Shooting at Virginia Tech!

[AAAhmed46]

There's been some reports claiming he was autistic, or had asperger's (yes spectrum I know) but people I know who work with such kids claim that something like this is impossible for them, given the forethought, planning, organization and deception involved.
We had a kid up here in MA who stabbed another kid in school and excitedly wanted to help the cops take pictures of the crime scene- that was aspergers. Maybe Judah would have an opinion here since I think he's a psych guy.

Some guy who works with autistic peopel responds:

There's definite links between aggressive actions and autistic spectrum disorders, evidenced both by my experience and by the evidence. It comes from a bunch of sources, depending on the nature of the autist. For instance, I deal with a lot of aggression because the resident feels like they aren't being understood, or they have a problem that they can't express, and they're frustrated to the point of lashing out. Usually, after we've been struck by a resident, the first thing we do is check them for wounds and injuries, because if you're non-verbal and mentally retarded, how do you tell someone you sprained your toe? Usually, the actions are in-the-moment occurrences rather than planned & premeditated actions of that sort.

I haven't heard of any definitive link between premeditated violence and ASD, but I suppose it's possible for high-functioning autists. It definitely wouldn't be possibly for the vast majority of people with autism because 3/4 people with the condition can't live on their own.

[AAAhmed46]

So i saw videos of the shooter.

Lots of responses, both texts and video are along the lines of:

"Stupid immigrant''

"He came to this country and killed a bunch of people''



What does immigration have to dow ith this?


REmember columbine? THose guys were not immigrants, why didnt anyone make racial cracks at them?


Oh and he was a LEGAL immigrant.

Hell isn't he born and raised in america, while his parents are immigrants(i think im wrong though)

[Bill Glasheen]

Don't pay any attention to that online filth, Adam. I don't know anyone (and I mean ANYONE) in Virginia whose head is in that place.

If anything, I hear apologists who want to rationalize the gunman's actions because he had an accent and was picked on in high school, blah, blah, blah... Nonsense. Read Cho's plays Richard McBeef and Mr. Brownstone. His own words show what kind of person he was. He didn't have a clue how normal people interacted with each other.

Race is a red herring.

- Bill

[Glenn]

isn't he born and raised in america, while his parents are immigrants(i think im wrong though)

He was born in South Korea and moved with his parents here when he was 8, so almost 20 years of his life and most of his formative years were spent in the U.S. This is in no way an immigration issue.

[AAAhmed46]

Don't pay any attention to that online filth, Adam. I don't know anyone (and I mean ANYONE) in Virginia whose head is in that place.

If anything, I hear apologists who want to rationalize the gunman's actions because he had an accent and was picked on in high school, blah, blah, blah... Nonsense. Read Cho's plays Richard McBeef and Mr. Brownstone. His own words show what kind of person he was. He didn't have a clue how normal people interacted with each other.

Race is a red herring.

- Bill

I read in the newspaper he was admitted into a mental institution for depression and suicidal tendencies, but was released because he 'posed no threat' or something like that.


Have you read the plays Cho wrote? That guy is SCREAMING violent.

Where the people at the institution smoking up or something?

EDIT:


It's weird though, since you read the plays bill, what do you think of some telll tale signs from them?

I mean today, lots of works of art are very violent, hell look at Tarintino films and Frank Millers work.

But they are not sick people(though from what i understand, Tarintino is a bit of a wierdo, but all geniuses are)

But his plays, there is something off about the violence, something very difficult to understand. I mean stephen segal movies, the terminator, video games, all are violent.

But there is something of the violence in movies and video games thats just....well its made so it's kind of hard to take any horror in them seriously really, even a clock work orange, though alex's actions were shoking, had a feel of 'parody of violence' to them, despite the strong social message the movie/book has.


But these plays, doesn't feel like that at all.

[AAAhmed46]

isn't he born and raised in america, while his parents are immigrants(i think im wrong though)

He was born in South Korea and moved with his parents here when he was 8, so almost 20 years of his life and most of his formative years were spent in the U.S. This is in no way an immigration issue.

Yeah, i found that out right after i posted that post.

[Ted Dinwiddie]

I find it interesting that the only person that did act was a 75 year old. A survivor of the Holocaust and communism. It's no conicidence.

A professor of French had her students help her push desks in front of the door. Then she made them all get down on the floor in the back of the classroom. She stayed at the door holding it closed. She was killed.

I am sure we will hear more as time goes on.

[AAAhmed46]

I find it interesting that the only person that did act was a 75 year old. A survivor of the Holocaust and communism. It's no conicidence.

