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Animal Cruelty andPsychiatric Disorders
Roman Gleyzer, MD, Alan R. Felthous, MD, and Charles E. Holzer III, PhD
Animal cruelty in childhood, although generally viewed as abnormal or deviant, for years was not consideredsymptomatic of any particular psychiatric disorder. Although animal cruelty is currently used as a diagnosticcriterion for conduct disorder, research establishing the diagnostic significance of this behavior is essentiallynonexistent. In the current study, investigators tested the hypothesis that a history of substantial animal cruelty isassociated with a diagnosis of antisocial personality disorder (APD) and looked for associations with otherdisorders commonly diagnosed in a population of criminal defendants. Forty-eight subjects, criminal defendantswho had histories of substantial animal cruelty, were matched with defendants without this history. Data weresystematically obtained from the files by using four specifically designed data retrieval outlines. A history of animalcruelty during childhood was significantly associated with APD, antisocial personality traits, and polysubstanceabuse. Mental retardation, psychotic disorders, and alcohol abuse showed no such association.
 J Am Acad Psychiatry Law 30:257–65, 2002
In 1806, Phillipe Pinel
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developed the diagnosticconcept of “mania without delirium,” considered a forerunner of today’s antisocial personality disorder(APD). One of his two examples of this disorderinvolved a man who showed extreme aggressionagainst both people and animals and who eventually killed a person. Several notorious mass and multiplemurderers have had a history of animal cruelty inchildhood.
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 A recent article by Johnson andBecker
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describes nine case histories of adolescents with prominent sadistic sexual fantasies, who talkedabout single or serial killings. Three of the nine per-sons had histories of animal cruelty. Besides theseindividual case reports, in several studies a history of animal cruelty was found to be associated with ag-gression against people.
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 A Swiss study of chil-dren
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 who engaged in animal cruelty and aggressivebehavior confirmed the association, at least in part,between sadistic behavior against animals and early childhood trauma. The important point, however, isthat even though animal cruelty is accepted today asadiagnosticcriterionforconductdisorderandthere-fore APD, its association with these or any psychiat-ric disorders has not been firmly established.During the 1980s, Felthous and others
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con-ducted several early studies that consistently showeda relationship between a history of cruelty to animalsand later aggression against people. The most defin-itive study to date was conducted by Kellert andFelthous,
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 whointerviewedsomeofthemostrecur-rentlyviolentmen(i.e.,menwithahistoryofviolentacts whose aggressive behavior persisted during in-carceration) within the federal prison system andcompared these violent criminal offenders with non-violent criminals and with noncriminals. Results of this study showed that those men with a high rate of recurrent and serious aggression had histories of a larger number of episodes of animal cruelty in child-hoodincomparisonwiththosewhowerenonaggres-sive, based on independent ratings. The associationbetween a history of substantial cruelty to animals(i.e., serious and recurrent cruelty, as defined later inthe article) and later aggression against people wasalso confirmed in a second publication of the find-ings in this same study.
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This investigation was im-portantinemphasizinganadequatedefinitionofan-imalcrueltyandthenatureoftheaggressivebehavioragainst people. Although many of the criminals whohadbeencrueltoanimalsshowedbehaviortypicalof an aggressive psychopath or at least typical of thepresence of an APD, there was no attempt in thatstudy to examine the subjects diagnostically.
Dr. Gleyzer is Forensic Psychiatrist, Western State Hospital, Tacoma, WA.Dr.FelthousisMedicalDirector,ChesterMentalHealthCenter,Chester, IL, and Professor and Director of the Forensic Psychiatry Service, Southern Illinois University School of Medicine, Springfield,IL. Dr. Holzer is Professor, Department of Psychiatry and BehavioralSciences, University of Texas Medical Branch, Galveston, Texas. Ad-dress correspondence to: Roman Gleyzer, Western State Hospital,9601 Steilacoom Boulevard, SW, Tacoma, WA 98498-7213. E-mail:rgleyzer1@msn.com
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Volume 30, Number 2, 2002R E G U L A R A R T I C L E
 
