Biological explanations of criminal behavior

Birth order moderates the association between adverse childhood experiences and externalizing behavior symptoms in adolescence

Adverse childhood experiences (ACEs) are associated with externalizing behaviors. Whereas some ACEs affect individual children (i.e., child-specific; e.g., failing a grade), others affect the family unit (i.e., family-wide; e.g., parent losing a job); effects of ACEs on externalizing behavior may manifest differently across groupings of ACEs. Moreover, birth order may modify the association between child-specific and family-wide ACEs and externalizing behavior due to differences in the experience of being a younger versus older sibling. This study examined the externalizing behavior of siblings in relation to their experiences of child-specific and family-wide ACEs to test the hypothesis that younger siblings are at greater risk for developing externalizing symptoms following familial ACE exposure. Participants were 61 sibling pairs (younger sibling Mage = 11.37 years, 44.1% male; older sibling Mage = 13.1 years, 52.5% male) recruited from six schools in the northeastern United States. Parents rated each child's externalizing behaviors (e.g., bullying, meanness) and retrospectively reported on each child's experience of 34 ACEs; two raters categorized ACEs as child-specific (n = 10) or family-wide (n = 24). Multilevel modeling revealed that both child-specific and family-wide ACEs were associated with increased externalizing behaviors. Birth order moderated the effect of family-wide (but not child-specific) ACEs on externalizing behaviors, independent of sex and age. Externalizing behavior was higher for younger siblings as compared with older siblings, particularly when a high number of ACEs (6+) were reported. This research should prompt future exploration of mechanistic theories of the impact of family-wide and child-specific ACEs and the role of birth order.

The neurobiology of antisocial personality disorder

Despite increasing recognition that there is a neurobiological basis of antisocial behavior in addition to its psychosocial foundation, much less is known about the specificity of the neurobiological findings to the psychiatric condition of antisocial personality disorder (APD). This article provides a review of research on genetic, brain imaging, neurocognitive, and psychophysiological factors in relation to assessments of APD. Findings show that there are significant genetic effects on APD, particularly related to the serotonergic system, as well as abnormalities in brain regions such as the frontal lobe. Associations between psychophysiological measures of autonomic nervous system functioning and APD are more mixed. Results indicating that APD has a significant genetic basis and is characterized by abnormalities in brain structure/function and neurocognitive impairments provide additional evidence that supports the conceptualization of APD as a neurodevelopmental disorder. Findings may also help inform treatment approaches that target neurobiological risks for APD symptoms. This article is part of the Special Issue on "Personality Disorders".

Of criminals and cancer: The importance of social bonds and innate morality on cellular societies

The current dogma in cancer biology contends that cancer is an identity problem: mutations in a cell's DNA cause it to "go rogue" and proliferate out of control. However, this largely ignores the role of cell-cell interaction and fails to explain phenomena such as cancer reversion, the existence of cancers without mutations, and foreign-body carcinogenesis. In this proof-of-concept paper, we draw on criminology to propose that cancer may alternatively be conceptualized as a relational problem: Although a cell's genetics is essential, the influence of its interaction with other cells is equally important in determining its phenotype. We create a simple agent-based network model of interactions among normal and cancer cells to demonstrate this idea. We find that both high mutation rates and low levels of connectivity among cells can promote oncogenesis. Viewing cancer as a breakdown in communication networks among cells in a tissue complements the gene-centric paradigm nicely and provides a novel perspective for understanding and treating cancer.

Longitudinal relations of prematurity and fetal growth restrictions with hyperactivity/inattention and aggression/delinquency

BACKGROUND

It is the aim of this study to analyze the longitudinal relationship between premature birth and low birth weight and the reciprocal influence between hyperactive/inattentive behavior and aggressive/delinquent behavior problems in children from early to late childhood.

