Healthcare Serial Killers as Confidence Men

Although there is adequate coverage of serial murder in the extant homicide literature, there is a lack of systematic examination of healthcare professionals who serially murder their patients. Using a sample of 58 healthcare serial killers located within North America, South America, and Europe between the years of 1970 and 2010, this study examines notable pre‐offense and post‐offense behaviours of healthcare serial killers. Patterns related to offender aetiology, victim cultivation, crime scene behaviour, and techniques of evasion were explored. The findings from this study suggest that the pre‐offense and post‐offense behaviours of healthcare serial killers can be conceptualised from the theoretical framework of confidence men or ‘con men’. The findings from this study also suggest that healthcare serial killings and offenders who perpetrate them continue to be elusive and warrant additional scholarly attention to reduce their likelihood of engaging in homicide undetected for extended time. Policy implications are also discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

Classification of Planning and Violent Behaviours in Serial Homicide: A Cross‐National Comparison Between South Africa and the US

Recent literature suggests that different ‘styles’ of homicide will most appropriately be reflected in the different types of behaviours committed by offenders during the crime. In the last few years, there has been a move to standardise classification systems of single homicides and establish their cross‐national generalisability. Literature on serial homicide to date has mostly centred on homicides occurring in the US. However, national differences due to factors such as culture, national identity, political, and socio‐economic circumstances may decrease the applicability of these models or certain aspects thereof in other countries and thus must be evaluated. The present study tested the applicability in the South African context of a recently developed US‐based serial homicide crime scene classification framework. Specifically, this study compared the thematic differentiation in planning and violent behaviours that the offenders engage in and how this differentiation compares with that in the US. The sample consisted of 25 homicides that were in total responsible for the murder of 267 victims. Results indicated that overall, the framework is useful and applicable in the South African sample, but important environmental and contextual constraints must be taken into account. Copyright © 2014 John Wiley & Sons, Ltd.     

Testing Existing Classifications of Serial Murder Considering Gender: An Exploratory Analysis of Solo Female Serial Murderers

Serial murder is a genre of crime that has received a great deal of media and academic attention, yet, serial murder committed by women has only begun to garner a portion of this attention within the last 15 years. This study examines the reliability of Kelleher and Kelleher's classification rubric, the only classification system developed for female serial murderers, as well as considering Hickey's classification of serial offenders by location. Other variables associated with homicide research have also been examined to determine their roles in both these crimes and classifying offenders. The current research will demonstrate that offender motivation is not an ideal basis for the classification of female serial murderers, who tend to defy simple or singular classification within existing typologies. The other variables analysed indicate that victim–offender relationship and victim approach are important to understanding these female offenders and their crimes, as well as the possible development of more accurate classification systems. Copyright © 2013 John Wiley & Sons, Ltd.     

South African Serial Homicide: A Victim‐Focused Behavioural Typology

This current study assessed the value of the Interpersonal Model in differentiating serial homicide offences in South Africa, notably in terms of how the offender may display behavioural patterns that are indicative of them dealing with the victim as a Person, an Object, or a Vehicle. The sample consisted of 302 offences committed by 33 offenders that occurred from 1953 to 2007 in South Africa. Multidimensional scaling analysis was used to test the Interpersonal Model and results indicated that crime themes did not directly correspond to the threefold model. Instead, two crime scene types were present: Victim as Object (where the focus was on tangible gains, interaction with the victim throughout the phases of the crime was limited, and victims included men and live women) and Victim as Vehicle (where the victim might be construed as a conduit through whom the offender could realise their specific psychological needs, the interaction was extensive, and victims tended to be vulnerable). South African serial homicides did not appear to have a specific sub‐theme of Victim as Person, suggesting that the themes engaged in centred more on instrumentally focused actions but in qualitatively different ways. However, victim types were integral to the overall behavioural model. Using the Victim as Object/Vehicle dichotomy, 85.7% of the offences could be seen to engage dominantly in one of the two patterns at the crime scene. This not only supported the results of a twofold model, but having these many offenders showing a dominant crime scene type also shows that the model is an excellent representation of serial homicide offending in South Africa. Copyright © 2014 John Wiley & Sons, Ltd.     

