Amoktype reactions

The term amok was originally derived from the Portuguese-Indian name amuco referring to heroic warriors ready to die in battle, and was immortalized in Malayan epics, similar to the berserkr in ancient Norse sagas. Today, 'running amok'—likewise 'going berserk'—has become a colloquial label for any episode of apparently unprovoked randomly aggressive and homicidal behaviour usually engaged in by attention-craving angry young men, often under substance influence. Such acts have become quite common in modern Western society and have to be seen in the context of the media popularization of macho 'Rambo' and other killer types. Although such behaviour has certain features in common with the amok reaction observed in Malayo-Indonesian men, it does not represent the specific dissociative syndrome described under this term by experienced clinicians. (22Z) Typical amok reactions are preceded by a prodromal state of dysphoria and tension experienced in conjunction with interpersonal or situational problems, especially feelings of slight or loss of 'face'. An upsetting incident, often seemingly trivial, then triggers an altered state of consciousness with changes in visual perception and threatening illusions causing fear and rage, followed by a sudden kinetic discharge starting the amok run during which randomly aggressive, destructive, and homicidal acts are committed. The amok run ends with suicide; alternatively, the exhausted perpetrator is overpowered and falls into a stupor or deep sleep, afterwards claiming amnesia for his deeds. Typical amok reactions have been presented as specific to the male ethos of Malayo-Indonesian culture,(2.8) but they also occur among other ethnocultural groups of Southeast Asia. In times of rapid social change and armed conflict, series of amok acts have been committed by young recruits in the Philippines and in Laos.(29) Cases of amok very similar to the Malayo-Indonesian syndrome have been diagnosed in Papua New Guinea(39 and these must be differentiated from the non-violent pseudo- amok, the psychodramatic 'wild man behaviour' of New Guinea highlanders. In historical analysis, amok in Southeast Asia appears to have changed from a glorified warrior ethos and means of social protest in the precolonial era, to a dissociative reaction which in more recent times is mainly found in marginal figures or as an episode during the course of a chronic neurotic, psychotic, or cerebro-organic disorder. (31) (ICD-10, F44.88, ?F68.8; DSM-IV, 300.15)

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