Incels, violence and mental disorder: a narrative review with recommendations for best practice in risk assessment and clinical intervention
Josephine Broyd , Lauren Boniface , Damon Parsons, David Murphy & Jonathan D Hafferty
BJPsych Advances (2022), page 1 of 11 doi: 10.1192/bja.2022.15Josephine Broyd , Lauren Boniface , Damon Parsons, David Murphy & Jonathan D Hafferty
Incels, violence and mental disorder: a narrative review with recommendations for best practice in risk assessment and clinical intervention | BJPsych Advances | Cambridge Core
Incels, violence and mental disorder: a narrative review with recommendations for best practice in risk assessment and clinical intervention
(interesting article! the vicious circle of inceldom and mental illnessl)
SUMMARY
In recent years, mass violence associated with men who identify as involuntary celibates (incels) has been of increasing concern. Incels engage in an online community where misogyny and incitements to violence against women are prevalent, often owing to the belief that women are denying them a ‘right’ to sex. Indeed, inceldom can be considered a form of extremism. Information released about the prepetrators of incel-associated violence consistently suggests that mental disorder is a contributory factor and may increase vulnerability to engaging with the incel community. Depression, autism and personality disorder are particularly relevant. To date, there has been little research into the mental health of incels and how, in some, this contributes to violence. This article considers the associations between mental disorder and inceldom, including the risk factors for incel-related violence, and makes recommendations for best practice in risk assessment and clinical intervention.SUMMARY
Incels, violence and mental illness
As the emergence of this community is relatively recent, much of our understanding of incel demographics is limited to surveys distributed by forum moderators. A recent online poll in which 665 incels participated revealed that respondents were young males, between 18 and 30 years old, who lived with their parents and had no experience of intimacy (Anti-Defamation League 2020). Most reported dissatisfaction in their lives and 95% found the blackpill ideology to be an accurate reflection of their reality. Some 68% of respondents reported depression, 74% experienced anxiety and 40% reported an autism diagnosis. Considering this, mental illness appears to be a major concern among the community. Indeed, a group of incels refer to themselves as ‘mentalcels’, a type of incel who attributes their inceldom to mental illness (Jaki 2019). This suggests the potential for subgroups of incels who have different contributing factors to their inceldom, but there is no available research suggesting how mental illness influences how they attribute blame for their lack of sexual relationships.
In recent years, mass violence linked to incels has been of increasing concern and raises questions about links with mental illness. Often cited in this context is the Isla Vista massacre in 2014, where 22-year-old Elliot Rodger killed 6 people, seriously injured 14 others and then killed himself. In seeking to understand Rodger’s motivations, attention was drawn to his autism and prolonged treatment with psychiatric medication (White 2017). Prior to his attack, Rodger released a 141-page manifesto entitled ‘My Twisted World’, detailing his grievances against society and his inability to attract the women he felt he was entitled to (Rodger 2014). Although Rodger did not self-identify as an incel, instead identifying with another manosphere group known as ‘Pick Up Artist haters’, he and his manifesto have become sanctified within the incel subculture.
Rodger has been influential on subsequent violent incels who see themselves as prepared to be blackpilled (Lavin 2018). A blackpilled incel willing to carry out violence could be described as a ‘violent true believer’, someone committed to a belief system promoting homicide and suicide to further their goal (Meloy 2004). Fixations on their belief system develop until they self-identify as warriors for their cause and target members of the outgroup (women and Chads) deserving of hatred and contempt (Meloy 2004). In 2015, after claiming ‘here I am, 26, with no friends, no job, no girlfriend, a virgin’, Chris Harper-Mercer killed nine people, injuring eight others before killing himself (Lopes 2022). In 2018, Nikolas Cruz killed 17 students and injured 17 more on Valentine’s Day, having previously posted online ‘Elliot Rodger will not be forgotten’ and complaining about his isolation (Hoffman 2020). This was followed by Alek Minassian’s van attack in Toronto in 2018, resulting in the deaths of 10 female victims and injury to another 16 (Williams 2021). It was later revealed that Minassian had hailed Elliot Rodger as his hero (Speckhard 2021) and explained that following Rodger’s attack he felt proud and radicalised, stating that it was ‘time to take action rather than fester in his own sadness’ (Regehr 2022). Before the most recent incel-inspired mass shooting in Plymouth, Jake Davison blamed the blackpill philosophy for his increasing hopelessness that ultimately led to his killing spree (Townsend 2021).