METHODS

This study contains data from the German Erlangen-Nuremberg Development and Prevention Study. It applies prospective longitudinal path analyses on data obtained from postnatal pediatric assessments as well as later psychosocial behavior assessments by teachers and parents on N = 667 children, out of which n = 83 children (12.44%) were born preterm/small for gestational age.

RESULTS

The results show direct effects of birth complications at the beginning of preschool on hyperactivity/inattentiveness (teacher rating: ß = 0.28; p = 0.017; parent rating: ß = 0.32; p = 0.005), but not on aggression/delinquency (teacher rating: ß = 0.002; p = 0.427; parent rating: ß = 0.12; p = 0.324). Reciprocal effects between aggression/delinquency and hyperactivity/inattentiveness were stable at the end of elementary school, but not at the end of preschool across informants.

CONCLUSION

Our results support a differentiated view on the potential development of behavior problems after birth complications and the demand for early prevention measures.

IMPACT STATEMENT

Our results extend to the existing body of research by providing insight into the longitudinal effects of prematurity and fetal growth restrictions on hyperactive and aggressive/delinquent behavioral problems throughout a rather long period of development in childhood. The results show direct effects of birth complications on the development of hyperactivity for boys, but not for girls across informants. No direct effects of birth complications on aggression/delinquency are found. Our findings speak against too simple views on behavioral consequences of birth complications and thus can relieve too anxious parents, however close monitoring of the behavioral development of respective children is indicated.

A Systems-Based Approach to Criminal Thinking and Behavior

Nearly all theoretical approaches and therapies to criminal thinking and behavior have been reductionist, meaning that they focus on a part or a subsystem of a system or a supra-system. While these reductionist theories and therapies have provided, and continue to provide, valuable information and rehabilitation, they offer a limited view of criminality and rehabilitation as a consequence of reductionism. Using general systems theory (GST), this article presents an integrated and interdisciplinary theoretical approach to criminal thinking and behavior. This article posits that criminality can be better understood, prevented, and treated using GST.

Childhood maltreatment and subsequent offending behaviors in Australian women: Exploring the role of borderline personality disorder

BACKGROUND

Childhood Maltreatment (CM) is linked to adverse outcomes, including Borderline Personality Disorder (BPD) and increased propensity for offending behaviors. However, research on the specific role that BPD plays between the two is limited and highly relevant given the high prevalence of CM in Australia.

OBJECTIVE

The present study aimed to investigate (1) the relationship between CM and subsequent offending behaviors, (2) whether BPD mediates the relation between CM and offending behaviors, and (3) which type of CM (physical, sexual, emotional abuse, neglect, exposure to domestic violence, multitype maltreatment) predicts BPD.

PARTICIPANTS

The sample comprised 106 self-identified Australian female survivors of interpersonal violent crimes.

METHODS

Participants completed an online survey consisting of the Adverse Childhood Events Questionnaire, the McLean Screening Instrument for BPD, and a self-created questionnaire to measure offending behaviors. Regression, mediation analysis, and logistic regression were conducted.

RESULTS

CM significantly predicted offending behaviors (path c, B = 1.39, p <. 001) with BPD partially mediating the relationship (path c', B = 1.04, 95 % CI [0.31, 1.77], p = .006; path a, B = 0.47, 95 % CI [0.12, 0.83], p = .009, path b, B = 0.34, 95 % CI [0.07, 0.61], p = .014). Emotional abuse and multitype exposure were identified as predictors of BPD symptom development (OR = 9.42, 95 % CI OR [2.58, 34.40]; OR = 3.81, 95 % CI OR [1.41; 10.28], respectively).

CONCLUSION

These findings indicate the necessity of early interventions addressing CM, with a particular focus on emotional abuse and exposure to more than one type of maltreatment, to reduce the risk of developing BPD symptomatology and mitigate future offending behaviors.