 Animal cruelty in childhood, although generally considered to be abnormal or deviant, for years wasnot considered symptomatic of any particular psy-chiatric disorder. Despite the inclusion of other be-havior, cruelty to animals was not mentioned as a symptomorevenanassociatedfactorofanydisorderin DSM-III.
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In 1987, however, this behavior wasincludedintherevisedthirdedition,asacriterionforconduct disorder and for APD,
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and it was retainedas a criterion in the fourth edition.
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Developmentsin biological psychiatry and research suggest the im-portanceofserotonergicsystemsinaggressivebehav-ior and impulsivity, including cruelty toward ani-mals.
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Nonetheless, research establishing thediagnostic significance of this behavior is essentially nonexistent. Although cruelty to animals has notbeengivendiagnosticsignificancefordisordersotherthan Conduct Disorder and APD in the DSMs, thebehavior has been reported in men with persecutory delusions.
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The tested hypothesis in this study was that a his-tory of substantial cruelty to animals in childhood isassociated with a diagnosis of APD in adults. Thestudy also afforded an opportunity to test whetherthis behavior is associated with other mental disor-ders or conditions commonly diagnosed in criminaldefendants.
Methodology
Index and Control Cases
 Wetestedthehypothesisthatahistoryofsubstan-tial animal cruelty is associated with a diagnosis of  APD by comparing, through retrospective forensicchart review, the diagnoses in 48 men who had thishistory with 48 men without such a history. All sub- jects in the index group were criminal defendants with a recorded history of substantial cruelty to ani-mals,definedas
apatternofdeliberately,repeatedly,and unnecessarily hurting vertebrate animals in a manner likely to cause serious injury 
 (Ref. 16, p 57)Before initiation, the study was approved by the In-stitutional Review Board of the University of TexasMedical School, Galveston.
Selection of Index and Control Cases
 We identified 48 men with a history of cruelty toanimals by reviewing records of all criminal forensicevaluations conducted by the county psychiatrist forGalveston County, Texas, from January 1984through December 1996. For most evaluees in bothgroups, the forensic issue was competency to standtrial, although sanity was also a recurrent question.Those in the control group were matched for sex,race,age,andyearofexaminationandhadnohistor whatsoever of animal cruelty, having answered neg-atively, as documented, to three separate questionsabout animal cruelty during their forensic evalua-tion. Matched control subjects were selected fromthe files of criminal defendants evaluated within thesame calendar year and belonging to the same racialorethnicgroupandagegroup(i.e.,plusorminusfiveyears). The search for control subjects was initiatedby the random drawing of a letter of the alphabet,after which the first file pulled was that of a subject whose last name began with the letter and who hadbeen evaluated in the same calendar year as the cor-respondingstudysubject.Ifthedefendantwhoselastname began with this letter did not fulfill the criteria to be a matching control subject, the search was con-tinued in alphabetical order.No subjects were excluded based on diagnosis.Subjects with files with incomplete information onitems listed in data retrieval outlines, however, wereexcluded. Any subject with some history of animalabuse or neglect who did not meet the thresholddefinition for substantial cruelty to animals was notincluded in either group. Subjects too psychotic ordisorganizedtoprovidehistoricalbackgroundwouldnot have had data on file to permit assignment toeither group. Also, subjects already included in thestudywhohadbeenreevaluatedforensicallyatalatertime were not included in the study a second time.
The Original Forensic Evaluation
 A description of any criminal forensic evaluationshould convey the types of data that were on file andavailable for the study. Because the evaluations wereperformed only for forensic purposes, they did notfollow a research protocol. Accordingly, evaluations wereindividualizedtothespecificforensicdiagnosticneeds of each evaluee. Nonetheless, a core battery of structuredinterviewswasusedfornearlyeverydefen-dant. This included a history of prior neurologic andbehavioral problems from an interview outline enti-tled
 
