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Does it matter if Sandusky has a personality disorder?

Could Jerry Sandusky have a psychiatric condition that helps explain the alleged acts of sexual abuse he's currently on trial for? That's what the defense for the former Penn State assistant football coach intends to argue, according to court documents released today.

Prosecutors have argued that letters Sandusky wrote to multiple young boys are proof of "grooming behavior" -- something pedophiles do that might include giving kids presents or acting nicely toward the child to establish an intimate relationship. Over time, it can make the child feel like he or she "owes" the predator sexual acts. The defense intends to argue that these letters exhibit signs of a histrionic personality disorder, a psychiatric condition in which people act in overly emotional and dramatic ways in order to draw attention to themselves.

The defense may or may not succeed in arguing that an undiagnosed personality disorder explains the letters, but when it comes to the case as a whole, the psychiatric issue is irrelevant, says Dr. Liza Gold, clinical prof of psychology at Georgetown University.

"This really has nothing to do with whether he molested boys," says Gold, who stresses that she has not examined Sandusky herself. 

"There's no evidence that I know of that links personality disorder to pedophilia," she says. Some pedophiles may have a personality disorder, and some with a personality disorder may be pedophiles. But there's no correlation between the two, argues Gold, who also serves as the vice president of the American Academy of Psychiatry and the Law. "It's apples and oranges. It's not even apples and oranges; it's apples and rocks."

People with histrionic personality disorder often need to feel like they're the center of attention, and they tend to seek endless reassurances and approval from others. They may believe a relationship is more intimate than it actually is, and they may act in inappropriately seductive ways toward other people. One hint of the disorder may be a string of failed romantic relationships or a history of many job changes -- and while that's not the case in all with the condition, it's worth noting that Sandusky has been married to the same woman since the late '60s, and he spent almost his entire three-decade career as an assistant coach at Penn State. 

To diagnose a person with the disorder, a psychologist will consider his or her current and past patterns of behavior and overall psychiatric history, and compare them with the current definition of histrionic personality disorder according to the Diagnostic and Statistical Manual of Mental Disorders, usually referred to as the DSM.

It's true that the defense could have evidence of a previous psychiatric history that hasn't been made public. But as Gold says, it's not uncommon for a person in legal trouble to claim they have a psychiatric disorder of some kind. She adds that it would be unusual for an older man to be diagnosed with the personality disorder late in life, especially because the condition is more common in women.

"Even if he has a personality disorder, it would not, to my mind, explain any kind of behavior involving child abuse and inappropriate relationships with children," Gold reiterates. 

"I think the money question is, So he has a histrionic personality disorder. So what?" she continues. "You have to show that there's some relationship to the behavior at issue. And the behavior at issue isn't writing some letters to some kids; the behavior at issue here is pedophilia."