All documented incel-related attacks, except for Nikolas Cruz, have been successful or attempted homicide–suicides (Hoffman 2020) and many of the incels were previously known to mental health services. Overall, the prevalence of mental disorders in incel-related violence and the rate of self-reported mental health difficulties on the forums highlight that mental disorder contributes to inceldom and, for some, the pathway to violence. As incel violence is not characteristically triggered by political motivations, it is not formally classified as terrorism (Hoffman 2020). However, there is an increasing consensus that the incel community could be considered a radical milieu by providing the breeding ground for those at risk of radicalisation (Brzuszkiewicz 2020). The UK government’s ‘Prevent’ strategy, an anti-radicalisation framework, has recognised incels as a category within radicalisation for several years (Adams 2021). Terrorism research suggests that complex interactions between terrorism and mental illness may increase vulnerability to engaging in violence through involvement with a group (Gill 2017). Additionally, under the right psychological circumstances, such radicalising online forums could encourage extremism in vulnerable incels (Ling 2018). Therefore, we propose that a better understanding of the contribution of mental illness to the risk of violence in incels is required.
The current literature
To our knowledge, no study has examined the current literature on the impact that inceldom has on mental health and risk of violence. We therefore conducted a narrative review to: identify the associations between mental disorder, inceldom and violence; identify potential risk factors for incelrelated violence to inform assessment and intervention; and propose avenues for future research. Our search methodology is available in the supplementary materials available at https://doi.org/10. 1192/bja.2022.15. We identified 17 papers with a strong emphasis on mental illness and inceldom. The following sections explore some of their findings.
Mental disorder
Depression, hopelessness and suicidality
Studies of incel literature have revealed that depression-related symptoms of low mood, hopelessness and suicidality are common themes (Speckhard 2021; van Brunt 2021). In an online survey of 272 self-identified incels from across the world, 64% reported experiencing depressive symptoms, 48% reported suicidal ideations, 60% reported anxiety symptoms and 28% reported symptoms of posttraumatic stress disorder (Speckhard 2021). Notably, there is also evidence that the incel community reinforces depression and suicidality in those with pre-existing vulnerability (Speckhard 2021). This aligns with frequent discussion on forums attributing feelings of loneliness and suicidality to inceldom (Glace 2021). Although gratitude is expressed towards the community for providing a safe, cathartic environment for like-minded individuals (Cottee 2020; Maxwell 2020; O’Malley 2020; Speckhard 2021), this occurs alongside strong suicidal rhetoric throughout the forums (Hoffman 2020; Maxwell 2020; Glace 2021). Furthermore, 71% of incels viewed their circumstances as permanent (Speckhard 2021), suggesting that preoccupation with self-degradation and the blackpill ideology further contributes to the hopelessness experienced by most incels (O’Malley 2020).
Hopelessness is a common theme in incel-related violence and is argued to be a central risk factor for mass violence by incels (van Brunt 2021), with most attackers displaying suicidal ideation (Williams 2020; van Brunt 2021). However, hopelessness is not enough to trigger extreme violence among those incels who transition from depression and loneliness to a mission-oriented plan to ‘punish’ those they deem responsible for their frustrations (van Brunt 2021). Hopelessness, signifi- cantly exacerbated by cognitive distortions such as over-generalisations, all-or-nothing thinking (across multiple contexts), misattributions, lack of empathy, neutralisation and victim stances, provides a justification for subsequent acts of extreme violence (Williams 2020, 2021). In all attacks by incels, perpetrators misattributed blame to women for frustrations in their life, specifically for sexual frustration (Murray 2017; Williams 2020).
