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This chapter introduces the concept of serial murder and provides the definition of “serial killer” used by many academics. The author discusses the coining of the term “serial killer” by Robert Ressler as well as the strengths and weaknesses of the most recent information that the US Federal Bureau of Investigation (FBI) provides to the public about serial murder. Although the FBI’s current information was assembled by a highly reputable team, it paints a broad-strokes portrait of serial murder as sexually motivated and does not acknowledge or make known the stark difference between female serial killers (FSKs) and male serial killers (MSKs) in crimes and victims. This can be to the detriment of law enforcement investigations. Harrison describes how FSKs tend to be unknown or ignored, perhaps because, as author Patricia Pearson argued, people are reluctant to believe women can be murderers. Furthermore, because psychopathy is a concept frequently emerging in serial killer psychology, the author provides a primer. Case studies of FSKs Kristen Gilbert, Patty Cannon, Aileen Wuornos, and Sharon Kinne illustrate various serial killer modus operandi and psychological concepts.
Dante must travel through Hell because there is that of Hell in himself. But his journey through Hell is not for him infernal, for Hell exists only for those eternally condemned there, and he, with Virgil, is but passing through. But it is still a transforming journey for Dante, and necessarily so. For him, the journey is purgatorial, not infernal, ascetical, not punitive. Is Dante’s journey possible? If Aquinas is right then no: For Hell’s condemnation is eternal and irreversible, and what you can make a fixed-time journey through cannot be Hell.
A number of studies have demonstrated the anti-aggressive properties of clozapine in schizophrenia and its positive effect in borderline personality disorder. There is no published literature on the treatment of antisocial personality disorder (ASPD) with clozapine. We present a case series of 7 patients with primary ASPD and high psychopathic traits treated with clozapine, having a significant history of serious violence and currently detained in a UK based high-security hospital.
Methods
A retrospective review of case notes was carried out to formulate Clinical Global Impression (CGI) scores and record incidents of violence and aggression. Effect on specific symptom domains (cognitive-perceptual, impulsive-behavioural dyscontrol, affective dysregulation) was also noted. Metabolic parameters and serum clozapine levels were also sampled.
Results
All 7 patients showed significant improvement on clozapine. It was shown to benefit all symptom domains, especially impulsive behavioral dyscontrol and anger. The number of violent incidents committed by 6 of the 7 patients reduced significantly, and all patients’ risk of violence reduced. Clozapine serum levels for 6 of the 7 patients were in the range 150–350 ng/mL.
Conclusion
Clozapine is of benefit in reducing the clinical severity of ASPD. It improved all symptom domains, especially impulsive-behavioral dyscontrol and anger, and reduced levels of aggression and violence, especially at lower doses (serum levels <350 ng/m). To our knowledge, this is the first account of clozapine treatment in patients with ASPD and high psychopathy.
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