Mothers Thinking of Murder: Considerations for Prevention
By Susan Hatters Friedman, MD and Phillip J. Resnick, MD |
September 1, 2006
One recent study characterizing women found not guilty by reason of insanity (NGRI) for filicide in 2 states established that most mothers had previous mental health treatment.18 Maternal motives in the sample were predominantly altruistic or acutely psychotic. Most were experiencing auditory hallucinations, often of a commanding nature. Half were depressed. Most had experienced considerable developmental stressors themselves, such as incest or the death of their own mother. Holden and colleagues19 studied mothers referred for forensic evaluation after filicide, comparing those found NGRI with those adjudicated criminally responsible (CR). When compared with women found CR, mothers found NGRI were significantly more likely to have made suicide attempts and to have experienced hallucinations or delusions, while they were significantly less likely to have other children who were not victims.
In summary, the motives for maternal filicide provide a framework for understanding the phenomenon as well as considerations for prevention. No single profile of the filicidal mother exists. Each mother that the psychiatrist is concerned about merits careful evaluation. Finally, we must become more comfortable inquiring about filicidal thoughts and considering filicidal risk.
Dr Simon is clinical professor and director of the program in psychiatry and law at Georgetown University School of Medicine, Washington, DC. He is co-editor, with Robert E. Hales, MD, of The American Psychiatric Press Textbook of Suicide Assessment and Management, published this year, and co-editor, with Lisa H. Gold, MD, of The American Psychiatric Press Textbook of Forensic Psychiatry, published in 2004.
Dr Friedman is a senior instructor in the department of psychiatry at the Case Western Reserve University School of Medicine, Cleveland. She is employed by Northcoast Behavioral Healthcare, the Court Psychiatric Clinic of Cuyahoga County, and the Perinatal Clinic of Northeast Ohio Health Services.
Dr Resnick is the director of forensic psychiatry at University Hospitals of Cleveland, the director of the Court Psychiatric Clinic of Cuyahoga County, and a professor in the department of psychiatry at the Case Western Reserve University School of Medicine, Cleveland.
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