South African Serial Homicide: Offender and Victim Demographics and Crime Scene Actions

There is an abundance of literature on serial homicide from a Western perspective that outlines operational definitions, types of offenders and how they prey upon their victims. However, currently, there is a lack of studies that compare serial homicide in different countries. The current study aims to give an overview of the demographics of serial homicide offenders and victims in South Africa and compare these to the demographics of offenders and victims from other currently available empirical studies of other countries. The sample consisted of 33 out of the total 54 solved series in South Africa between 1936–2007, which includes a total of 33 offenders, 302 victims, and 254 crime scenes. Results of the sample as a whole showed that South African serial homicide offenders are similar to offenders in other countries in terms of their actions at the crime scene and victim choice, with some notable exceptions. Additional analysis looked at the offender's consistency of targeting certain types of victims across their homicide series in comparison with the patterns of serial homicide offenders in other countries. Copyright © 2014 John Wiley & Sons, Ltd.     

Serial murder in America: case studies of seven offenders

This article summarizes and compares information on seven interviewed serial killers in an ongoing project designed to study similarities and differences among these individuals. The aim of this article is to increase our collective knowledge of the dynamics of serial murder by examining the perpetrators' backgrounds, as well as the unique ways in which they view themselves and the world around them. Although qualitative interview research alone is not sufficient to fully understand such behavior, it is useful in many ways. Some of the information discussed based on the seven offenders interviewed is compared with broader epidemiological studies, and the strengths and limitations of each type of research are discussed.     

The Cross‐Cultural Relevance of Person‐Centered Counseling in Postapartheid South Africa

In this article, the need for effective cross‐cultural counseling in South Africa is emphasized against the background of the country's sociocultural context. The characteristics of person‐centered counseling that make it cross‐culturally suitable in the South African situation are discussed. Rogers's cross‐cultural group work during his visits to South Africa is briefly described. The ways in which specific cross‐cultural obstacles can be overcome by means of the person‐centered approach are pointed out. The relationship between person‐centered counseling and traditional African healing practices is described. Finally, ways to address the language barriers in cross‐cultural counseling in South Africa are discussed.     

Driving,Pseudo‐reality and the BTK: A Case Study

The significance of occupational choice, in particular those that involve driving, has not yet been studied or investigated in relation to serial murder. This paper, which adopts a case study approach, attempts to shed light on how driving as an occupation may instrumentally influence the offending behaviour of one North American serial murderer—Dennis Rader. Attention is given towards how spending such significant amounts of time driving may have held deep psychological importance for Rader, with regard to the development of his offending‐oriented fantasies. In particular, the “offending space model” is used to examine the relationship between ‘thinking and doing’. In providing this micro‐level analysis, we suggest that transient oriented occupations provide a rich array of practical advantages that may aid serial murderers in avoiding detection, whilst also holding deep psychological influence in the nurturing and development of their fantasies. Copyright © 2015 John Wiley & Sons, Ltd.     

Of Monsters and Men: Exploring Serial Murderers’ Discourses of Neutralization

Techniques of neutralization are used by petty and serious criminals to verbally account for their behavior, mitigate responsibility, and socially construct identity. Since serial killers often appear “normal” while simultaneously killing, neutralizations may provide the process by which serial killers “drift” between conventional societal attachments and murder. These neutralizations may also function as a form of stigma management, as it does for other offenders, assisting in the maintenance of a positive presentation of self. To explore these propositions, a content analysis of narratives and case histories was used to examine serial murderers’ accounts to determine if neutralizations were offered, and if so, the implications of this theory as a general (or universal) theory of crime.     

An Examination of Serial Homicide in South Africa: The Practice to Research Link

In this paper, South African serial homicide cases will be used to illustrate how practice can inform research and how research can aid practice by highlighting key questions that need to be answered and practice‐based assumptions that need to be empirically tested. The cases will also be used to highlight some of the unique features of series in South Africa. Copyright © 2014 John Wiley & Sons, Ltd.     

