Extreme Beliefs Often Mistaken for Insanity

A clearer distinction needs to be made between an extreme belief system and insanity, particularly in our justice system, as the former is often misinterpreted as the latter, according to University of Missouri School of Medicine researchers who studied the 2011 case of Norwegian mass murderer Anders Breivik.

The researchers assert that a new forensic term be used to classify non-psychotic behavior that leads to criminal acts of violence.

When people commit acts of horrific violence, others often assume that mental illness is at the root of it. And yet, at times, the perpetrator is found to be clinically sane, and instead has committed a violent crime due to an extreme belief system.

“When these types of tragedies occur, we question the reason behind them,” said Tahir Rahman, M.D., an assistant professor of psychiatry at the University of Missouri School of Medicine and lead author of the study.

“Sometimes people think that violent actions must be the byproduct of psychotic mental illness, but this is not always the case,” he said. “Our study of the Breivik case was meant to explain how extreme beliefs can be mistaken for psychosis, and to suggest a new legal term that clearly defines this behavior.”

An “extreme overvalued belief” is a belief that is shared by others and often cherished, amplified and defended by the accused, said Rahman. The individual has an intense emotional commitment to the belief and may act violently because of it.

Although this person may have other forms of mental illness, the belief and the actions associated with it are not the result of insanity.

“In courts of law, there are not clearly defined, standard methods of diagnosing insanity for legal purposes,” Rahman said. “This new term will help forensic psychiatrists properly identify the motive for the defendant’s criminal behavior when sanity is questioned.”

Anders Breivik was a Norwegian terrorist who killed 77 people in 2011 in a car bombing in Oslo and a mass shooting at a youth camp on the island of Utøya in Norway. Claiming to be a “Knights Templar” and a “savior of Christianity,” Breivik stated that he committed this violence in an effort to save Europe from multiculturalism.

Breivik was examined by two teams of court-appointed forensic psychiatrists. The first psychiatric team diagnosed him with paranoid schizophrenia. However, after widespread criticism, a second team concluded that Breivik was not psychotic and diagnosed him instead with narcissistic personality disorder. Breivik was sentenced to 21 years in prison.

“Breivik believed that killing innocent people was justifiable, which seems irrational and psychotic,” said Rahman, who also conducts forensic psychiatric examinations but was not involved with the Breivik case.

“However, some people without psychotic mental illness feel so strongly about their beliefs that they take extreme actions. Current clinical guides, such as the Diagnostic and Statistical Manual of Mental Disorders, offer vague descriptions of alternative reasons a person may commit such crimes. Our suggested term for criminally violent behavior when psychosis can be ruled out is ‘extreme overvalued belief.'”

More studies on extreme overvalued beliefs are needed to understand how they develop, said Rahman. Identifying those at risk may give mental health professionals an opportunity to intervene before any violence occurs.

“Certain psychological factors may make people more vulnerable to developing dominating and amplified beliefs,” Rahman said. “However, amplification of beliefs about issues such as immigration, religion, abortion or politics also may occur through the internet, group dynamics or obedience to charismatic authority figures.”

“We already warn our youth about the dangers of alcohol, drugs, teen pregnancy and smoking. We need to add the risk of developing extreme overvalued beliefs to that list as we work toward reducing the violence often associated with them.”

The study is published in The Journal of the American Academy of Psychiatry and the Law.

Source: University of Missouri-Columbia