A multifaceted approach to identifying and managing juvenile delinquency by integrating psycho-physiological indicators

To understand and treat juvenile delinquency, the study explores the relevance of psycho-physiological indicators. It also emphasizes the necessity for thorough research to minimize the gap existing between psycho-physiological measurements and conventional psychosocial components. The study focuses on the relevance of personality features, habituation, and autonomic arousal required to monitor the proper management of delinquent conduct. Through the integration of biological, psychological, and social elements into a multidimensional approach, researchers can uncover novel insights and create cutting-edge therapies for youths who are at risk of delinquent behavior. The study proposes to develop a comprehensive framework that considers biological antecedents in addition to conventional metrics to reach the root cause of delinquency; thereby drawing special attention to current literature and research that emphasizes the psycho-physiological correlates of delinquency. By examining the complex interactions between stress, physiology, emotions, behavior, and social structures, the study highlights the intricacy of delinquent conduct and the necessity for adopting a multifaceted strategy to fully address the problematic areas. Future research paths are emphasized, with a focus on the significance of longitudinal studies, moderating and mediating variables, and creative treatment techniques. By utilizing psycho-physiological markers and psychosocial traits, researchers can tailor intervention strategies to meet individual needs effectively. Early identification of psycho-physiological deficits in children is crucial for implementing successful behavior modification techniques and promoting the well-being of future generations. This is expected to help the government agencies to save time and public money.

Exploring the relationship between depression and delinquency: a sibling comparison design using the NLSY

Relative to the general population, adolescents with psychiatric disorders such as major depression disorder are incarcerated (and reincarcerated) at higher rates. Current research is mixed on whether this association is a cause, consequence, or the product of selection. For example, aggression can lead to more depressive symptoms, yet depression is associated with antisocial behaviors (e.g., delinquency). To better understand the relationship between depression and delinquent behavior, we used the discordant kinship model to examine data from sibling pairs in the National Longitudinal Surveys of Youth 1979, a nationally representative study. By explicitly modeling within- and between-family variance, we reduced the influence of genetic and shared-environmental confounds on our analysis. Our results suggest that the relationship between depression and delinquency is not causal, but rather a product of selection.

Bio-behavioral scientific evidence alters judges' sentencing decision-making: A quantitative analysis

The present study surveyed judges to examine how they consider and apply scientific information during sentencing determinations. Judges in criminal courts are increasingly asked to assess and make decisions based on evidence surrounding psychiatric disorders, with unclear results on sentencing outcomes. We qualitatively interviewed 34 judges who have presided over criminal cases in 16 different states and also administered vignette surveys during the interviews. We asked them to make sentencing decisions for hypothetical defendants in cases presenting evidence of either no psychiatric disorder, an organic brain disorder, or past trauma, as well as to rate the importance of different goals of sentencing for each case. Results indicated that the case presenting no evidence of a mental health condition received significantly more severe sentences as compared to either psychiatric condition. Judges' ratings of sentencing goals showed that the importance of retribution was a significant mediator of this relationship. Trauma was not deemed to be as mitigating as an organic brain disorder. These results provide unique insights into how judges assess cases and consider sentencing outcomes when presented with scientific information to explicate defendants' behavior. We propose ways forward that may help better integrate scientific understandings of behavior into criminal justice decision-making.

Capital sentencing and neuropsychiatry

The neuropsychiatric contribution to capital sentencing proceedings has grown substantially in recent decades as the consideration of neurological and psychiatric factors in criminal behavior has been increasingly accepted as relevant to the quest for justice. This review article will focus on the legal theories underlying neuropsychiatric input into capital sentencing decisions, as well as some of the investigative techniques and resulting data which may be offered by forensic neuropsychiatrists in this context. The death penalty is unique in its severity and irreversibility, as the courts, including the U.S. Supreme Court, have noted repeatedly. "Death is different," and the recognition of this has generated a set of court decisions and statutes pertinent specifically to capital proceedings, both procedural and substantive.

