Olympic sprinter Oscar Pistorius, 26-years-old, known as ‘Blade Runner’ is running for his life. Charged with the premeditated murder of his model girlfriend, Reeva Steenkamp, Pistorius could be stopped in his famous tracks if found guilty. Under South African law the charge is a Schedule 6 offense and means that he would likely be sentenced to life in prison if convicted.

Today, Pistorius cleared his first hurdle and was released on bail. His ultimate fate will be determined by a judge and two magistrates, as South Africa has moved away from the jury system.

Pistorius has asserted his innocence by alleging that he mistook his girlfriend for an intruder when he shot her in a locked bathroom in his home. Police in South Africa have been investigating whether Pistorius had an anger-management problem. Prosecutors are meanwhile building a case against Pistorius by claiming that this is a classic case of domestic abuse culminating in murder.

Last summer in London, the double amputee earned universal fame for running on carbon-fiber blades. His story was sensational. The first athlete to compete against able-bodied runners at the Olympics, Pistorius was launched into hero status. He was a man who defied the odds. A real-life example of how perseverance and fortitude could prevail over disability.

Like millions, I watched him race, and I was smitten. There was something relatable about this soft-spoken, humble appearing man that resonated with me and the rest of the world. Now, this luminary celebrity is accused of brutality and murder.

As society watches the media coverage of Pistorius’s trial and behold pictures of the beautiful 29-year-old victim, they grapple with disillusionment. Conflicting feelings of fascination and intrigue coalesce with disgust and horror. A hero has fallen, a beautiful woman is dead, and people are wondering; how could this happen?

I have neither met nor interviewed Pistorius and am not involved in this investigation, so I cannot comment on whether abuse allegations or his guilt are true. But I have interviewed numerous batterers and know about the warning signs of violence.

There are “aggression centers” in everyone’s brains that can become activated for a variety of reasons. Overstimulation of these centers due to drugs, alcohol, physical injury, or mental illness can lead to disinhibition, poor judgment, and violence.1

Chemicals in the brains of violent offenders can also be out of balance. For example, excessive levels of serotonin, acetylcholine and dopamine (all chemicals that in normal quantities lead to happiness, productivity, and creativity) have been correlated with impulsive aggression. There is also strong evidence that hormones influence aggression, including androgens and cortisol which can be elevated by external use of testosterone and steroids.2

Batterers can also be formed as a product of their environment. A strong predictor of whether a man will abuse his spouse or significant other appears to be whether he has experienced or witnessed violence in his own family while growing up. Although violence is a learned behavior passed down through generations, not every man exposed to violence will be an abuser himself. Those who do are less capable of healthy attachments, are impulsive, lack social skills, and have degrading attitudes towards women.3

Neuropsychological characteristics of abusers have been extensively studied. The following character traits are serious warning signs that a man is prone toward violence and abuse of his partner.3

• Witness to violence in childhood household

Personality type: Needy, Dependent, Non-assertive, Low self-esteem

• Pathological jealousy

• Abuse of drugs or alcohol

• Excessive concern with outward appearances

• Degrading attitude towards women

• Immature mechanisms used to resolve conflict

While I never treated nor examined Pistorius, I have read about this case and with the rest of the public have learned that forensics allegedly identified a bloody cricket bat found in the house. They also claim that Steenkamp had a blunt-force trauma wound to her head.

To give credence to the prosecution’s case, they will undoubtedly theorize that the couple fought, Pistorius bashed Steenkamp’s head with the bat, and she fled to the bathroom where she was shot. If they can prove that Pistorius went and got a gun and pursued her, they will have a good case for premeditated murder.

This case highlights a World Health Organization crisis, which is domestic violence. Battering leads to multiple physical and mental health consequences. In some circumstances these are grave. Attention to violence risk, nevertheless, does not often occur before the criminal justice system has become involved. This headline case of ‘The Blade Runner’, as terrible as it is, provides an opportunity for the public to be attentive to warning signs of abuse and seek help before it is too late for victims and perpetrators of violent crimes.

1. Kavoussi, R. Armstead, P. et al. The Neurobiology of Impulsive Aggression. Psychiatric Clinics of North America. 20 (2); 395-403, 1997.

2. Renfrew, J. Aggression and its Causes: A Biopsychosocial Approach. New York: Oxford University Press. 1997.

3. Walker, L. Psychology and Domestic Violence Around the World. American Psychologist. 54, 21-29, 1999.

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About the Author

Helen M. Farrell, M.D.

Helen M. Farrell, M.D., is a psychiatrist with Harvard Medical School. She researches forensic psychiatry and violence.

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