Madness or Malingering?

Jody and Donna were his first two victims. As they sat in Jody’s car in front of Donna’s house on a warm and muggy late summer evening in the Bronx, David Berkowitz walked up with his Bulldog revolver and fired, prematurely ending Jody’s life and critically wounded Donna. Arrested a year later, Berkowitz claimed that he was obeying orders of a demon conveyed to him by the dog of his neighbor, Sam. He eventually admitted that the story about canine-delivered demon messages was a hoax.

Malingering is defined as the intentional exaggeration or falsification of symptoms, motivated by personal incentive. Research reveals that about 20% of criminal defendants deliberately exaggerate or fake their psychiatric symptomatology. It is the psychological examiner’s responsibility to make sure that the defendant’s symptoms are authentic and not a manipulative gambit to avoid criminal responsibility. The task is especially difficult when the defendant has a bona fide psychiatric disorder, but still might be employing his condition and knowledge of symptoms to his legal benefit.

A Case Study

Take the case of Jonathan, a 30-year-old man who admitted to beating his mother Beth to death. He had a long and documented history of experiencing auditory hallucinations and paranoid thinking. And he became physically aggressive at times. Once, for instance, he was arrested for slapping a student at a junior college who, he believed, was spreading rumors about his sexual inadequacies.

A month or so before the killing, Jonathan was again psychiatrically hospitalized. As was usual, he had stopped taking his medication because of the side effects - weight gain and grogginess. After about two weeks of having been medication-free, his father Walter found Jonathan sleeping with a kitchen knife in bed. Jonathan had been receiving messages from the internet that “the end was near.” Taken to the hospital by his parents to be evaluated, he was again admitted.

At a family therapy session with the facility’s social worker prior to his discharge, Jonathan's parents told him that, upon release, he’d have to live in a residential home for psychiatric patients. They were open to having him eventually return home, if he stayed on his medication and remained stable for a sustained period of time.

This didn’t sit well with Jonathan, who was sullen and angry on the day of his release from the hospital. Two days after being at the residential home, he complained to his parents that “the food sucked” and “nobody talks to me…I’m scared.”

For some reason Jonathan believed his mother was the driving force behind the decision. On the evening of the murder, Beth picked Jonathan up from the residential home and took him out to eat. They then went grocery shopping, after which Beth drove home to drop off the groceries before taking Jonathan back to his residence.

At the house, Jonathan erupted. He first grabbed his mother’s neck from behind and began choking her. Soon, she lost consciousness and fell. Beth was still breathing, but by now, Jonathan was fulminating with agitation and rage. He stomped her until she was breathless, dead.

I was asked by Jonathon’s defense attorney to examine Jonathan’s mental condition at the time of the killing and to opine whether there was a mental state defense, such as insanity (was he incapable of knowing right from wrong?)

During my interviews with Jonathan, he said that at the time of the attack, he believed his mother was a demon who wanted to destroy him. That’s why she sent him to live “in that dangerous place” (i.e., the residential facility.) He continued, “I just wanted to kill her… I couldn’t stop. I did it....” He admitted to being angry with her just before the assault, as she readied to take him back to his new residence. But, he said, he also “feared for my life” and figured, irrationally, that he’d be safer with his mother gone. He added, "She always...put me in hospitals..."

As I said, crimes involving an individual with a chronic mental illness are the most difficult when it comes to assessing for possible malingering. In Jonathan’s case, he had a history of delusional thinking, including the sort of beliefs he said prompted the deadly assault. Walter told me that Jonathan once asked him, “Is mom the devil?’

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I conducted a number of psychological tests that included scales that helped me to gauge the validity of his symptom presentation. One such test was the Minnesota Multiphasic Personality Inventory-2-Reformulated Form. It includes a multitude of scales to assess for symptom exaggeration and the defendant’s degree of openness. I compared his scores with those of genuinely mentally ill patients who responded honestly to the test items.

Jonathan’s scores on the MMPI-2-RF were in the range that suggested he was exaggerating his symptoms, including his psychotic ones. I then utilized a specialized interview format that assesses for genuineness of psychotic symptomatology, the Structured Interview of Reported Symptoms, or SIRS-2. Again, the results strongly suggested that Jonathan was exaggerating his symptomatology.

Mentally Ill But Still Legally Culpable

Given the results of the testing and my interviews with Jonathan, it was clear that he suffered from schizophrenia, a major mental illness. Nonetheless, I concluded that it was his poor self-control that led to the homicide, not delusional and irrational beliefs about his mother. I found no clinical evidence that he irrationally believed his mother was an impending threat to his life. Although suffering from a serious and chronic mental illness that likely compromised his ability to control his anger and see things objectively, Jonathan killed her as a result of his rage and resentment at having to reside outside the family household.

Still, Jonathan‘s mental illness did have a mitigating effect. The jury found him sane but guilty of second degree murder, not first degree, and not with premeditation and deliberation.

In a future blog, I’ll dig deeper into the complexities of the insanity defense.