Added value of neurotechnology for forensic psychiatric and psychological assessment

The attention for neuroscience in relation to criminal behavior is growing rapidly, and research shows that neurobiological factors have added value to the understanding of psychological and social factors in explaining delinquency. There is evidence that neurotechnology can be used in criminal justice and may be of relevance for forensic psychiatric and psychological assessment. However, the question is whether scientific knowledge of neurobiological factors is applicable in daily practice of forensic assessment. Incorporation of basic technologies, e.g., psychophysiology (heart rate, skin conductance, wearables), hormonal measures (cortisol, testosterone), and neuropsychological testing might be evident, since they can be applied relatively easy. Moreover, a body of research shows the additive value of these technologies in this field. In addition, first steps are taken to apply these technologies in individual diagnostics, treatment, and risk assessment. Complex neurotechnologies like functional MRI (e.g., brain reading) and EEG show potential to be applicable in criminal justice, once it is known what additional information these indices offer for individual cases.

Forensically relevant challenging behaviors and the genetics domain

Impulsive and aggressive behaviors along with intellectual disabilities often manifest in the context of genetic disorders and are a persisting challenge to professionals in the forensic psychiatric and psychological setting. The following chapter comprises an overview of relevant factors in the gene-context-behavior interaction such as monoamine oxidase A activity and specific epileptic phenomena. It presents several examples of monogenetic disorders with behaviors from the aggression spectrum and summarizes emerging strategies for treatment and clinical management thereof. The final part focuses on challenges and future developments in this field with relevance for the judicial and forensic systems. It is concluded that the relationship between a genetic syndrome and forensically relevant and/or violent behaviors should typically be addressed within a multidisciplinary framework that also includes the application of modern genetic techniques.

A jury of scientists: Formal education in biobehavioral sciences reduces the odds of punitive criminal sentencing

This study examines how formal education in biological and behavioral sciences may impact punishment intuitions (views on criminal sentencing, free will, responsibility, and dangerousness) in cases involving neurobiological evidence. In a survey experiment, we compared intuitions between biobehavioral science and non-science university graduates by presenting them with a baseline case without a neurobiological explanation for offending followed by one of two cases with a neurobiological explanation (described as either innate or acquired biological influences to offending). An ordinal logistic regression indicated that both science and non-science graduates selected significantly more severe punishments for the baseline case as compared to when an innate neurobiological explanation for offending was provided. However, across all cases, science graduates selected significantly less severe sentences than non-science graduates, and only science graduates' decisions were mediated by free will and responsibility attributions. Findings are discussed in relation to scientific understandings of behavior, the impact of science education on attitudes towards punishment, and potential criminal-legal implications.

Personal insult disrupts regulatory brain networks in violent offenders

The failure to adequately regulate negative emotions represents a prominent characteristic of violent offenders. In this functional magnetic resonance imaging study, we used technical, nonsocial frustration to elicit anger in violent offenders (n = 19) and then increased the provocation by adding personal insults (social provocation). The aim was to investigate neural connectivity patterns involved in anger processing, to detect the effect of increasing provocation by personal insult, and to compare anger-related connectivity patterns between offenders and noncriminal controls (n = 12). During technical frustration, the offenders showed increased neural connectivity between the amygdala and prefrontal cortex compared to the controls. Conversely, personal insults, and thus increased levels of provocation, resulted in a significant reduction of neural connectivity between regions involved in cognitive control in the offenders but not controls. We conclude that, when (nonsocially) frustrated, offenders were able to employ regulatory brain networks by displaying stronger connectivity between regulatory prefrontal and limbic regions than noncriminal controls. In addition, offenders seemed particularly sensitive to personal insults, which led to increased implicit aggression (by means of motoric responses) and reduced connectivity in networks involved in cognitive control (including dorsomedial prefrontal cortex, precuneus, middle/superior temporal regions).