Post‐incarceration Recidivism of Lone versus Group Juvenile Homicide Offenders

Killings by juvenile homicide offenders (JHOs) who use accomplices have been increasing since the 1980s and currently represent approximately half of juvenile arrests for murder in the United States. Nevertheless, prior research has not compared JHOs who kill alone with JHOs who kill in groups. The present research followed up 30 years later on a sample of 59 male murderers and attempted murderers sentenced to adult prison. This study was designed to analyze whether lone and group JHOs differed on pre‐incarceration, incarceration, and post‐incarceration variables. Significant findings indicated that compared with lone offenders, group JHOs had a higher mean of pre‐homicide arrests and were more likely to be Black, have a pre‐homicide delinquent record, commit a crime‐related homicide offense, and target a stranger. With respect to post‐homicide variables, group JHOs were more likely to be released from prison and more likely to be rearrested. The two types of JHOs did not differ significantly in relation to the number of post‐release violent offenses. Preliminary implications of the findings and avenues for future investigation are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

In Search of the ‘Angels of Death’: Conceptualising the Contemporary Nurse Healthcare Serial Killer

Focusing specifically upon nurses who commit serial murder within a hospital setting, this paper aims to establish insights into this particular subcategory of healthcare serial killer. In addition, the paper aims to test the usefulness of an existing checklist of behaviours among this group of serial murderers. Drawing upon existing lists of healthcare serial killers produced by other scholars as well as legal records and an online news archive, we identified and researched healthcare serial killer nurses, collating socio demographic and criminological data and applying the aforementioned checklist to each case. Our findings suggest that to date, the label ‘healthcare serial killer’ has been applied in too loose a manner, making the understanding of this phenomenon problematic. In further refining the definition and identifying the socio‐demographic and criminological characteristics of the victims, perpetrators and crimes, we have developed more specific and therefore useful insights for practitioners and identified a potentially useful checklist which, with revisions, could contribute towards preventative strategies and interventions. Copyright © 2014 John Wiley & Sons, Ltd.     

South African Serial Homicide: Consistency in Victim Types and Crime Scene Actions Across Series

Key to understanding the significance of behavioural evidence for linkage purposes is in establishing how consistently an offender displays the same or similar behaviours across their series. There have however to date been very few studies aiming at identifying salient components of offending behaviour that can be used reliably for linking individual crimes as part of a single series. In addition, studies that have been conducted have all dealt with serial homicide in the Western world and have been based on small samples of cases from each country. Some of the recent literature has started to disentangle some of these salient features, notably the victim, violence levels, control, and planning. The current study focused on evaluating the consistency of these features across series, using a sample of serial homicides from South Africa consisting of 30 offenders with a total of 283 victims and 235 crime scenes. Results indicate that the level of interaction with the victim may be influential to the stability or instability of offending patterns across the series. How offenders approach planning in their offence also showed a certain degree of consistency, with patterns of violence being the least consistent across the series of all components tested. Copyright © 2014 John Wiley & Sons, Ltd.     

Features and investigative implications of muti murder in South Africa

Drawing upon anthropological, legal and forensic publications, an interview with a South African Zulu traditional healer and direct information gained during homicide investigations, the nature of Muti murder is discussed. Muti murder is defined as a murder in which body parts are removed from a live victim for the sole purpose of using the victim's body parts medicinally. These body parts are then often mixed with other ingredients or used alone to make a medicine called muti. Muti is a Zulu (umuthi) word meaning medicine. The victim usually dies as a result of blood loss from the wounds. While muti murders have occurred throughout history in South African culture, little is known about them and little research exists on the phenomenon. The term muti murder has been used interchangeably with the term ritual or sacrificial murder, often adding to confusion in terminology and definitions regarding these types of cases. This paper provides an overview of muti murder, explains the context in which these types of murder occur, defines the offenders and victims involved, and provides guidelines for investigating these types of murders. Two cases where muti murder was suspected are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

Murderers' and sexual offenders' experiences of police interviews and their inclination to admit or deny crimes

This research concerns murderers' and sexual offenders' experiences of Swedish police interviews and their attitudes towards allegations of these serious crimes. The explorative study is based on a questionnaire answered by 83 men convicted of murder or sexual offences. Results show that when police officers interview murderers and sexual offenders, the individuals perceive attitudes that are characterized by either dominance or humanity. Logistic regression shows that police interviews marked by dominance are mainly associated with a higher proportion of denials, whereas an approach marked by humanity is associated with admissions. When suspects feel that they are respected and acknowledged, they probably gain more confidence and mental space, allowing them to admit criminal behaviour.     

