Did NASA miss any red flags?

Did NASA miss any red flags indicating that a woman put into a position of trust was a dangerous person? I follow this story with interest, having made this mistake myself. Could it be that even the rigorous psychological evaluations done by NASA fail to predict behavior or detect a sociopathy spectrum disorder? If that is true, those of us also conned by sociopaths can lighten up on ourselves.

Trained professionals often miss sociopaths

It is well known that even trained and experienced mental health professionals are not very good at predicting behavior and assessing sociopaths. In one study, repeat violent acts could be accurately predicted by therapist’s good reports. That’s right, the individuals who therapists thought were doing well were most likely to re-offend.

What about the case of Lisa Nowak, the space shuttle astronaut now charged with attempted murder? Why didn’t NASA detect a person with a potential for dangerous, irrational behavior? Since other psychiatrists are weighing in on this issue, I will present my analysis of this case given what has been reported so far.

To read more about the details of this case visit CNN.com. Briefly, in addition to being a naval officer, Nowak is a separated mother of 5-year-old twin girls and a teenaged boy. She claimed to police she was having a relationship with another astronaut. There is no independent corroboration of this. Papers filed in court indicated that Nowak allegedly stalked another female, an Air Force captain, for the past two months. It is alleged that Nowak viewed the Air force captain as a romantic rival. In addition to two months of stalking, Nowak is charged with attempting to kidnap and murder her rival.

Nowak reportedly followed her rival 900 miles wearing a disguise. She allegedly assaulted her with mace and after the victim got away, attempted to dispose of garbage bags, a brand-new steel mallet, a folding knife with a four-inch blade, and four feet of rubber tubing. Authorities charge that Nowak planned to kill her rival, cut up her body, and dispose of her in the garbage bags. I just have one question: What type of person commits acts like this?

Psychosis or sociopathy?

In my opinion, the most important issue is whether Nowak is psychotic or otherwise out of touch with reality. Perhaps she is currently delusional about the relationship and was responding to the delusion or hallucinations. In the absence of psychosis, we have to question her character. Some have asked whether PTSD or depression could cause this type of behavior. I searched the recent psychiatric literature for any evidence linking depression or PTSD with homicide or kidnapping of another adult. I found none. There is however, an extensive literature connecting character (personality disorders) and psychosis to aggression.

Keep in mind that personality disorders exist on a continuum with each other and with “normality.” I again assert that the best way to understand antisocial spectrum personality disorders is by examining the Inner Triangle: Ability to Love, Impulse Control and Moral Reasoning. Let’s look at this case, considering the Inner Triangle, and see if barring a psychosis, Nowak passes the Inner Triangle test.

Consider first her Ability to Love, again assuming the news reports of the case are true. Nowak is a risk-taker; she has to be to do her job. One report stated that Nowak flew as a Navy test pilot while pregnant. So there is at least one report of a history of risking another in addition to herself.

My son is four; one of him is a full time job. Two of him would be extremely demanding. I also have two teens. They require much TLC. Her twin girls are five, and she has a teenager. That makes her family structure similar to my own except she is not a single parent. Even with an attentive father, I can’t mathematically figure out how she has the time to mother her children, work full-time, have an affair, and chase a rival across the country. In light of the above, I believe it is likely she has neglected her children and put them at risk. She therefore fails the Ability to Love test.

What about the Impulse Control test. Some have said the apparent premeditation here speaks against poor impulse control. I disagree. The idea that she is so consumed with anger and jealousy that she can’t control her aggression is an indication of poor impulse control. I have also put forward the view that the impulse that sociopathic individuals have the most difficult time controlling is the urge for power and control. A power motive also seems to fit the available data here.

Lastly, let’s look at Moral Reasoning in this situation. Our social conventions dictate that if we lose a battle for the affection of a member of the opposite sex, we try to cope. Some become suicidal following a romantic loss. To become homicidal and/or aggressive toward a rival is not considered acceptable. She therefore fails the entire battery of Inner Triangle tests and likely has a character disorder if she is not acutely psychotic. (She could have also been on a stimulant binge as a cause of the psychosis.)

Power corrupts

We may also wonder if there are any circumstances in which a previously non-disordered person could be moved to assault, kidnapping and homicide. There is an interesting alternative explanation that I think should be considered. That is the Power Corrupts explanation. This explanation does not necessarily assume a completely “normal” individual to begin with. In a beautifully written paper, Power, Approach and Inhibition (Psychological Review 110:265-284, 2003), Dr. Keltner and colleagues at the University of California at Berkeley discuss the effect that possessing power has on apparently non-disordered, high functioning people. These authors show that when apparently non-disordered people are put into positions of power, their behavior changes.

People in power typically have a positive, energized affect, athough they may also be more prone to anger. They are more outgoing and seek out pleasurable rewards. Importantly, they are also disinhibited and may be aggressive. The authors also put forward the hypothesis that, “Elevated power increases the tendency to construe others as a means to one’s own ends,” and, “Elevated power increases the likelihood of socially inappropriate behavior.” Notice then, having power can make a “normal” person show sociopathic tendencies.

I think the Power Corrupts explanation may be operative here. There are few individuals in our country with higher status than the space shuttle astronauts. One could envision this status giving a person the feeling that he or she is above prosecution. If having power gives most people sociopathic tendencies, then this effect may be even more pronounced in individuals who are already adventurous, energetic and assertive.

In summary, we have to wait for more information about Nowak. On face, it seems that NASA may indeed have missed identifying a person with sociopathic tendencies.