Clarifying the synergistic effects of emotion dysregulation and inhibitory control on physical aggression

Rising rates of violence underscore the need to better understand how systems that regulate distress and impulse control jointly modulate aggression risk. The goals of the current study were to investigate the unique and interactive effects of emotional dysregulation and inhibitory control on the perpetration of physical aggression. We recruited a high-risk community sample of 206 adults (M/SD_age  = 33.55/10.89 years old; 47.1% female) who reported a range of physically aggressive behaviors. All participants completed a self-report measure (Difficulties in Emotion Regulation Scale), neuropsychological testing (Color Word Interference Test), and clinical interviewing (Lifetime History of Aggression Interview), and a subset of individuals (n = 134) underwent a neuroanatomical scan. As expected, the interplay of emotional and inhibitory control explained unique variance in physical aggression above and beyond their main effects. The positive association between emotion dysregulation and aggression strengthened as inhibitory control decreased. Cortical thickness in two right prefrontal clusters, one that peaked in the superior frontal gyrus and one that peaked in the caudal middle frontal gyrus, was also associated with the interactive effects of emotional dysregulation and inhibitory control. Notably, thickness in the superior frontal gyrus mediated the association between emotion dysregulation and physical aggression at low levels of inhibitory control. Using a multilevel and multimethod approach, the present study revealed neuroanatomical correlates of emotion-cognition interactions that have translational relevance to violence perpetration. These findings extend previous work primarily focused on functional-based neural assessments and point to the utility of examining neuroanatomical correlates of emotion-cognition interactions for understanding human aggression.

Forensic Value of Genetic Variants Associated with Anti-Social Behavior

Insanity defense is sometimes invoked in criminal cases, and its demonstration is usually based on a multifactorial contribution of behavioural, clinical, and neurological elements. Neuroradiological evidence of structural alterations in cerebral areas that involve decision-making and moral reasoning is often accepted as a useful tool in these evaluations. On the other hand, the genetic predisposition to anti-social behavior is still controversial. In this paper, we describe two cases of violent crimes committed by young carriers of genetic variants associated with personality disorder; both the defendants claimed to be insane at the time of the crime. We discuss these cases and review the scientific literature regarding the relationship between legal incapacity/predisposition to criminal behavior and genetic mutations. In conclusion, despite some genetic variants being able to influence several cognitive processes (like moral judgement and impulse control), there is currently no evidence that carriers of these mutations are, per se, incapable of intentionally committing crimes.

External locus of control and cognitive ability independently distinguish men in prison from community living non-offending men

BACKGROUND

The ability to cope with failure and subsequent feedback is crucial for prisoner rehabilitation. Impaired executive function in prisoners, high trait aggression and external locus of control can undermine the capacity to react to feedback in socially adaptive ways.

AIM

To investigate the relationships between aggression, locus of control, and attribution in an experimental task involving feedback about failure and success.

METHODS

Two groups were compared: 1. Imprisoned men, 2. Community living men without a history of incarceration. Aggression, locus of control and reasoning ability were assessed by means of psychometric instruments. An experimental task building on cognitive ability and providing performance-related feedback was carried out. Attributions of failure and success were measured using an ad hoc rating scale.

RESULTS

Prisoners reported higher levels of aggression and generalised externality, but poorer reasoning ability than the comparison group. Aggression was associated with external locus of control. In the experimental task, the community group showed higher success rates; higher scores on the task were correlated with less external attribution of own performance. Higher external locus of control and lower reasoning ability were independently associated with being a prisoner in a logistic regression model.

CONCLUSIONS AND IMPLICATIONS

Men in prison were characterised by greater social and fatalistic externality paired with lower reasoning ability than never incarcerated community men. In-prison rehabilitation strategies should pay early attention to improving reasoning ability and enabling men to recognise likely overuse of externally attributing their difficulties to fate, then helping them to become more realistic in their attributions and make use of realistic feedback.

