Tuesday, January 11, 2011

The Tucson Shootings: Representative Giffords, Predicting Violence Among Schizophrenics and Our Partisan Craziness

The Disease Management Care Blog's prayers go out to U.S. Rep. Gabrielle Giffords and the other victims of the senseless Arizona shooting. So far so good for brain-injured Ms. Giffords' post-operative recovery: consciousness and language seem intact. The bad news is that the neurosurgeons are keeping mum on how well Rep. Giffords is moving the (opposite to the injury) right side of her body.

There is also little information on the underlying motivation of the shooter, who impresses the medically-minded DMCB as seriously disturbed. Yet, while this loon turned out to be especially lethal, it seems he was not all that dissimilar from the borderline functional persons often seen in physicians' waiting rooms. Assuming the media's reasonable conjectures about the presence of schizophrenia are correct, the DMCB points out that it's difficult to predict which persons like him are prone to violence. Concurrent drug abuse (as apparently was the case here) appears to increase its odds. In addition to drugs, this remarkably detailed study of close to 1500 schizophrenic persons also found a prior history of arrest or crime, childhood "conduct" problems, greater severity of mental illness, being homeless and being "nonviolently victimized in the prior 6 months" to be among the more risk factors. Violence prone schizophrenics may also have a different brain structure. When the DMCB adds it all up, it unhappily concludes that the science has not progressed to the point where it can be used to prospectively identify persons at special risk.

Speaking of bad brains, DMCB readers are undoubtedly aware of how the shooting has prompted widespread media commentary on the need to tone down our partisan vituperation. The contrarian DMCB doubts the behavior of persons with significant mental illness are influenced by the likes of Rush Limbaugh or Keith Olbermann; instead, that special pathology seems to be restricted to our political class. The vulgarity of conservatives being linked to crazy anti-government violence has prompted them to brand their liberal-progressive foes with politically motivated opportunism. And so it goes on and on.

The DMCB has a far more benign explanation for its left-leaning friends' perspective in this matter. Whenever it debates the modern role of government with them, many are simply unable to comprehend the DMCB's general tilt toward markets and federalism. Stymied by an obliviousness toward enlightened government and social justice, liberal-progressives can only conclude that the DMCB is evil or suffers from some sort of mental insufficiency. Since the DMCB's bonhomie obviously rules out evil, liberals half jest but also half wonder if it and others like it are "crazy." Given the pervasiveness of that illogic, who can blame some for succumbing to the temptation of painting schizophrenic shooters and conservative opponents to such fine ideas (like health reform) with the same broad brush?

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