The association between adolescent risk behaviours and feelings of sadness or hopelessness: a cross-sectional survey of South African secondary school learners

Poor mental health in adolescents has shown associations with engagement in other risk behaviours. However, evidence of this association in Sub-Saharan Africa, particularly South Africa, is lacking. This study examines the associations between pertinent risk behaviours and feelings of sadness or hopelessness amongst a nationally representative sample of South African school going adolescents. Data was analysed from the South African Youth Risk Behaviour Survey 2011 (n=10,997), a cross-sectional national survey among grades 8–11 school learners. Logistic regression examined the association of demographic, substance use, violent behaviour, sexual activity and suicidal plans and attempts with the primary outcome, feelings of sadness or hopelessness. Having feelings of sadness or hopelessness was significantly associated with more senior grades, being bullied (AOR:1.67, 95% CI: 1.42–1.96), being assaulted by a partner (1.33 [1.05–1.68]), forced sex (1.78 [1.37–2.32]); gang membership (1.32 [1.06–1.65]), binge drinking (1.37 [1.14–1.65]), ever having sex (1.23 [1.02–1.47]), having ≥1 partner/s in preceding three months (1.25 [1.02–1.53]), having made a plan to attempt suicide (2.50 [1.95–3.21]) and suicide attempt (1.49 [1.21–1.85]). Adolescents in South Africa are experiencing a multiple burden of risk. Health promotion strategies targeting adolescent mental health and risk behaviours need to be developed and implemented in a timely and comprehensive manner.     

Reduced prefrontal and increased subcortical brain functioning assessed using positron emission tomography in predatory and affective murderers

There appear to be no brain imaging studies investigating which brain mechanisms subserve affective, impulsive violence versus planned, predatory violence. It was hypothesized that affectively violent offenders would have lower prefrontal activity, higher subcortical activity, and reduced prefrontal/subcortical ratios relative to controls, while predatory violent offenders would show relatively normal brain functioning. Glucose metabolism was assessed using positron emission tomography in 41 comparisons, 15 predatory murderers, and nine affective murderers in left and right hemisphere prefrontal (medial and lateral) and subcortical (amygdala, midbrain, hippocampus, and thalamus) regions. Affective murderers relative to comparisons had lower left and right prefrontal functioning, higher right hemisphere subcortical functioning, and lower right hemisphere prefrontal/subcortical ratios. In contrast, predatory murderers had prefrontal functioning that was more equivalent to comparisons, while also having excessively high right subcortical activity. Results support the hypothesis that emotional, unplanned impulsive murderers are less able to regulate and control aggressive impulses generated from subcortical structures due to deficient prefrontal regulation. It is hypothesized that excessive subcortical activity predisposes to aggressive behaviour, but that while predatory murderers have sufficiently good prefrontal functioning to regulate these aggressive impulses, the affective murderers lack such prefrontal control over emotion regulation. © 1998 John Wiley & Sons, Ltd.     

Professional Counseling in South Africa: A Landscape Under Construction

The focus of this article is on the history, status, and trends of the counseling profession in South Africa and on the similarities with the development of the counseling profession in the United States. A need exists for South African professional counselors to refocus their research efforts to reflect the realities of the 21st century and link counseling practice and theory with global realities to suit the needs and collectivist origins (ubuntu) of the South African population.     

Killing your children to hurt your partner: A South African perspective on the motivations for revenge filicide

The aim of the study was to investigate the offence characteristics and motivations for revenge filicides. Revenge filicide is an act where one parent kills their own offspring for retribution to hurt and upset the other parent. The cases of 20 revenge filicide murderers (14 male and six female) were analysed to determine the motivations and offence characteristics of revenge filicide offenders. It is the first South African study to highlight the motivations and associated characteristics in revenge filicides. Themes such as a loss of social identity due to rejection; extreme rage type anger; external locus of control; sadism; a desire to cause pain and a need to inflict harm are highlighted in this article. The initial emotional response may escalate from mild anger to a level of narcissistic rage which eventually culminates in the murdering of the child to punish and hurt the other parent and to restore control.