A Misleading Review

In Reply: I do not have a particular quarrel with Dr. Englander when she states that "antisocial personality disorder and mental illness are far from the most important causes of violence." That is a legitimate point of view, which can be debated scientifically. That was not why I criticized her book. My criticisms (most of which her letter does not mention) were broader, and addressed whether the book would be useful to Psychiatric Services readers. I did not and do not think so.

It is not clear what Dr. Englander means by "the mental illness model of violence." If she means that she believes most psychiatrists believe mental illness is the sole explanation for violence, I think her view would be inaccurate. If she means that a mental-illness-oriented assessment of violence has little to offer, a look at the recent literature would be instructive (1). There is an active and expanding literature on the relationship between psychiatric diseases and violent behavior, a literature that is very relevant to the readers of this journal, and it is essentially ignored in Dr. Englander's book.

Dr. Englander seems to argue that it is proper for her book to trivialize the diagnosis of antisocial personality disorder (and indeed not mention any other personality disorder) and to dismiss the relationship between serious mental illness and violence in three paragraphs. The readers of this journal can judge whether a text on violent crime that does that would be useful to them.