Parents Who Kill: Clinical and Legal Perspectives

Oct 30, 2015

Psychiatrists should not be afraid to assess parenting issues and other stressors when treating depressed or psychotic parents of young children.

The bodies of several dead infants are discovered in a woman’s garage.

One mother drowns her young children after a divorce because they are a hindrance; another mother drowns her young children in the delusional belief that she is sending them to heaven to protect them from being forced into child pornography.

A father shoots his sons and wife before turning the gun on himself.

A child dies of a traumatic head injury; both parents initially disavow any knowledge of trauma and later say he accidentally fell from his changing table.

These cases demonstrate a wide range of behavior that ends in the death of children at the hands of their parents. For the very different motives in these cases, different prevention strategies are needed and different legal outcomes can be anticipated.

Filicide refers to the killing of a child by a parent. Neonaticide is defined as the killing of an infant in the first 24 hours after birth1,2; it has its own characteristics and is a different entity than other filicides. Infanticide is a less precise term that commonly denotes the murder of an infant in the first year of life.

[[{"type":"media","view_mode":"media_crop","fid":"42461","attributes":{"alt":"© ALEKSEI POTOV/SHUTTERSTOCK.COM","class":"media-image media-image-right","id":"media_crop_7729834092617","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4603","media_crop_rotate":"0","media_crop_scale_h":"98","media_crop_scale_w":"150","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"float: right;","title":"© ALEKSEI POTOV/SHUTTERSTOCK.COM","typeof":"foaf:Image"}}]]Approximately 15% of all murders are filicides.3 Rates of child murder in the US are greater than the rates in other developed countries.4 About one-third of victims are infants (up to 12 months old), and more than two-thirds are younger than 6 years.

Motives

In 1969, 5 motives that explain why parents kill their children were described (Table).5 These motives include fatal maltreatment, partner revenge, unwanted child, altruistic, and acutely psychotic. The most common reason a child is killed by a parent is fatal maltreatment, the end result of abuse or neglect.6 The least common is partner revenge, in which a parent kills the child in order to make the other parent suffer emotionally. An unwanted child is killed because that child is seen as a hindrance to the parent’s goals. Alternatively, in altruistic child murder, the parent kills the child out of love. These parents may kill their child in association with their own suicide or to protect the child from a fate worse than death. Finally, in the case of acutely psychotic filicide, the parent in the throes of psychosis or mania kills the child for no comprehensible reason.

For a person to be found legally insane, mental illness must cause the individual not to know the wrongfulness of his or her act (crime). In approximately one-third of states, insanity may be the finding if the defendant was unable to control the (offending) behavior because of mental illness. Our study of those mothers found insane for the crime of child murder in Michigan and Ohio concluded that their motives were altruistic or acutely psychotic.7 Other motives are not likely to result in a successful insanity defense, even if the mother was mentally ill.8

Andrea Yates’ drowning of her 5 children is an example of altruistic filicide. She had the delusional belief that if she did not take her children’s lives before the age of accountability, all her children (age 6 months to 7 years) would go to hell because of her defective mothering. She killed them out of love so that they could be with God for all of eternity. She qualified for an insanity defense because she had the delusional belief that she was doing what was right for her children.

Maternal neonaticide

Neonaticide is almost always committed by the mother acting on her own. The true rates of neonaticide are difficult to ascertain because when the pregnancy is hidden and the newborn baby disposed of, no one knows of the crime. Of the 5 motives described by Resnick, the most common motive for neonaticide is because the infant is unwanted.1,2

Neonaticide perpetrators almost always deny or conceal their pregnancies and rarely seek prenatal care. Although they may develop psychiatric symptoms after the murder, they rarely have preexisting psychosis or major depression.1,2 Some women may experience dissociation around the time of the birth and murder.9 Suicide after neonaticide is extremely rare.

Maternal filicide

Depending on the type of sample, researchers’ findings vary across filicide studies. In samples of administrative records (such as those from coroners’ offices or law enforcement departments), the mother often was the primary caregiver and had social stressors, such as financial problems, and a personal history of abuse.4 Mothers from psychiatric populations (such as those found in psychiatric hospitals) unsurprisingly had high rates of mental illness, especially psychosis and depression. They often had financial stressors and a history of earlier traumatic events. Mothers in samples from incarcerated populations were often undereducated, single, unemployed, and previously victimized, and had little social support. Some had a history of mental illness or substance abuse.4

Paternal filicide

Fathers and mothers kill their children at similar rates; however, mothers’ victims are younger on average.10 Fathers are more likely to kill impulsively, to be intoxicated, and to use violent methods.3,11

Mothers who kill their children are much more likely than fathers to pursue an insanity defense successfully. Therefore, after a filicide, fathers are more often incarcerated than mothers, while mothers are more frequently hospitalized in a psychiatric facility. In addition, fathers are more likely to kill themselves after murdering their children than mothers are.12 Furthermore, fathers are more likely than mothers to kill the entire family, an act known as familicide.12

Prevention

Strategies for prevention vary with the motive for the child homicide. Women who commit neonaticide are unlikely to have previously come to psychiatric attention. However, several efforts may be helpful in neonaticide prevention.2 First, improved contraceptive education can reduce rates of unintentional pregnancy. Second, women and teenagers who become pregnant should be urged to seek prenatal care. Teachers, parents, and physicians should ask teenage girls whether there is any likelihood that they are pregnant. If there is any suspicion, physicians should test for pregnancy.

