Amok syndrome: causes, symptoms and treatment

Culturally based homicidal impulse: how to explain this curious disorder?

Disorders such as schizophrenia, anxiety disorders, major depression or obsessive-compulsive disorder are widely known to the vast majority of the population.

These are conditions that occur consistently in the vast majority of cultures around the world, occasionally varying in their manifestations but exhibiting distinctive patterns in the majority.

However, not all mental disorders are so common. There are some syndromes and disorders that are considered to appear specifically in certain cultures, linked to their beliefs and lifestyles. One such case is known as Amok's syndrome, or homicidal insanity..

A rare disorder: exploring Amok Syndrome

Amok syndrome is a very uncommon disorder whose main characteristic is the appearance of an outbreak of wild rage that induces the subject to a murderous behavior.provoking murder or serious injury with intent to kill all persons encountered by the subject.

This outbreak or episode arises in an apparently random manner, without there being any phenomenon that provokes the attack. Such an episode usually ends with the death of the subject, being produced either by the subject's suicide or by being shot down in order to stop the attack.

It has also been observed that in many cases individuals with this syndrome present a series of prodromes or symptoms that indicate the possible future presence of the disorder. Specifically the presence of moderate depression, isolation and a high level of fatigue are common..

In cases in which the subject presenting Amok syndrome survives, the presence of lacunar amnesia (i.e. no memory of the homicidal episode) and a high level of fatigue and exhaustion, both physical and mental, have been observed.

This is a syndrome traditionally linked to culture, first visualized and described in the Malay population. Historically, it has also been associated with other cultures, such as in the case of the the Viking Berserker warriors, who were known to enter a state of rage in battle, during which they would attack both the during which they assaulted both enemies and allies with special ferocity and resistance to pain.

Etiology (causes) of Amok

The causes of this disorder are not yet well known, due to its low overall prevalence and the fact that a large proportion of those affected end up dying, either by suicide or by being shot to end their actions.

However, it is noted that for the Malay population this syndrome was seen as a response to frustration and humiliation. Likewise, the religious beliefs of this population, which included ideas of possession by spirits, facilitated the suggestion and presence of this type of actions, as well as a magical interpretation of the phenomenon.

It has also been detected that the presence of chronic physical disorders is relatively common in subjects with Amok syndrome, and it is not totally excluded that this may occur during an episode of substance intoxication. Specifically, it has been observed that in the Indonesian regions where this disorder was detected, the consumption by both adults and infants of Brugmansia suaveolens or floripon, which is used as a painkiller as well as to prepare hallucinogenic drinks, is common.

A disorder not as specific to the culture as previously thought.

Although it is considered a culturally related disorder, Amok syndrome has recently been expanded and exported on a more global level, Amok syndrome has recently been expanded and exported to a more global level, with some experts associating it with multiple recent mass murders.It has been associated by some experts with multiple recent mass murders. However, it is not clear to what extent this is due to cultural exchange, as the increased scope of globalization cannot be separated from other factors that could also explain this phenomenon.

Typical profile of the affected person

It has been mentioned previously that Amok syndrome is a very rare and difficult disorder to see in the population. However, the serious implications and consequences of this syndrome have prompted the study of both this disorder and the characteristics of those who suffer from it, thereby common patterns have been visualized in the subjects who have suffered from it..

Generally, the subjects in whom this syndrome arises are usually males, usually young, who present a shy, introverted and unexpressive personality. shy, introverted and not very expressive personality.. They are usually subjects who present a high level of vital inhibition and sometimes feelings of dissatisfaction and frustration. It is common that throughout their lives they have lived some kind of traumatic experience that is unbearable for them.

The presence of a history of very prolonged harassment over time, as in the case of bullying, or of violence within the family is a frequent element found in subjects who have suffered from this disorder, suggesting that the outbreak may be due to sequelae of these phenomena that arise provoking homicidal rage.

Increasing prevalence

In recent times an increase in the prevalence of Amok's syndrome has been detected.. This is due to the well-known call effect, through which the observation of certain cases and their consequences can provoke other people to imitate the behavior of these subjects.

Thus, there is a learning of a form of behavior that the subjects may not have had before, and they may value and desire the level of social attention they observe for themselves. The same phenomenon has been observed in cases of gender violence, suicide, vandalism and even homicide or terrorism.

Crimes apparently associated with Amok syndrome

Amok syndrome is an extremely rare and uncommon disorder, but the fact that it can provoke mass murder has led to many known massacres being linked to Amok syndrome.. 

Some known cases that have been associated with this disorder are as follows:

Columbine massacre 2.

On April 20, 1999, this notorious massacre occurred. In it, two students stormed the Columbine High School campus, killing 15 people and injuring twenty-four others before both perpetrators committed suicide.

2. Virginia Tech Massacre

Another massacre or mass murder that has been linked to the Amok syndrome. In this 2007 case the subject involved murdered thirty-two people before killing himself.

Sandy Hook Elementary School Massacre.

In this well-known case produced in 2012 a teenager took the lives of a total of twenty children and seven adults, shortly before committing suicide.

4. Munich shooting

In July of this same year 2016 a young man with no apparent links to terrorist organizations carried out a massacre where nine people lost their lives and twenty-seven others were injured. The perpetrator of the act would end his life shortly thereafter.

Caution when linking Blood crimes to this syndrome.

It must be taken into account that in many of the cited cases the person had intentionality and prior planning before carrying out his attack. The definition of the disorder does not indicate that it is a premeditated act, so it is debatable whether these massacres are due to the presence of Amok syndrome. Nevertheless, in the opinion of many professionals, the characteristics of these homicidal behaviors are linked to this disorder.

The association of this disorder with violent crime has led to some killings and murders committed without apparent motive being considered to be due to Amok syndrome, such as those seen above. However, it should be it should be noted that most of the crimes are committed by people without any mental pathology.Whether or not their actions have a clear objective for others, the subject should be treated with caution and not to err on the side of reductionism, considering that all apparently unjustified blood crimes are due to Amok or other mental syndromes or illnesses.

The murders, many in the majority of cases, are explained no longer by situations linked to mental disorders, delusions and hallucinations, but rather by contexts in which a conflict has been escalating little by littlesituations involving organized crime, or because of some kind of ideological and discriminatory indoctrination.

Treatment

Because it is an extremely rare phenomenon and is characterized by being sudden and unexpected, the only immediate treatments are based on the physical containment of the patient for the duration of the episode. It is important to do so keeping in mind that the only goal is that no one gets hurt, so punishments or any act of revenge, of course, are out of the question.

However, it is in preventive it is in preventive work that greater effectiveness can be found and massacres can be avoided.. The treatment of possible psychological and social conditions that may lead to outbreaks of this type may be essential. Thus, fidelity with the follow-up of psychological and pharmacological treatments is important.

Bibliographic references:

• World Health Organization. (1992). International Classification of Diseases - Tenth Revision. Madrid: WHO.

• Sofsky, W. (2004). Times of horror. Amok, violence, war. Madrid: Editorial Siglo XXI.

• Westermeyer, J. (1972). A comparison of Amok and other homicide in Laos. American Journal of Psychiatry, 129: 703-709.