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PaperclipPerfector  4d ago (text post)   14011 thread views

Culture War Roundup for the week of August 17, 2026

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I'm quite interested in the differential, even if the information to really figure it out isn't available (and it wouldn't be appropriate anyway).

The impression I got is that she didn't endorse any CAH before or after the killings until meeting with someone hired by her defense. If this is true....yikes.

While patients lie about and minimize AH all the time it's usually noticeable enough, especially in someone getting enhanced scrutiny (for instance after murdering their children).

I'm therefore not sure I buy that she has some form of postpartum psychosis or unmasked BP w/PF, especially given the blatant doctor shopping, help seeking/unseeking behavior, and odd regimens (which can of course stem from poor clinical care but usually involves some element of questionable patient decision making).

If you toss out primary psychotic pathology it rapidly gets really interesting (and this dovetails into your original post). The observed behaviors are demonstrably abhorrent. Do you need to automatically catch a diagnosis as a result?

DSM personality pathology requires persistence and pervasiveness, I haven't heard any evidence to establish that. Is this instead Cluster-B adjacent coping mechanisms in the setting of some other process such as anxiety, depression, or abusive behavior from the accused of being personality disordered himself husband?

I don't think laymen should really be weighing in on criminality and legal proceedings for psychosis because that gets thorny pretty quickly (aka what is Anosognosia anyway?), but I think it's pretty mainstream and reasonable to treat DSM personality pathology (especially BPD and ASPD) as criminality instead of insanity. Likewise terrible stuff that doesn't quite fit into a diagnostic box.

Although if psychosis was present - it's easy to underestimate the danger in first episode psychosis, without proper practice managing symptoms things can go off the rails very fast.

The impression I got is that she didn't endorse any CAH before or after the killings until meeting with someone hired by her defense.

Uh-oh. In my experience CAH tend to be quite persistent and well-documented, since they are public enemy no. 1 when it comes to patient safety.

...without proper practice managing symptoms things can go off the rails very fast.

I think this is the only scenario that I could really accept - if the killings happened in her first episode of psychosis, prior to treatment. It's going to come down to how thorough her psychiatrists were in documenting the progression and severity of her symptoms, so they can generate a rough timeline of her illness. I think we will probably never know these details and can only hope the court does its due diligence.

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