Violent Crime Offenders: Victims of Their Own Crimes?

Introduction

As a medical student, I study diseases every day. I know exactly what the most common diseases are, who is most likely to be affected and how to treat it. We learn about cardiovascular disease, cancer, and chronic respiratory diseases being the top three leading causes of death and why more research is required so we can treat patients to the best of our ability. However, there is a new epidemic on the rise that is becoming more and more dangerous. Currently being the 16th leading cause of death in the United States, it kills around 18.000 people a year in the United States alone. Moreover, it especially affects people in the age groups of 1-4, 5-14, 15-24, 25-34 and 35-44, where it is within the top 5 causes of death1. As it is now thought to have spread to the United Kingdom, research for this condition called violent crime or homicide is more important than ever.

This essay is based on states that London has reached its 100th homicide early September, at an earlier point in the year than at any time since 2008. As it is clear intervention is needed, the Mayor of London has declared that the city will take over Scotland’s and Chicago’s attitude towards reducing homicides by approaching it as a public health issue3,4. When Scotland implemented this system, it had an average of 115 cases of homicide per year. Nowadays, more than a decade after the Scottish police changed its attitude towards violent crime, they have seen the number of homicides almost halved to 61 cases per year, as shown in figure 1. Where Glasgow used to be the ‘murder capital of Western Europe’, by tackling violent crime the same way as obesity or HIV, homicides in Glasgow have now hit a forty year low. As there are many positive articles on this subject on the BBC website, the new global health approach seems to be working. But is it really possible to consider violent crime an infectious disease?

What Makes A Disease A Disease?

The definition of a disease is “a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms”6. The brain is important in making decisions and changes in brain structure and can make people more likely to become offenders, but is this enough to qualify ‘violent crime’ as a symptom of a brain condition? Although it is mostly used comically – a Dutch comedian recently won a Lovie Award for a video about the National Rifle Association (NRA) being a brain condition called ‘Nonsensical Rifle Addiction’ causing patients to shoot people – violent crime may have more overlap with medical conditions than one might think.

Violent Crime As A Symptom

In recent studies, more and more evidence is found that there are many genes involved in whether or not someone becomes a criminal offender7,8. These genes are known as ‘crime genes’ with MAOA as the most notorious one. This is a gene encoding an enzyme that is responsible for the catabolising of amine neurotransmitters such as noradrenaline, serotonin and dopamine and plays an important role in aggressive behaviour. In these studies, the low activity form of the MAOA gene (MAOA-L) corresponded with higher levels of violence and aggressive behaviour. Long-term studies showed that those people with the MAOA-L gene combined with environmental factors such as maltreatment during childhood, were correctly predicted to become violent crime offenders. However, it is important to keep in mind that there are a substantial amount of people carrying this gene and only a small percentage eventually becomes an offender. Although a significant number of violent crime offenders carry this gene, screening the entire population would be useless because of the very high false positive rate.

As with most diseases, one’s environment plays an important role as well. More often than not, violent crime offenders come from deprived backgrounds. Some of these people do not go to school regularly, do not have a stable family or do not have safe place to stay9. Stressful life events like this, especially in early life, can cause lasting changes in physiology and behaviour10,11,12. When exposed to high cortisol levels at a young age, demethylation of certain genes such as the glucocorticoid receptor gene takes place. As a result, when later in life these people are experiencing stress, their cortisol levels will be significantly higher than in people who had a normal childhood. Although more research is needed before one can jump to conclusions, higher cortisol levels are associated with aggressive behavioural problems and a higher risk of developing psychiatric conditions, which are both major risk factors for violent crime.

Furthermore, violent incidents usually do not take place randomly14. In Chicago, USA, there is a distinguished pattern of where homicides take place. Violent crime seems to occur at certain places at certain times, drawing/creating a pattern that seems to be very similar to an infectious disease such as cholera, which is shown on the right in figure 2. In addition, it appears to be replicating itself: one event would be a reason for another, and so on. The greatest predictor of a case of violence is a preceding case of violence, which is very similar to catching a cold or the flu. Finally, crime appears to come rapidly and eventually decrease again, as like epidemic waves. As shown in figures 3 and 4 below, there is a striking resemblance between the epidemics of flu and pneumonia on the one hand and homicides on the other hand. In other words, violent crime shows many similarities to a contagious disease: there is clustering, self-replication and epidemic waves.

Conclusion

Although most people would agree violent crime offenders should take responsibility for their actions and should be punished for their choices, it appears not to be that black and white. Having had a traumatic environment during childhood and the ‘wrong’ genes is not something one can change, but we can try to minimalize the effect of these factors later on in life. As it appears to have a significant amount of overlap with an infectious disease such as cholera or the flu, we should treat violent crime as a contagion with infected people instead of viewing it as “a problem with bad people”. This way, we can prevent future casualties of violent crime – both victims and offenders.