Gun Violence and Gun Control IV

 

7.  If we are going to place the onus in reducing gun violence or the occurrence of mass shooting incidents on addressing mental illness, then we have to have a clear conception of WHAT MENTAL ILLNESS IS and FROM WHOM WE ARE TRYING TO IMPEDE ACCESS TO FIREARMS.

The Roberts Court opens the door with Heller by making the critical exception, in its reading of an individual right to bear arms in the Second Amendment, regarding regulation of firearms possession by the mentally ill and felons.  Leaving felons aside for the purposes of my argument as a relatively sensible exception (provided we believe that prison systems nominally established with the purpose of rehabilitating criminals will always, invariably, fail to transform, presumably, ingrained predispositions toward criminality in the minds of convicts), the idea that legislatures should be empowered to inhibit access to firearms by the mentally ill deserves some scrutiny.  Specifically, who exactly are we going to be preventing from using guns?  Is our definition of mental illness too broad or too narrow to achieve the goals that we have in mind in prohibiting access?  Just what is it that defines mental illness?

            There seem to be some obvious symptomatic candidates here arising from the genetic inheritance of bio-chemically-induced cognitive abnormalities.  Such instances might include schizophrenics and other individuals relying on the continuous and permanent use of anti-psychotic medications.  It probably makes good sense to prevent the legal purchase or possession of firearms by such individuals if only because their possession of the capacity to inflict lethal physical violence might generate highly unpredictable patterns of use, endangering others and themselves.  Nationally, approximately 2.2 million individuals suffer from clinically diagnosed schizophrenia (see “Schizophrenia Facts and Statistics” at: http://www.schizophrenia.com/szfacts.htm).  Notwithstanding apparent difficulties in diagnosing such conditions, relative to other anxiety-driven mental/emotional conditions, this scale of illness appears susceptible to effective regulatory control, at least with respect to the purchase of firearms.  On the other hand, there are clearly diagnostic issues in the identification of a disease like schizophrenia, relative to chronic depression, bipolar disorder, and other conditions.  Moreover, I simply do not understand the capabilities and social limitations of schizophrenics and individuals with similar mental/emotional conditions in such a way that I could definitively argue that they merit legal restriction from firearm use.  Sadly, I am not a psychiatrist – just a deli clerk and a Marxist political-economist/urbanist.  With my own limitations in mind, permit me to contribute some intellectual speculation on mental illness based on what I think I do understand about bio-chemical signatures/correlations, behavioral symptoms, and socio-environmental inducements that might complicate the discussion if we are contemplating what individuals should be allowed access to firearms and who should not be. 

            Bio-chemically speaking, one thing that interests me a lot is cortisol.  Cortisol is a hormone produced by the adrenal gland, regulating levels of glucose within the bloodstream.  When a “normal” individual begins to experience stress, the adrenal gland increases cortisol production.  The increase both elevates the level of glucose within the bloodstream and reduces the immuno-suppressive capacity of the body, enabling the body to devote an increased quantity of energy to relieve the socio-environmental sources of the stress.  For this reason, cortisol is frequently referred to as the “fight or flight hormone.”  Pleading some degree of ignorance on the chemistry of cortisol, its activation pathways, and its particular effects on organic systems, I am interested in some of the research done within various academic and clinical settings linking cortisol production to stress, particular psychological conditions like post-traumatic stress disorder (PTSD), and connections between cortisol levels and levels of other bodily hormones, like testosterone, as bio-chemical precursors to socially aggressive behaviors.                   

            Summarizing the very small subset of studies on cortisol (mostly literature reviews) that I have examined, certain patterns are evident.  First, baseline (basal) cortisol levels in the blood stream and stress-reactive cortisol secretions appear to correlate positively to pro-social, empathetic behavior (see Shirtcliff et al. (2009)).  Conversely, anti-social, callous behavior patterns appear to correlate with lower basal levels of cortisol and lower reactive secretions.  Relating such behavioral patterns to environmental contexts, cortisol secretions, arising from reactivity to stressors, appear to respond both to stressors impacting the individual and to stressors impacting others in close association to the individual (i.e. friends, loved ones – Shirtcliff et al. (2009) cite Sethre-Hofstad et al. (2002), who note enhanced cortisol responses by mothers watching their young children undergo stressful situations).  Additionally, basal cortisol levels and reactive secretions appear to respond over time to extreme/traumatic stress and to chronically stressful conditions in ways that tend to readjust adrenal cortisol production (see Miller et al. (2007)).  As a result, individuals experiencing post-traumatic stress disorder, within at least certain studies, display lower levels of basal cortisol and a higher reactive threshold for reactive cortisol secretions.  Finally, some relationship appears to exist between basal cortisol levels and testosterone in the prevalence of aggressive behaviors (see Popma et al. (2007)).  In particular, higher levels of basal cortisol appear to moderate aggressive behaviors linked to high testosterone production. 

