Elliot Rodger: Asperger Syndrome?

Elliot Rodger (choose one):
A. Had Asperger Syndrome
B. Was Mentally Ill
C. Both
D. Neither
E. Don’t know
I’ve been mulling on this ever since Friday when the news broke. I’ve watched his video selfies, read his autobiography (available here: http://www.nytimes.com/interactive/2014/05/25/us/shooting-document.html?_r=0), and combed through the news reports.

Before going any further, let me make one thing clear: Asperger Syndrome (if he had it) would not be “to blame” for his behavior, nor would it be “irrelevant.” The truth is more complicated than either of those positions. We have blogged on this before (Is one of my patients the next Adam Lanza? and When is “co-morbidity” no longer “co-morbidity”? ).

For the moment, however, I just want to get the facts straight, and that is hard enough.

The impressions I got from his autobiography were:
Profound lack of self-worth early on, which eventually flipped over to grandiosity and glorification of self-perceived victimhood
A world view in which everything was always about him
Saw himself as the outsider
Black and white thinking; very limited repertoire of adaptive responses
Repetitive themes in his writing and behavior
Lack of insight into the emotions or behavior of others
Psychic pain

The impressions I came away with from watching his video selfies were similar, plus:
Excellent eye contact (“lens contact”?)
Speech was not pedantic and hyperverbal, but at times contained “cartoonish” phrasing worthy of the villain in a Batman movie.

And from reading the media reports:
It’s unclear whether he was ever diagnosed with Asperger Syndrome or a psychiatric disorder
It’s unclear how much intervention he received, at what ages, and with what orientation. What does seem to be the case (from his Manifesto) is that no one ever “got through” to him in any meaningful way.

At least at the moment, the correct answer is “E.” Some of his behaviors are “consistent with,” but not necessarily “diagnostic of” either AS or mental illness (or some mixture of both, that transcends the fictitiously neat categories in the DSM).

Nothing can undo the past. However, much as the parents of a teen who dies in a motor vehicle accident find solace in releasing their child’s organs for transplantation so that others may live, one thing that Elliot Rodger’s parents can do to salvage some meaning from their son’s death is to release his case file (medical record, psychosocial and family history, and educational records), so that we can have a clearer idea of what was going on not just inside his head, but within his family and within “the system,” in an effort to reduce the risk of “next time.”

James Coplan, MD is an Internationally recognized clinician, author, and public speaker in the fields of early child development, early language development and autistic spectrum disorders.