Marks Psychiatry

The short answer is yes. Anabolic Androgenic Steroids are the steroids used by those wanting to increase muscle mass usually in the context of sporting competitions. We hear about athletes being penalized after they are caught testing positive for these substances. This topic has gained much attention recently with former professional wrestler, Chris Benoit who killed himself as well as his wife and son in Fayetteville, Ga. He was found to have anabolic steroids in his home.

The term “Roid Rage” has been around for a while and even used as a defense in some cases where someone claimed to have harmed someone under the influence of anabolic steroid use. Non-anabolic steroids such as prednisone are commonly prescribed for many inflammatory conditions or other conditions such as asthma.  However, they can have mental health consequences such as psychosis, depression and mania. Androgenic anabolic steroids are testosterone-based and in addition to psychosis, depression and mania, can also cause increased aggression. Some athletes who use these performance enhancing drugs, will notice changes such as being more easily angered or irritable. Some athletic activities that involve contact, can be a natural outlet for the increased aggression.

Some criticize the wrestling community for lending itself to athletes abusing these drugs unchecked. As an activity that is a mix of sports and entertainment, the participants are not monitored in the same way as professional athletes.

Perhaps this recent death of a wrestling heavy weight and the deaths of several other wrestlers will bring more attention to the issue of anabolic androgenic steroid use.

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This term has become a popular on the internet lately with the recent murder of Jessie Davis, the pregnant woman from Canton, OH who was found dead after a massive search.  Her boyfriend, Bobby Cutts is the prime suspect.  I saw an interview on a morning news program where an FBI profiler said men who murder pregnant women are psychopaths.  They discussed Mark Hackett who killed his pregnant wife Lauri in Salt Lake City, UT and Scott Peterson who murdered Lacey and their unborn son.

The profiler went on to say that these men are psychopaths because they only care about themselves and have little concern for the victims.  She went on further to explain that a common reason they kill is because when their significant other gets pregnant, it stirs up emotions that may make them realize they made a mistake and they need to erase their mistake.  So to get out their situation, they kill. 

The news program played an excerpt of an interview with Bobby Cutts (Jessie Davis’ accused killer) where he told a local newspaper that he “can’t sleep, can’t eat”.  The profiler used this as an example of how he, just like the other psychopaths only think about themselves.

Although I agree psychopaths have very little feeling for others, I thought it was a bit simplistic to use Cutt’s interview to show that he was only thinking of himself.  If his girlfriend is missing and he’s upset by it, what’s he supposed to say?  In fact, if he told reporters he was eating and sleeping fine and not that worried, he actually would look more like a psychopath.

Psychopathy is a term synonymous with sociopathy that describes a person’s attitude toward others.  Robert Hare, Phd. from Canada has studied psychopathy extensively and designed a checklist of characteristics used to diagnose psychopathy.  These characteristics include:
• glibness
• shallow emotions
• lack of remorse or empathy
• manipulation of others
• lying
• egocentricity
• low frustration tolerance
• few and shallow relationships
• parasitic lifestyle
• persistent violation of social norms

I used the picture of Hannibal Lecter because he is a good media example of how these individuals can be very charming and intelligent, but cold and cunning. For more information, you can read one of Dr. Hare’s many books – the one listed below “Snakes in Suits,” is one of several choices.

DISCLAIMER: The views expressed by this author do not neccessarily reflect my views. I reference this book as a source of more information (among many sources) for those interested in the subject as the author has extensive knowledge and experience working in this area.

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In April 2007, The US Supreme Court overturned the death sentences of three Texas men convicted of murder. Their sentences were thrown out by a 5-4 decision because it was the court’s opinion that the juries were not able to consider relevant information about their mental histories that could have been used to lessen their sentences.

One of the cases was Brewer vs. Quarterman (05-11287) see Brewer V Quarterman for details about the case. In short, in 1990 Brent Brewer stabbed a man to death during the course of a robbery in Amarillo, TX. He was found guilty of the murder, but during the sentencing phase wanted the jury to consider his history of being physically abused as a child and of him having a substance abuse problem.

The jury was not allowed to use this information to determine the severity of his sentence, but the prosecutor used the information to suggest that Mr. Brewer was a risk of future dangerousness. The court ruled that the prior judges were in error by not letting the jury consider this information as mitigating evidence (evidence that could lighten his sentence). As a result, Mr. Brewer was sentenced to death.

This ruling could affect the approximately 40 Texas inmates awaiting execution.

As a forensic psychiatrist, I’ve performed evaluations on inmates in similar situations, usually for the purpose of determining whether or not they have a mental illness that could have affected their behavior or made them unable to understand that what they were doing was wrong. Sometimes if the defendant’s legal team did not think the mental problem rose to the level of making them no longer responsible for their actions, they may still have a psychiatrist evaluate the extent of their problems so that a jury can consider this during the sentencing phase.

Juries have a high calling. They essentially exact justice by deciding people’s fate. As a psychiatrist, I’m asked specific questions about whether or not a mental disorder exists and what affect it has on the defendant’s behavior. Although this takes skill, I still consider the difficult decisions to lie with the jurors. What do you think of someone who has abused drugs who says have mercy on me for killing someone? Or, do you think someone who has been abused as a child should have a lighter sentence if they kill someone? These are hard questions that involve moral reasoning as opposed to purely clinical or legal reasoning.

In the case of Mr. Brewer, the trial judge relieved the jury of having to answer the questions I just posed by not allowing the information to be heard. The Supreme Court said this was an error and he now can either be retried by Texas or have his sentence converted to life.

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