            Acknowledging that anyone interpreting my conclusions should exercise a high degree of caution given my lack of any formal education in psychiatry or bio-chemistry, the evidence that I have read seems to suggest that individuals who have experienced either traumatic or chronic stress, resulting in lower basal cortisol levels and higher reactive thresholds for cortisol secretion, with simultaneous high levels of testosterone production, will be both more prone to aggressive and anti-social behavior and significantly less apt to experience empathy (and, thus, remorse for their actions).  Supplementing these insights, normal production of testosterone, measured in nanograms per deciliter in the bloodstream, by post-pubescent males exceeds post-pubescent female production, on average, by at least a factor of ten, and male testosterone levels tend to reach a maximum between ages 16 and 30.  Thus, males, between the ages of 16 and 30, emerging from one or multiple episodes of chronic or traumatic stress, will be likely to combine high levels of testosterone production with lower levels of basal cortisol and an elevated threshold for reactive cortisol secretion.  In fact, evaluating homicide statistics in the U.S. from 1980 to 2008, males constitute 89.5 percent of all offenders and individuals between the ages of 14 and 34 constitute 78.1 percent of all offenders (see Cooper and Smith (2011), at: http://www.bjs.gov/content/pub/pdf/htus8008.pdf).  Implicitly, without actually breaking out Bureau of Justice Statistics (BJS) homicide victimization and offender series and performing regression analysis, there would seem to be some statistically significant correlation between gender-specific average patterns in the level of testosterone concentration in the bloodstream and the gender and age-specific prevalence of lethal violence, but the role of cortisol does not emerge here.  If cortisol mediates the socio-behavioral effects of high testosterone production, then the presence of incidents or circumstances that result in the diminution of basal cortisol and the elevation of thresholds for cortisol secretion, specifically in males between the ages of 16 and 30, should send out a red flag for potential danger in granting access to firearms!  So, what sorts of stressful incidents or circumstances might impact cortisol production?

            This is the point where I want to transition from the bio-chemical realm of cortisol and testosterone to territory that I feel at least a little bit more comfortable dealing with as a social scientist: social contexts that might place individuals in a state of emotional duress or inflict long-term/chronic personal anxiety.  For some reason, the mainstream media and various political constituencies, particularly right-wing conservative ones supportive of gun rights and otherwise looking for a good scapegoat, have centered their attention on video games.  The logic here is that playing one of the current generation of violent, bloody video games will generate a traumatizing effect on young minds, stressing and subsequently realigning cortisol production in ways that will diminish the mediating capacity of cortisol in developing minds.  As reasonable as this argument seems, the actual evidence for effects from video games is mixed.  An Iranian research team has recently confronted the question of effects from violent video games on cortisol production in males head-on and concluded that violent games do, in fact, elevate levels of cortisol for an extended period of time, relative to cortisol levels from playing non-violent video games (see Hossini et al. (2011)).  On the other side, a Swedish team performed a research experiment under similar conditions, with a slightly younger (12-15 years rather than 17-19 in the Iranian sampling) and smaller (21 rather than 50) male population sampling for a longer period (2 hours rather than 30 minutes) with comparably designed sampling frequencies for retrieval of salivary cortisol samples and found no significant statistical difference between the effects of violent and non-violent video games on cortisol production (see Ivarsson (2009)).  Given the mixed nature of evidence on the effects of violent video games on cortisol, it seems more likely that the attention that has been given to video games as a “smoking gun” in the social inducement of violent male behavior, in general, and gun violence, in particular, has been a “red herring” – in political rhetoric, it is always more satisfying to find a logically convincing scapegoat for a significant public policy problem than to admit that the problem is much more complex and nuanced to ever be adequately addressed with available statutory tools. 

