Review Article
Karen Herrera-Ferra
Abstract
Human violent behavior is a complex phenomenon that is ranked among the most urgent global public health concerns, and remains a prevalent and challenging scientific, social, ethical, legal, and political problem. Of particular note are the occurrence, basis, and developmental – and psychosocial effects – of recurrent violent behavior (RVB). We opine that RVB should be a diagnostic psychiatric classifier that warrants diligent assessment, evaluation, reporting, observation and treatment in light of the repetitive pattern of physical and/or psychosocial harm to others, potential escalation, and/or possible predisposition and advancement to subsequent criminality. Recent calls for improved mental health and public safety, taken together with the missional foci of the new DSM-5, ICD-10 and BRAIN initiative suggest, support, if not prompt consideration of both more accurate classification of psychiatric conditions and states, and more pragmatic, prudent integration of neuroscience and neurotechnology within psychiatry. This approach could be criticized as overtly materialist, pathologizing, and medicalizing violence and its treatment; as well, there are possible burdens and risks and need for neuroethical scrutiny when using assessment and/or interventional neuroscience and neurotechnology to affect not only medical outcomes, but potentially socio-legal actions. Therefore, we posit that any such attempt at revising classification of RVB should seek to (1) maximize individual and social benefits versus burdens, and in this way (2) be fully aligned with ethical obligations of psychiatry – if not medicine writ-large - as a public good.