Life With Corona: Increased Gender Differences in Aggression and Depression Symptoms Due to the COVID-19 Pandemic Burden in Germany

Gender differences (GD) in mental health have come under renewed scrutiny during the COVID-19 pandemic. While rapidly emerging evidence indicates a deterioration of mental health in general, it remains unknown whether the pandemic will have an impact on GD in mental health. To this end, we investigate the association of the pandemic and its countermeasures affecting everyday life, labor, and households with changes in GD in aggression, anxiety, depression, and the somatic symptom burden. We analyze cross-sectional data from 10,979 individuals who live in Germany and who responded to the online survey "Life with Corona" between October 1, 2020 and February 28, 2021. We estimate interaction effects from generalized linear models. The analyses reveal no pre-existing GD in aggression but exposure to COVID-19 and COVID-19 countermeasures is associated with sharper increases in aggression in men than in women. GD in anxiety decreased among participants with children in the household (with men becoming more anxious). We also observe pre-existing and increasing GD with regards to the severity of depression, with women presenting a larger increase in symptoms during the hard lockdown or with increasing stringency. In contrast to anxiety, GD in depression increased among participants who lived without children (women > men), but decreased for individuals who lived with children; here, men converged to the levels of depression presented by women. Finally, GD in somatic symptoms decreased during the hard lockdown (but not with higher stringency), with men showing a sharper increase in symptoms, especially when they lived with children or alone. Taken together, the findings indicate an increase in GD in mental health as the pandemic unfolded in Germany, with rising female vulnerability to depression and increasing male aggression. The combination of these two trends further suggests a worrying mental health situation for singles and families. Our results have important policy implications for the German health system and public health policy. This public health challenge requires addressing the rising burden of pandemic-related mental health challenges and the distribution of this burden between women and men, within families and for individuals who live alone.

A multilevel examination of lifetime aggression: integrating cortical thickness, personality pathology and trauma exposure

Aggression represents a significant public health concern, causing serious physical and psychological harm. Although many studies have sought to characterize the etiology of aggression, research on the contributions of risk factors that span multiple levels of analysis for explaining aggressive behavior is lacking. To address this gap, we investigated the direct and unique contributions of cortical thickness (level 1), pathological personality traits (level 2) and trauma exposure (level 3) for explaining lifetime physical aggression in a high-risk sample of community adults (N = 129, 47.3% men). First, the frequency of lifetime aggression was inversely associated with cortical thickness in regions of prefrontal and temporal cortices that have been implicated in executive functioning, inhibitory mechanisms and socio-emotional processing. Further, aggression was positively associated with pathological personality traits (antagonism and disinhibition) and exposure to assaultive trauma. Notably, all three levels of analysis (cortical thickness, pathological personality traits and assaultive trauma exposure) explained non-overlapping variance in aggressive behavior when examined simultaneously in integrative models. Together, the findings provide a multilevel assessment of the biopsychosocial factors associated with the frequency of aggression. They also indicate that cortical thickness explains novel variance in these harmful behaviors not captured by well-established personality and environmental risk factors for aggression.

Executive functioning among first time and recidivist inmates in Uruguay

Previous research has found association between antisocial behavior and deficits in executive functioning. However, research into a link between them accounting for criminal history has found divergent results in western countries. The present study sought to determine the severity of executive functioning deficits in offenders compared to a normative sample, and the differences between first time offenders as compared to recidivists in Uruguay using a cross-sectional design. The neuropsychological performance of 334 male adult inmates was assessed using the BRIEF- A and a normative sample of 377. Results indicated that offenders performed significantly worse than non-offenders in the global score and the subscales of the BRIEF-A. Moreover, first time offenders exhibited less performance deficits in cognitive functioning than recidivist offenders. Compared to first time offenders, recidivist showed executive dysfunction concerning behavioral regulation index and globally. These results enhance our knowledge about executive dysfunction associated with criminality and may help to tailor the offenders' programs to offenders with executive deficits.