            Socially speaking, my big concern is not with the effects of video games on young minds.  That is not to say that exposing young men to violent images from video games or movies does not produce potential traumatic stress.  Rather, I am convinced that there are many other social processes, present intermittently but with imposing effects that, in combinations, will expose individuals at various ages to overwhelming levels of stress.  Lets start with a range of processes with which I am much more familiar – those involving the functioning of regional macroeconomies in the present era of economic globalization.  In this respect, I am talking about variability in rates of economic growth, employment, measurements of income inequality (e.g. Gini coefficients), reflecting impacts on individual workers of the increasing openness of regional economies with the rest of the global economy.  How does the turbulence of economic growth, employment, and income in American metropolitan regional economies impose personal stresses on males between the ages of 16 and 30, and how are these stresses negotiated?  Evidence does exist for higher basal cortisol levels among long-term unemployed individuals relative to individuals in stable employment (see Detteborn (2010)), but, to my knowledge, neuroendocrinology researchers have never broached this question in reference to target groups of unemployed young men.  What about chronically unemployed young men in urban communities characterized by significantly below average income levels and higher than average community unemployment rates?  What about young, male college graduates, continuously unemployed or under-employed (relative to average compensation rates for college graduates in their field) for at least one year following graduation, with over, say, $25,000 in educational debt?  The burden of fundamental uncertainty may hover over the heads of hedge fund managers, but it must also, invariably, rest on the minds and provoke unmanageable stress for young men in chronically socially disadvantaged communities and, even, for young men in labor markets that have not offered immediate returns on the promise of higher education. 

            In evaluating the possibilities for social inducement of chronic and traumatic stress on young men, I would be amiss if I did not venture into the realm of love and sexuality.  How does the variability of sexual relations in the lives of young men impact cortisol production?  In particular, how do variations in the frequency and quality of sexual relations (e.g. dating, monogamous long-term sexual relationships with and without fathering, polygamous relations) constitute a source of chronic or traumatic stress for young men?  If, in this regard, testosterone production correlates positively to both the intensity of sexual desire and propensities toward aggressive behavior in males, then sexuality, sexual behavior, and multifarious sexuality-derived sources of stress must constitute a significant part of the equation in considering the regulation of cortisol and its mediating role relative to aggression.  Returning briefly to BJS statistics on homicide from 1980 to 2008, intimates (i.e. spouses, ex-spouses, or boyfriends/girlfriends) are involved in 41.5 percent of homicides in which the victim is female, compared to 16.7 percent of female homicides accountable to other family members, 29.9 percent accountable to other acquaintances, and 11.9 percent to strangers.  At issue here are the bio-chemical effects of jealous, possessive behavior by males and their manifestations in domestic violence against partners (presumably both heterosexual and homosexual). 

            It is not my intention in this section to lay the psychological onus of gun violence entirely on the bio-chemical relationship between cortisol and testosterone.  Rather, my point is that, if we want to emphasize the role of mental illness in incidents like Newtown, Aurora, Virginia Tech, or Columbine and utilize mental illness as a parameter in determining who should and should not have access to firearms, then we need to ask, more broadly, what mental illness is and how social conditions might contribute to the manifestation of mental illnesses through the functioning of physiologically known bio-chemical mechanisms in order to determine who might be at risk for committing violent behavior and, thus, whose access to firearms should be restricted.  If, in this regard, we are not going to just scapegoat schizophrenics or individuals taking anti-psychotic medications (and, further, ask what sort of individuals might benefit from psychiatric treatment but have never actually sought treatment), then we need to seriously look at a much broader range of socio-environmental risk factors (e.g. economic, sexual, cultural, familial) contributing to unmanageable stress, specifically in young males.  Such evaluations, if seriously pursued, would be likely to vastly expand the range of individuals under suspicion for the potential to utilize firearms in the performance of both impulsive and premeditated violent criminal acts. 

            Having made the argument here that our psychiatric/pharmacological definition of mental illness is far too narrow to impact the prevalence of gun violence by restricting access by mentally ill individuals, I am equally confident that, in constitutionally evaluating restrictions on access to firearms by the mentally ill, the Roberts Court and, by recourse to precedent, the federal judiciary, in general, will apply the much more strict psychiatric definition of mental illness that I am rejecting here as too narrow.  As with the scapegoating of video game designers, it is much easier and more satisfying for both conservative politicians and jurists to accept a clinically clear boundary between sane, rational people and the mentally ill, who have to take medications and undergo therapy.  If regulation of firearms access under psychiatric/pharmacological standards is apt to accomplish anything, it may, thus, be expected to reinforce social stigmas associated with emotional disorders and dissuade individuals who might otherwise benefit from anti-depressants or therapy from seeking help.  Therefore, the idea of saving the lives of potential victims in mass shooting incidents, to say nothing of saving the lives of women involved in domestic abuse and murdered by their partners with a gun, by preventing mentally ill individuals from accessing guns seems entirely ludicrous within the present political and constitutional context.