Psychosis
We found very little discussion on the association between psychosis and inceldom and no confirmed cases of psychosis in incel-related violence. Analysis of incel forums shows that beliefs are more comparable to extreme overvalued beliefs that are shared, amplified and defended by the entire community and not an example of delusion (Rahman 2021). Furthermore, impaired communicative skills may make it challenging for individuals suffering from a psychotic disorder to engage with the fast-paced nature of an online community (Haker 2005). A survey on the use of technology among individuals with schizophrenia showed that although many respondents did use technology in a similar, positive way to non-clinical populations, almost half reported that they ‘rarely’ or ‘never’ used technology when experiencing symptoms (Gay 2016). More research is required to understand how a psychotic disorder may influence an individual’s engagement with the online incel community and any related violence.
Eating disorders and body dysmorphia
At present there are no available data on the prevalence of eating disorders or body dysmorphia within the incel community. However, both incels and individuals with eating disorders demonstrate dichotomous thinking. For example, incels view the world through a lens of ‘Chads’ and ‘Stacys’ and individuals with anorexia fixate on ‘fat’ and ‘skinny’ (Rahman 2021). It could also be argued that both groups show extreme fixations on physical appearance (‘lookism’), fuelling feelings of worthlessness. There is evidence of toxic forums within the incel community dedicated to critiquing each other’s appearance (O’Malley 2020). Online communities also exist for individuals with eating disorders (e.g. various pro-ana groups; Juarascio 2010) and although they aim to provide social support for people with eating disorders, they also have the potential for harm by encouraging maladaptive eating behaviours. Although an eating disorder would not fuel violence against others, associated distorted thinking, such as inferior body image in relation to others, could contribute to feelings of hopelessness and feed extreme overvalued beliefs. In addition, given that research suggests over 60% of individuals with an eating disorder report selfharm or suicidal thoughts (Cliffe 2021), incels might be more vulnerable to self-inflicted violence if they have an eating disorder. In fact, one-third of incels participating in an online survey reported ever engaging in acts of self-harm and the intensity of this self-harm significantly correlated with their agreement that belonging to the incel community made them want to harm themselves (Speckhard 2021). Nevertheless, while there are similarities between the two groups, there is no evidence to suggest that having an eating disorder increases vulnerability to inceldom.
Autism
The literature suggests that there may be a specific relationship between autism and incel-related activity (Williams 2021). In one online survey, almost a quarter of incels self-reported autism symptoms (Speckhard 2021) and analysis of seven incelrelated cases of violence suggested that more than half showed characteristics of autism (Williams 2021). Some of the difficulties associated with autism may increase vulnerability to being drawn into the ‘rule-based’ incel ideology and increase risk of radicalisation (Williams 2021). Key factors are likely to be a specific cognitive style characterised by literal thinking and interpretations, as well as difficulties with various aspects of social cognition, resulting in social naivety and problems forming intimate relationships (Murphy 2020). Although there is nothing in the literature, a preoccupation with sex may also be a driver towards inceldom.
Some individuals with autism may be particularly vulnerable to the online nature of the incel community because of problems understanding relationships and associated dynamics (Williams 2021). In addition, co-occurring conditions such as depression and anxiety are often present in autism (White 2017). Although autism is not directly linked to violence (Heeramun 2017), in some contexts the combination of certain characteristics may lead to outbursts and criminal behaviour (Murphy 2020). For example, difficulties with emotion regulation and poor impulse control, combined with specific cognitive styles associated with autism, such as literal thinking, may increase vulnerability to engaging in violence.
It is suggested that Rodger’s autism contributed to the significant frustrations that he experienced and provided the ‘psychobiological foundation’ for the development of his defensive personality that facilitated his mass violence (Allely 2017; White 2017). However, as rates of autism in the incel community mostly come from self-report or retrospective diagnosis following a homicide–suicide, this must be interpreted with caution given the lack of valid assessments (Williams 2021). In regards to the association between having autism and vulnerability to inceldom, it is important not to infer that all men with autism are at risk of inceldom. It may be a particular subgroup of individuals in certain circumstances who are more vulnerable. More research is required, including robust diagnostic assessment of individuals.