Detention in Juvenile Correctional Facilities Is Associated with Higher Platelet Monoamine Oxidase B Activity in Males

Juvenile delinquency is related to several biological factors, yet very few vulnerability biomarkers have been identified. Previous data suggest that the enzyme monoamine oxidase B (MAO-B) influences several personality traits linked to the propensity to engage in delinquent behavior. Building on this evidence, we assessed whether conduct disorder (CD), juvenile delinquency adjudications, or detention in a correctional facility were associated with either platelet MAO-B activity or the MAOB rs1799836 polymorphism. The study enrolled 289 medication-free male youths, including 182 individuals detained in a correctional facility (with or without a diagnosis of CD). Of the remaining 107 participants, 26 subjects had a diagnosis of CD, and 81 were mentally healthy controls. Platelet MAO-B activity was determined by spectrophotofluorometry, while MAOB rs1799836 was genotyped using qPCR. Platelet MAO-B activity, corrected for age and smoking, was significantly higher in juvenile detainees (p < 0.001), irrespective of CD diagnosis. MAOB rs1799836 was not associated with platelet MAO-B activity or with detention in a correctional facility, CD diagnosis, or delinquent behavior. These data suggest that detention in a juvenile correctional facility increases platelet MAO-B activity in male adolescents. Future studies are needed to determine the mechanisms and functional significance of MAO-B peripheral elevation in juvenile male detainees.

The effects of essentialist thinking toward biosocial risk factors for criminality and types of offending on lay punishment support

This research uses experimental methods to gauge how different facets of essentialist thinking toward (1) types of offending and (2) biosocial risk factors for criminality predict lay punishment support. A randomized between-subjects experiment using contrastive vignettes was conducted with members of the general public (N = 897). Overall, as hypothesized, aspects of essentialist thinking, particularly informativeness, continuity, immutability, and discreteness, toward both biosocial risk factors and types of offending behavior generally predicted more severe punishments surrounding retribution, incapacitation, and deterrence. Yet, surprisingly, several of the same beliefs, specifically toward discreteness and informativeness, also predicted non-punitive sentiments toward restoration and decreased prison time in some contexts. This work demonstrates that essentialist thinking not only may affect how the public cognitively categorizes biosocial risk factors for criminality and types of offending, but also may have consequences for public support for the punishment of offenders with particular offense records or characteristics.

Should Behavior Harmful to Others Be a Sufficient Criterion of Mental Disorders? Conceptual Problems of the Diagnoses of Antisocial Personality Disorder and Pedophilic Disorder

Generally, diseases are primarily harmful to the individual herself; harm to others may or may not be a secondary effect of diseases (e.g., in case of infectious diseases). This is also true for mental disorders. However, both ICD-10 and DSM-5 contain two diagnoses which are primarily defined by behavior harmful to others, namely Pedophilic Disorder and Antisocial (or Dissocial) Personality Disorder (ASPD or DPD). Both diagnoses have severe conceptual problems in the light of general definitions of mental disorder, like the definition in DSM-5 or Wakefield's "harmful dysfunction" model. We argue that in the diagnoses of Pedophilic Disorder and ASPD the criterion of harm to the individual is substituted by the criterion of harm to others. Furthermore, the application of the criterion of dysfunction to these two diagnoses is problematic because both heavily depend on cultural and social norms. Therefore, these two diagnoses fall outside the general disease concept and even outside the general concept of mental disorders. We discuss whether diagnoses which primarily or exclusively ground on morally wrong, socially inacceptable, or criminal behavior should be eliminated from ICD and DSM. On the one side, if harming others is a sufficient criterion of a mental disorder, the "evil" is pathologized. On the other side, there are practical reasons for keeping these diagnoses: first for having an official research frame, second for organizing and financing treatment and prevention. We argue that the criteria set of Pedophilic Disorder should be reformulated in order to make it consistent with the general definition of mental disorder in DSM-5. This diagnosis should only be applicable to individuals that are distressed or impaired by it, but not solely based on behavior harmful to others. For ASPD, we conclude that the arguments for eliminating it from the diagnostic manuals overweigh the arguments for keeping it.