How does one go from a PhD Candidate to one of the worst serial killers in American history? This was the question posed by Good Morning America anchor George Stephanopoulos when speaking about James Holmes, the 24-year-old neuroscience PhD student who went on a rampage in Aurora, Colorado killing 12 people and wounding another 58.

Video of an 18-year-old James Holmes taken 6 years ago at a science camp is in stark contrast to the video of him appearing in court for his initial arraignment. The slim, dark-haired teen whose dream was to own a Slurpee machine stands in stark contrast to the flame-red-haired 24-year-old who sat in court with wide eyes and a vacant stare. What makes a person go from one extreme to another?

The booby-trapped apartment designed to kill anyone who entered. The fact that almost no digital footprint of any kind was left behind by Internet searches. The costume, the firepower, the gas mask…what does it all mean? Is James Holmes a mad scientist? A calculated killer? Mentally ill?

While it is too early to know much of anything about James Holmes, his history indicates that he is an intelligent individual who has done well throughout his educational endeavors. Apparently, about four months ago he went on a shopping spree for guns and explosives and, at the beginning of June, wrote a letter to the school indicating that he was dropping out of school. What happened?

As a forensic psychologist, one of the first thoughts that comes to mind is whether this individual is suffering from some type of mental illness. Males who are prone to psychosis typically experience their first psychotic break between the ages of 18 and 24 so, theoretically at least, it is possible that James Holmes is experiencing some type of mental illness.

There are various mental illnesses that are common among mentally disordered offenders and Delusional Disorder is one of the first that comes to mind when thinking about the extreme lengths that Holmes appears to have gone through in booby-trapping his apartment and in planning and setting up the mass shooting.

Whether James Holmes would qualify for an insanity (criminal responsibility) defense or whether his lawyers will present an insanity defense are questions that many are asking and for which only time will tell but we will watch this case with interest and horror as it moves forward.

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