Personality disorder
There are few articles addressing personality disorder within the incel community. Analysis of Rodger’s writings reveals evidence of grandiosity, pretentiousness and entitlement that is suggested to be indicative of narcissistic personality disorder. This is also highlighted by his extreme jealousy of those in sexual relationships (Williams 2021). It has been argued that narcissistic rage was the main contributor to the mass shooting that he perpetrated. Furthermore, the co-occurrence of autism and narcissism may be a particularly explosive combination, increasing the risk of someone with autism engaging in violent behaviour (Allely 2017). To date, there is no discussion of the contribution of dissocial, emotionally unstable or paranoid personality disorders to inceldom, which may be expected in cases where there is evidence of violence, suicidality and difficulties forming healthy relationships. However, a study of men from a general US population who completed an ‘incel trait’ measure found that the combination of personality traits frequently seen in inceldom (e.g. rejected, insecure, paranoid, resentful) with grievances about gender roles and hostile attitudes towards women was associated with increased reports of fantasies about mass murder and rape (Scaptura 2020). However, these ‘traits’ may be more a reflection of cognitive distortions and maladaptive schemas, reinforcing the role of distorted thinking in the incel community. Such traits also present opportunities for targeted intervention. Nevertheless, the ‘incel trait’ measure was developed from the analysis of media reports of incel violence and there has been no validation of the measure in incel populations.
Discussion
The vast majority of incels are not a significant threat to women. However, increasing cases of incel violence have been considered acts of violent extremism (Zimmerman 2018) and there are rising concerns that incel subculture embodies characteristics of terrorism (Speckhard 2021). Therefore, there is a need to determine the risk factors among incels that lead to individuals supporting and engaging in violence. This includes improving our understanding of incel mental health.
Incel ideology relies on the individual having a negative view of themselves, the world and their future due to the belief that their genetically determined physical appearance condemns them to a life of isolation, loneliness and rejection by women and society (Hoffman 2020). This ‘negative triad’ influencing their world-view is common in people experiencing depression (Beck 1979), thus explaining the high prevalence of hopelessness in the incel community. However, the combination of hopelessness with the ‘triad of risk’ consisting of (a) fixation on a lack of sexual experience, (b) cognitive distortions and (c) blaming women for their frustrations appears to be central in exacerbating the difficulties associated with inceldom. Incels may escalate to violence if they feel misunderstood by society and view harming themselves and/or others as their only option (van Brunt 2021).
Some difficulties associated with autism may increase vulnerability to the development of additional risk factors that ultimately push an individual towards inceldom and potential violence. Examples include difficulties navigating social interactions and increased susceptibility to depression and anxiety. Research shows that when an individual with autism does commit violence there is often a comorbid condition such as mood disorder, psychosis or psychopathy (Im 2016). For a comprehensive risk assessment, it is important that the combination of difficulties associated with the individual’s autism is considered in the context of their personal circumstances. For example, social naivety, difficulties with emotion regulation and preoccupation in the context of certain cognitive characteristics (such as rigid thinking and lack of awareness of consequences), sensory processing deficits and social exclusion have a profound impact on decision-making and behaviour (Murphy 2020). The contextual role of autism will differ depending on the individual, and individual case formulation should be used to establish the contributing factors to risk (Al-Attar 2020). This will also identify vulnerabilities associated with autism that could be nurtured as strengths and increase the individual’s resilience to extremism (Al-Attar 2020). It is not autism alone that confers risk, but the combination of the specific difficulties experienced by the individual in certain circumstances.
Less clear is the impact of other neurodevelopmental disorders, as there has been no research on attention-deficit hyperactivity disorder (ADHD) or intellectual disability and their associated challenges among incel groups. Moreover, further research is required to understand how psychosis may contribute to inceldom and incel-related violence, particularly considering that engaging with an online community may be challenging for individuals with active symptoms of psychosis (Gay 2016).
There is emerging research on the contribution of personality disorder to incel violence. Narcissistic personality disorder appears to be of particular interest. This is noteworthy given the complex interaction seen in incels between their sense of male superiority in relation to women and their feelings of inferiority triggered by perceived or actual rejection by women. Research suggesting specific cognitive patterns leading an incel to believe that wrong is deliberately being done to them may contribute to the pathway to violence (Allely 2017). However, clarification is needed to establish whether it is apparent ‘personality traits’ or, perhaps more likely, the development of a specific set of maladaptive schemas associated with increased risk of inceldom.
