THE KELLER CASE: PSYCHOPATHY OR PSYCHOBIOLOGICAL DIATHESIS?
John A. Liebert, M.D., Alan Unis, M.D., Charles Wright, M.A.
Dept. of Psychiatry, Univ. of Washington Medical Center, Seattle, WA 98195 USA
Within six months, Paul Keller, then 26, had committed 96 arsons. One killed 3 nursing home patients. He had no prior offenses, either as a child or adult, except for an isolated episode of firesetting at age 9- cleared by the police as curiosity.
He suffered a perinatal injury resulting in cyanosis and incubator care at birth and, unlike siblings, never reciprocated affection with his mother. At 10 he was diagnosed by a Pediatric Neurologist as having Minimal Cerebral Dysfunction Syndrome. At 11 he was temporarily placed in a private residential facility for uncontrollable behavior. He was socially awkward and an academic underachiever in childhood without Specific Learning Disabilities. There was a pattern of arrogance and grandiosity in adulthood. Family history is positive only for alcoholism in both grandfathers.
Married at age 22 and divorced two years later, adult-onset alcohol and marijuana usage escalated. Six months prior to his arson spree, he presented for neurological assessment. An MRI was ordered but never accomplished. Four months prior to his arson spree, he presented at a Mental Health Center. Psychological testing showed stress intolerance with suicidality, but clinical follow-up was not accomplished. Throughout the year of his firesetting, he was consuming 15 ounces of 100% Southern Comfort and three bowls of “bud” cannabis daily. Three months following psychological assessment, he declared bankruptcy. Just days later, while stopping to urinate off the road, he set his first fire.
Expert testimony at sentencing demonstrated undisputed Axis I diagnoses of Attention Deficit Disorder with associated Conduct Disorder in childhood; rapid-cycling Bipolar Mood Disorder and severe, chronic substance abuse disorders. Axis II diagnoses, likewise undisputed, included Narcissistic Personality Disorder with reaction formation to pyromania and comorbid Social-Emotional Learning Disability.
Virkkunen found Borderline Personality Disorder and, compared to other violent offender populations, significantly lower CSF 5-HIAA and MHPG levels in arsonists. Many also had explosive behavior associated with alcoholism. Both reactive hypoglycemia and alcohol intoxication were found to be associated with impulsive firesetting committed during confusional states, particularly in recidivists like Keller. Research is planned to study the psychoneuroendocrinology of Paul Keller. Select psychobiological states and behavioral parameters can be monitored chronobiologically with supplemental inclusion of brain imaging and pharmacological challenges, including alcohol.