Macdonald Triad Essay

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The MacDonald Triad is a set of behaviors first presented in "The Threat to Kill", a 1963 paper in the American Journal of Psychiatry by Dr. JM Macdonald, that are potential indicators to future violence also known as the triad of sociopathy, and while the triad is “proposed as a pathognomonic sign, as an alert to parents and the community” according to Hellman and Blackman (1966) that a child exhibiting the signs of the triad: Animal cruelty, Enuresis (bed wetting past the age of 5) and a propensity for starting fires could be expected to continue in this path onto adulthood. In a study involving hospitalized patients Macdonald focused on those who had threatened to kill rather than on patients who had killed, although some of these very patients later committed homicide. His sample consisted of forty-eight psychotic and fifty-two non-psychotic patients. Macdonald himself reported that the triad, even if all present, was not on its own a good predictor of future homicidal behavior. Conversely Dr. Hellman and Dr. Blackman, claimed from a similar study they conducted a few years later, that these signs in fact did, and even went so far as to claim that enuresis was a form of sadism. These were some the earliest studies to report the prevalence of animal cruelty in a male prisoner population; these authors found that prisoners charged with a violent crime were three times as likely to report an incident of animal cruelty having occurred in their childhood compared to prisoners charged with nonviolent crimes. The animal cruelty “sign” is seen as more indicative of future violent sociopathic behavior. Enuresis has been seen as a response to childhood trauma from sexual, physical or emotional abuse. It is seen as quite stressful for both the child as they grow older and the parents who may be at their wits end as to how to control it. A large percentage of
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