Thursday, April 19, 2007

Troubled Youth: The Neurobiology of Violence and Schizophrenia

As more details surface over the troubled life of Seung-Hui Cho, unrecognized schizophrenia seems to increasing likelihood in the tragedy that unfolded at Virginia Tech.

As with any slowly progressive brain condition that affects behavior, the changes may be so gradual that it may be hard to recognize. The first neurosurgery operation I ever scrubbed in on was a storeowner who had been shot during a robbery. It was thought that he had been grazed by a bullet, but after he had returned home, his wife brought him back to the hospital saying that he had undergone a personality changed and now had an explosive personality. What they found was that a bullet fragment had lodged in his temporal lobe, and it had been missed on a CT scan because it had - blended into bone.

Schizophrenia can go unrecognized for a time because its onset is commonly in the teen and young adult years, a time when young people are afforded more independence and they may keep their thoughts and activities to themselves.

From the Mayo Clinic, the Signs and Symptoms of Schizophrenia may include some, but not necessarily all of the following:

- Delusions — personal beliefs not based in reality, such as paranoia that you're being persecuted or conspired against
- Bizarre delusions — for example, a belief in Martians controlling your thoughts
- Hallucinations — sensing things that don't exist, such as imaginary voices
- Incoherence (rambling narratives)
- Lack of emotions or inappropriate display of emotions
- A persistent feeling of being watched
- Trouble functioning at work or in social situations
- Social isolation
- Difficulty with personal hygiene
- Clumsy, uncoordinated movements

There have been many neurobiological findings associated with psychopathy, and generally changes in executive functioning and emotional and memory networks like the amygdala and temporal lobe have been seen. In schizophrenia, extensive gray matter loss can be seen in these same networks, and aberrant activation in the temporal lobes correlate with individuals' reports of hallucinations.

If you are worried that someone you know or care about may have schizophrenia, it's a good idea to get them help sooner rather than later. There is evidence that early diagnosis may improve the results of treatment.

The Virginia Tech victims and their families and friends are in our thoughts and prayers.

Recognizing Warning Signs of Violence in Others at the APA
Virginia Tech Gunman at Fox News
Neurobiological Correlates of Violent Behavior Among Persons with Schizophrenia
Neuroimaging studies at
Auditory Hallucinations fMRI Schizophrenia

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