The episodic dyscontrol syndrome and criminal responsibility.

A growing body of literature suggests that violent behavior, especially when it is episodic, explosive, and out of all proportion to the provocation, can be a manifestation of what is currently termed the episodic dyscontrol syndrome. As elaborated by Monroe (1970, 1978), it represents a subgroup of the more general category of episodic (vs. continual) behavior disorders, and is defined as an "interruption in the lifestyle and life flow of the individual, and involves either a single act or short series of acts with a single intention .... The common features ... are precipitous onset of symptoms, equally abrupt remission, as well as the tendency of frequent recurrences." I The syndrome typically has been behaviorally defined, t but there is general agreement that in many cases a structural or functional brain defect is a necessary element of the total picture. Such a defect is presumably operative at the level of the limbic system and may be secondary to a wide variety of causes including, for example, physical trauma to the head, perinatal hypoxia, stroke, and encephalitis. 3 New work has been reaching the literature in which attempts are made further to refine the concepts, standardize the criteria, and examine for the presence of this syndrome in criminal offenders. Further, the same authors endeavor to document the extent and degree to which "faulty equipment" in Monroe's terms (i. e., a functional brain defect as opposed to "faulty learning") is responsible for the symptomatology of this syndrome. Inevitably, such research raises many issues for practitioners of forensic psychiatry and psychology. For one, the possibility of improved treatment, e.g., with certain anti-convulsant medication based upon new