Third, Safe Haven laws have been passed in every state in the US. These laws seek to reduce the number of abandoned babies and neonaticides. The specifics of these laws vary depending on the state, but in general women can leave their unwanted infants at a hospital or fire station within the first few days of life, with no questions asked. However, one problem is the lack of public awareness of these laws, especially among young women.

The murders of older infants and children are difficult to prevent because many parents-who would never kill their child-possess the same factors, such as mental illness and social stressors, found among those who do kill. In addition, one must keep in mind that most child murders stem from child abuse, rather than from mental illness in the parents.

Some parents with a severe mental illness, personality disorder, or substance abuse do abuse their children. Psychiatrists should inquire whether their patients are parents, and assess their parenting capacity and the risk of harm toward their child. All physicians have a duty to report a suspicion of child abuse or neglect to child protective services.

Even among parents without mental illness, aggressive thoughts and fantasies toward infants may occur. In fact, one study found that more than one-quarter of mothers with colicky infants experienced infanticidal thoughts.13

Psychiatrists should not be afraid to inquire about thoughts of harming a child. More than 40% of depressed mothers of infants and toddlers admitted to having such thoughts.14 Obviously, most do not go on to harm their child. However, psychiatrists often underestimate how often these thoughts occur.15 Psychiatric hospitalization should be considered when there is an elevated risk of child harm. In addition, psychiatrists should search for unrealistic concerns about a child’s health and delusions about the child.6

Parents who are suicidal should be asked about their plans for the children if they were to take their own life. A loving father who plans to kill himself because of his depression may have thoughts about taking the whole family with him.

During the postpartum period, women should be routinely screened for both postpartum depression and psychosis. Untreated postpartum psychosis significantly increases the risk of both suicide and child murder. Keep in mind that fathers also can experience exacerbations of mental illness during the stressful postpartum period. Finally, care must be taken not to mistake postpartum obsessive-compulsive disorder (OCD) symptoms for postpartum psychosis. Parents with OCD sometimes experience obsessive thoughts about harm to their baby; however, there is no evidence that these ego-dystonic obsessions in OCD (without depression) raise the risk of child murder.16

Conclusions

In summary, parents have various motives for killing their children. Fathers and mothers kill at similar rates; however, mothers are the perpetrator in almost all cases of neonaticide. Psychiatrists should assess parenting issues and other stressors when treating depressed or psychotic parents of young children.

Disclosures:

Dr Friedman is Associate Professor in Psychiatry at Case Western Reserve University School of Medicine in Cleveland; she is also Associate Professor of Psychological Medicine at the University of Auckland in New Zealand. Dr Resnick is Professor of Psychiatry and Director of the Division of Forensic Psychiatry at Case Western Reserve University School of Medicine. He has performed research on child murder for 50 years. The authors report no conflicts of interest concerning the subject matter of this article.

References:

1. Resnick PJ. Murder of the newborn: a psychiatric review of neonaticide. Am J Psychiatry. 1970; 126:1414-1420.

2. Friedman SH, Resnick PJ. Neonaticide: phenomenology and considerations for prevention. Int J Law Psychiatry. 2009;32:43-47.

3. Mariano TY, Chan HC, Myers WC. Toward a more holistic understanding of filicide: a multidisciplinary analysis of 32 years of U.S. arrest data. Forensic Sci Int. 2014;236:46-53.

4. Friedman SH, Horwitz SM, Resnick PJ. Child murder by mothers: a critical analysis of the current state of knowledge and a research agenda. Am J Psychiatry. 2005;162:1578-1587.

5. Resnick PJ. Child murder by parents: a psychiatric review of filicide. Am J Psychiatry. 1969;126:325-334.

6. Friedman SH, Resnick PJ. Child murder by mothers: patterns and prevention. World Psychiatry. 2007;6:137-141.

7. Friedman SH, Hrouda DR, Holden CE, et al. Child murder committed by severely mentally ill mothers: an examination of mothers found not guilty by reason of insanity. J Forensic Sci. 2005;50:1466-1471.

8. Friedman SH, Cavney J, Resnick PJ. Child murder by parents and evolutionary psychology: a framework for approaching forensic assessment. Psychiatr Clin North Am. 2012;35:781-795.

9. Spinelli MG. A systematic investigation of 16 cases of neonaticide. Am J Psychiatry. 2001;158:811-813.

10. Putkonen H, Amon S, Eronen M, et al. Gender differences in filicide offense characteristics-a comprehensive register-based study of child murder in two European countries. Child Abuse Negl. 2011;35:319-328.

11. West SG, Friedman SH, Resnick PJ. Fathers who kill their children: an analysis of the literature. J Forensic Sci. 2009;54:463-468.

12. Friedman SH, Hrouda DR, Holden CE, et al. Filicide-suicide: common factors in parents who kill their children and themselves. J Am Acad Psychiatry Law. 2005;33:496-504.

13. Levitzky S, Cooper R. Infant colic syndrome-maternal fantasies of aggression and infanticide. Clin Pediatr (Phila). 2000;39:395-400.

14. Jennings KD, Ross S, Popper S, Elmore M. Thoughts of harming infants in depressed and nondepressed mothers. J Affect Disord. 1999;54: 21-28.

15. Friedman SH, Sorrentino RM, Stankowski JE, et al. Psychiatrists’ knowledge about maternal filicidal thoughts. Compr Psychiatry. 2008;49:106-110.

16. Booth BD, Friedman SH, Curry S, et al. Obsessions of child murder: underrecognized manifestations of obsessive-compulsive disorder. J Am Acad Psychiatry Law. 2014;42:66-74.