A professor of French had her students help her push desks in front of the door. Then she made them all get down on the floor in the back of the classroom. She stayed at the door holding it closed. She was killed.

I am sure we will hear more as time goes on.

And people say the french were cowards.

Hats off to her, i know i wouldn't have the balls to do that. She has bigger balls then i do. Thats embarassing.

[Bill Glasheen]

Be careful here. A professor of French doesn't mean the professor was French. Cho after all was majoring in English.

But there were many acts of heroism in the tragedy coming from every ethnic group. Sadly there were few who understood the situation in the fog of it all, and understood what actions maximized their survival.

Grossman talks a lot about the paralyzing effect of loud noise. Even before the days of rifling where guns essentially where shooting knuckleballs, the less-accurate firearm beat the more accurate bows and arrows on the battlefield. It's an interesting thing to ponder.

- Bill

[Bill Glasheen]

Adam

A couple of things to ponder.

A few mental health professionals really dropped the ball on this one. If they had access to his medical records - and they SHOULD have gotten access to them - then they should have seen the toxic combination of depression, autism, and suicidal thoughts. There was a small community screaming to get help for this kid, and some bozo releases him for outpatient treatment. He needed a LOT more than that.

Another interesting thing to consider is where "the system" dropped the ball in terms of someone with his mental state getting access to a firearm. I understand VERY well the need to remove all barriers for people to get treatment for mental illness. Cho is certainly your case history here. At the same time, we need to balance the needs of the individual with the needs of society here. I'm thinking there will be a lot of work done on this over the next generation or so. And it certainly won't be a simple fix until the mental health community gets out of the dark ages on the diagnosis and treatment issues.

As for Cho's specific brand of autism... I don't think it's Asperger's. But you do have it right that this is a spectrum of illnesses. And this young man missed out big time on getting treatment when it would have done the most good.

- Bill

[IJ]

It's really hard to judge psych care in retrospect. Cho was sent to that hospital on a hold, meaning his freedoms were revoked temporarily for his own good for an evaluation. He clearly had some issues, but so does everyone who is sent to a psych facility and many of the rest of us. There's a strong literature showing that predicting violence and suicide is notoriously inaccurate. All of the research has found some risk factors, for example, owning a gun might increase your suicide risk 2 fold, but that's from next to zero to next to next to zero. These are rare events and one can't, for example, hold everyone who's written a violent play or owns a gun, as I'm sure the NRA would remind us. We certainly can't hold them indefinitely, which would be the only way to stop these events. Anytime someone who got some care did anything, its obvious that what was done "wasn't enough," but that tells us little about how things could have been different. Further, psych is in the unusual position of having to beg to treat people, by calling up county or private insurance and pitching their case to a beancounter with no relevant training who merely obstructs and tallies up their days already used that period. That doesn't happen to medicine or surgery, we just admit people and never beg insurance. So what they wanted might not have happened, and what people are saying is what they wanted Cho to receive in the past is not necessarily what they would have provided, had they been asked to have their taxes uup to fund broad psych care for their community. It's expensive.

[Bill Glasheen]

Everything you say is true here, Ian. I do however want to add a few points.

From a public health standpoint, there were significant and numerous barriers to care.

• Cho's parents kept quiet about the illness, and sheltered the child. Was there a stigma compounded by culture? We didn't even know about the issue until relatives spilled the beans in Seoul.
• By relatives' accounts, they couldn't afford the intensive care that those with autism can benefit from at an early age. Once the brain gets hardwired and less plastic with age, it can be a lot more difficult to benefit from therapy.
• I'm thinking a combination of language and culture made it difficult for most to see Cho's unusually regressed communication skills.
• Many people who aren't in my business (or similar) don't understand how combinations of illnesses as well as acute exacerbations and environmental factors can turn a low simmer of an illness into a raging boil.
• Not all autism is created equal. And for the most part, people don't even know what the hell it is.

The only thing that stands out to me, Ian, is the record which states that the clinician based release upon the patient saying he was OK. (More or less.) If that doesn't scream of idiocy, then I don't know what does. That's like asking an addictive personality for an opinion about their affliction. As they say, the way to know when an addict is lieing is to watch for the lips moving.

There may be a few other pieces missing here. For example, did he recently have his medication changed? Sometimes treating depression can have a paradoxically dangerous effect. You make them well enough for them to realize that their life really does suk, and give them enough energy to get off their butt and do something (bad) about it. Oye!

