COMBINED HOMICIDE-SUICIDES - A REVIEW

Although the rate of combined homicide-suicides is low compared with t hat for suicide alone or homicide, homicide-suicides generate much pub lic concern. In some cases, the homicide-suicide involves annihilation of an entire family or multiple nonfamily members. A difficult phenom enon to study-in part because the perpetrator is dead-it is, nonethele ss, crucial to attempt to advance our understanding of this tragic phe nomenon from a psychiatric view. This literature review then addresses demographic variables; proposes two classifications, one based on psy chopathology, the other on the relationship between offender and victi m; and suggests a three dimensional analytical approach to understandi ng homicide-suicide: 1) psychopathology and ego deficits of the perpet rator, 2) cumulative and precipitating stressors, and 3) motivation an d vector of destructive urges against self and the other victim(s) [I] . Finally, some implications for mental health clinicians and forensic experts are offered. In attempting to understand acts of homicide-sui cide, inquiry into the following dimensions should be useful: Ego Weak ness. What type of mental disorder(s), psychopathology, or personality traits may have contributed to the homicidal-suicidal behavior? Stres sors. What type of acute and chronic stressors did the individual expe rience leading up to this act? Vectors. Whom did the individual select to kill and why? Were some victims more clearly primary and others se condary or incidental?