individuals who appeared to obtain sexual gratification from acts of sadistic domination. The next major psychiatric contribution to our understanding of serial murderers was in 1970 when forensic psychiatrist Robert Brittain produced detailed descriptions of sadistic murderers he had encountered over his career. Beginning in the early ’70s, media coverage of notorious cases such as Ted Bundy and the Hillside Strangler produced a sense of urgency to study and explain the phenomenon. Thus far, the study of serial murder has been somewhat hampered by lack of a unanimously agreed upon definition. However, most experts agree on the criteria that the offender must have murdered at least two victims in temporally unrelated incidents. This phenomenon usually involves a cooling off or refractory period between killings that varies in duration for each individual offender. To date, our greatest source of knowledge and data on serial murder has come from experts working in the Federal Bureau of Investigation’s Behavioral Science Unit, now called the Behavioral Analysis Unit. To emphasize the sexual nature of the crimes, and to distinguish these offenders from others who murder serially for other reasons (e.g., contract killers), Douglas et al. (1997) have used the term sexual homicide . For each individual serial sexual homicide offender, the performance and meaning of the sexual element may vary. Researchers at the FBI gathered data from detailed interviews of 36 convicted serial murderers and were able to extract and analyze important personality and behavioral characteristics that helped distinguish different types of serial murderers. For ease of communication and conceptualization, the offenders were categorized into either “organized” or “disorganized” types ( Table 1). These terms were initially meant to help law enforcement interpret crime scenes and can be understood as generally applicable concepts. They may also have appeal to forensic mental health professionals in that they provide illustrative descriptors of personality and behavior. The term ixed sexual homicide is used to describe the offender whose crime scene reflected aspects of both the organized and disorganized types. Finally, the term sadistic murderer describes the offender who is primarily a sexual sadist and derives the greatest satisfaction from the victim’s response to torture. Meloy (2002) has advanced a similar typology, but with a clinical emphasis. Sexual homicide perpetrators may be described as either “compulsive” or “catathymic. ” The compulsive perpetrators are similar to the FBI’s organized killers. They leave organized crime scenes and can be diagnosed with sexual sadism and antisocial/narcissistic personality disorders. The catathymic perpetrators leave disorganized crime scenes and may be diagnosed with a mood disorder and varying personality traits. While the compulsive type display emotional detachment and autonomic hyporeactivity, the catathymic type are less psychopathic. In contrast, the catathymic type are autonomically hyperreactive and may have histories of abuse. Again, these types were intended to be generalities, and any individual case is likely to fall on a continuum between the two.