Assessing Homicidal Mental States at the Time of Offense III: The 2011 Norway Massacre: The 2nd forensic psychiatric examination.

Based on publicity and professional commentary (“…intense media coverage, with repeated requests for a new evaluation by major newspapers and politicians”), the court ordered a second forensic psychiatric examination of Breivik. It was conducted 6 months after the first examination. The two psychiatrists “conducted a considerably longer evaluation, and used additional psychological assessment instruments.” They noted that Breivik’s grandiose and paranoid delusions were not delusions at all, but expressions of an extremist ideological viewpoint. They saw no signs of gross disorganization or outward signs of auditory hallucinations. They noted that his “social withdrawal” [to a farm outside Oslo] was actually the plannning stage for constructing the fertilizer bomb and planning his attack. They agreed that “they were viewing a man with pathological self-aggrandizement.” Using the SCID – II, they concluded that he met criteria for both severe narcissistic disorder, antisocial personality disorder, and “pseudologia fantastica.” They concluded that he was “psychotic neither during their interviews nor at the time of his crimes” (Mele, 2013, p. 18). He was therefore not insane at the time of the offenses.

However, note this: Breivik had reviewed the previous examination and had apparently followed the media concerning his case. Breivik defended himself against the claim he was psychotic. He was well behaved and functioned appropriately in the court room. The court wondered “whether Breivik’s knowledge of the first report enabled him to give answers about his ideas that made him seem less delusional than he was,” whether he was able to feign sanity.

Next: Breivik and American insanity tests.

Reference:
Roth, W., & Dager, S. (2014). Psychiatry on Trial: The Norway 2011 Massacre. The Journal of Nervous and Mental Disease, 202, 3, 181-185.

Mele, I. (2013). The Breivik case and what psychiatrists can learn from it. World Psychiatry, 12, 1 16-21.

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