Early Childhood Behaviors,
 an intervieschedule on
 
Demographics and Family Back-ground,
 and a comprehensive
 
Mental Status Ex-amination.
 During the inquiry about early behav-ior, most defendants were asked three questions
Animal Cruelty and Psychiatric Disorders
258 
 The Journal of the American Academy of Psychiatry and the Law
 
regarding animal cruelty, and typically those whoreported a history of some animal cruelty were theninterviewed in depth with the animal-relations sec-tion of the interview schedule that had been used inthe aforementioned Kellert and Felthous
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animalcruelty study. Occasionally, a defendant was so ex-tremely disturbed that he was unable to cooperate with a structured interview. In such cases, the dis-turbed subject was not asked about animal cruelty.The history of present illness and the defendant
sunderstanding of his legal situation were also in-cluded in the formal written reports.Many but not all defendants underwent psycho-logical testing to clarify further the diagnosis and toassess psychological strengths and weaknesses. Spe-cific tests selected depended on the diagnostic ques-tion to be resolved. Much less commonly, other di-agnostic procedures were ordered on an individualbasis (e.g., computed tomographic scan, electroen-cephalogram, specific blood studies). When available, the following reports and docu-mentswerealsoread:statementofindictment,policereports,andcriminalrecordsprovidedbythedistrictattorney and Texas Department of Public Safety. Insome cases, a parent, spouse, or witnesses were inter-viewed for collateral, confirmatory, or early back-groundinformation.Parentsorotherprimaryfamily members were then provided an opportunity to con-firm or deny the defendant
s history, including hisaccount of animal cruelty.Diagnoses established by the forensic evaluator fol-lowed the criteria established by the American Psychi-atric Association in its official diagnostic manuals. Be-cause these evaluations were conducted over the timespanfrom1984through1996,DSMIII
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criteriawereused until DSM III-R 
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criteria were published in1987, and DSM III-R criteria were applied untilDSM-IV 
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became available in 1994, after which, cri-teria of the latest manual were used. Diagnoses weresupported by specific signs and symptoms that corre-spondedtodiagnosticcriteriaintherespectivemanual.Typically, a forensic evaluation required two,sometimes three, clinical interviews with the defen-dant, with each interview lasting between 1 and 3hours.Someevaluationswereaccomplishedwithinshorter time frame, and others took much longer.
Procedure for Data Collection and Analysis
Dataweresystematicallyretrievedfromthefilesinboth groups by using four retrieval outlines: demo-graphic data, animal cruelty, diagnostic profile, andcriminal history. When registering diagnoses, we at-tempted to verify the diagnosis independently, onthe basis of recorded diagnostic criteria. VerificationofadiagnosisofAPDandantisocialpersonalitytraits was made without using the history of cruelty, whenpresent. After data were collected on respectivetheme outlines, they were entered into a computerfor collation and analysis.Most comparisons between groups were made us-ing the chi-square test of independence with correc-tion for continuity. When the numbers were very low, the Fisher exact probability test was used. Be-cause of the small sample sizes, the power to detectdifferences was limited. Because multiple compari-sons were made between groups there is some possi-bility of inflated significance, although for the diag-nostic comparisons the classifications were oftenmutuallyexclusiveandthuswerelesslikelytoleadtocorrelated positive findings. We set the error rate at
.01foreachanalysisofstatisticalsignificance,tominimize the risk of Type I error.
Results
Demographiccharacteristicsforthecontrolgroup were matched as closely as possible to the character-istics of subjects in the study group (Table 1). Thestudy and control groups had comparable mean ages(31.65 and 31.75 years, respectively) and age ranges.Differences in demographic characteristics betweengroups were statistically insignificant. In a single in-stance, a Hispanic subject was matched with a whitesubject. All other subjects were matched for race andethnicity. It is evident that social adjustment and thegeneral level of functioning of subjects in both thestudy and control groups were comparable and gen-erally poor.Psychiatric diagnoses in the two groups were sim-ilar and typical of the most frequently encountereddiagnoses in this defendant population. The twogroupsshowednosignificantdifferencesinthenum-bersofdefendantswithpsychoticdisordersandmen-tal retardation and in the prevalence of alcohol abuseand dependence. Group differences were not foundfor less-frequently encountered disorders: adjust-ment disorder, dysthymia, depressive disorders, cog-nitive disorders and dementias, anxiety disorders, bi-polar affective disorder, sexual disorders, anddissociative disorders. However, the group of sub- jectswithahistoryofanimalcrueltyshowedasignif-
Gleyzer, Felthous, and Holzer 
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Volume 30, Number 2, 2002

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