- Bill

[AAAhmed46]

[quote] * Cho's parents kept quiet about the illness, and sheltered the child. Was there a stigma compounded by culture? We didn't even know about the issue until relatives spilled the beans in Seoul.[quote]
I dont know much about koreans, but i have ADHD, and my parents were in denial for YEARS, saying the doctors are wrong. Only recently have they really accepted it. And STILL they want me to be more secretive about it. Whats strange is that my oldest brother is severely autistic(I dunno what kind, some brother i am) but it's so obvious, he doesn't know how to talk, thats how bad it is. So i guess they knew it was no point in hiding it if it's that obvious. From what i know of Asians, in this regard at least, they are not different from Indian-Pakistani culture when it comes to fear of Stigma. Obviously they are two completely different cultures, but here is one similarity i think.


[quote] * By relatives' accounts, they couldn't afford the intensive care that those with autism can benefit from at an early age. Once the brain gets hardwired and less plastic with age, it can be a lot more difficult to benefit from therapy.[quote]

Well, he seemed high functioning. I mean he could talk, he went to college. I mean if it was worse, maybe it was impossible. THen again, CHo was eight years old when he came to america, i bet they didn't have much money when the first landed. So your probably right maybe.

[quote]* I'm thinking a combination of language and culture made it difficult for most to see Cho's unusually regressed communication skills.[quote]
His english isn't that bad, he just has a weird way of talking.

[quote]Many people who aren't in my business (or similar) don't understand how combinations of illnesses as well as acute exacerbations and environmental factors can turn a low simmer of an illness into a raging boil.[quote]
I hear you. I was aware of it due to circumstance.

[quote] * Not all autism is created equal. And for the most part, people don't even know what the hell it is. [quote]

My brothers autistic, and i still really cant define it or know what the hell it is.

[IJ]

Bill: Haven't seen the psych note re: the statement the patient said he was ok. And I know that many weird or outright stupid things are written in charts by doctors, since most of us are (just) human. BUT, a lot of psych is done through patient report (collateral should always be sought too). It's the same in medicine... I might send someone out to hear that their aorta exploded and they died, and my note would also say that the patient felt fine. That's the only way to figure out what's inside and if the crazy person won't talk, you only have observation. In many settings that's just not enough. At UVA, one of the residents was severely affected by the death of a patient who, after the interdisciplinary team met and the attending, resident, intern, nurse, therapist, etc all agreed he was well enough to leave, walked out of the unit, headed directly to the parking garage on the downtown mall, and jumped to his death. Self assessment is one of our key tools, unfortunately.

Also, how long was it between the statement and the crime? You just wrote that many things at a simmer (ie, worthy of discharge to outpatient treatment) can suddenly boil over.

"My brothers autistic, and i still really cant define it or know what the hell it is."

Don't feel bad. Psych doesn't understand the brain, either, and everyone is different. Autism cure is nearly unheard of... there is a book, I belive, by one of the very few who "came out of it." But I'll grab some diagnostic criteria for a later post. I've never heard about a violence connection with it before... the major offenders there are "antisocial personality disorder" which basically means that you're a criminal / lack empathy, plus psychosis--although you don't often see floridly crazy people designing well organized killing sprees.

[Bill Glasheen]

Just read this, Ian. When I read it, I keep shaking my head. If I did something this sloppy in my line of work, I'd never hear the end of it.

Somebody really messed up here. Not even an acknowledgement of his underlying disorder. How can it not be seen by this bozo? Every lay person who knew him understood his communication issues.

Doesn't this doctor even read the patient's medical history, for Christ's sake???

- Bill

Cho posed 'imminent danger'

BY BILL MCKELWAY
TIMES-DISPATCH STAFF WRITER Apr 18, 2007


The Times-Dispatch has obtained court records that Cho Seung-Hui posed "an imminent danger to himself as a result of mental illness" in December 2005 but was released to receive outpatient treatment.

A Montgomery County magistrate issued a temporary detention order Dec. 13, 2005.Cho was "mentally ill and in need of hospitalization and present an imminent danger to self or others as a result of mental illness, or is so seriously mentally ill as to be substantially unable to care for self and is incapable of volunteering or unwilling to volunteer for treatment," the order states.

Cho, who was listed as 5-foot-8 and 150 pounds, was brought in by Virginia Tech authorities and was examined the next day by a licensed clinical psychologist.

The doctor, who works for a private practice in Blacksburg, reported that Cho's "affect is flat and is depressed," but "he denies suicidal ideations. He does not acknowledge symptoms of a thought disorder. His insight and judgment are normal."