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Kratos is the main character in the "God of War" series. He was a Spartan military leader serving the Greek gods when he was about to be slaughtered by a barbarian horde. He prayed to the god of war, Ares, and obtained the Blades of Chaos (seen above). He vanquished his enemies and went on to be a successful and brutal warrior. His bloodlust grew so great that, while destroying a village, he accidentally killed his wife and daughter. Blaming Ares, he vowed vengeance. Though the storyline is different in each game, Kratos always appears highly motivated by revenge and will destroy anyone or anything in his way.
It should be noted that I have not interviewed Kratos in person. However, after examining many hours of data provided over several years, my diagnosis can be made with a reasonable degree of confidence.
My initial diagnostic impressions include:
-Antisocial Personality Disorder
-Intermittent Explosive Disorder
-Posttraumatic Stress Disorder
-Adjustment Disorder, With Mixed Disturbance of Emotions and Conduct
ANTISOCIAL PERSONALITY DISORDER
The essential feature of Antisocial Personality Disorder is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.
Diagnostic Criteria:
A: There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:
(1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
(2) deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
(3) impulsivity or failure to plan ahead
(4) irritability and aggressiveness, as indicated by repeated physical fights or assaults
(5) reckless disregard for safety of self or others
(6) consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
(7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another
B: The individual is at least age 18 years.
C: There is evidence of Conduct Disorder with onset before age 15 years.
D: The occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode.
Analysis of Criteria
A1 describes behavior that Kratos often engages in. For example, Kratos has killed probably hundreds of thousands of opponents. Some of his behavior is probably legally justified as an act of war or self defense, but it is clear that much of his behavior is against rule-setters (the Greek gods). Kratos has displayed significant issues with impulsivity, not least of which was the killing of his wife and daughter (criteria A3). As mentioned previously, Kratos has often acted aggressively and engaged in much violence (criteria A4 and A5). Though Kratos was clearly affected by the killing of his family, he does not appear to express remorse for the other individuals he has harmed, and has provided many rationalizations for his behavior (criteria A7). It is unknown if Kratos displayed these behaviors prior to age 15. However, inasmuch as he assaulted Ares as a child, one may conclude he had other behavioral issues as well (criteria C). There is no evidence that Kratos suffers from Schizophrenia (lack of positive and negative symptoms) or a manic episode (his behavior is displayed across far too long a time).
Cultural and environmental considerations appear particularly relevant in understanding Kratos' behavior. He has spent considerable time as a soldier during times of war, and his culture probably did not consider killing as particularly unusual behavior given his circumstances. Additionally, Kratos may have some legitimate justifications for much of his behavior. For example, he assaulted Ares as a child due to Ares kidnapping Kratos' brother. He had violent attitudes and behaviors towards his father due to repeated deceit and violence from his father. Kratos' culture and environment definitely muddy the diagnostic waters. However, there appear to be some instances in which Kratos shows a complete lack of empathy towards entirely innocent person's and his attitudes lead to homicidal behavior. For example, on more than one occasion Kratos has been helped by a neutral, non-violent person and subsequently killed them without provocation or reason. These behaviors are particularly troubling and revealing. Though certain behaviors may be understandable given the level of trauma Kratos has experienced, most people who endure trauma do not proceed to kill hundreds of thousands of individuals.
INTERMITTENT EXPLOSIVE DISORDER
The essential feature of Intermittent Explosive Disorder is the occurrence of discrete episodes of failure to resist aggressive impulses that result in serious assaultive acts or destruction of property.
Diagnostic Criteria:
A: Several discrete episodes of failure to resist aggressive impulses that result in serious assaultive acts or destruction of property.
B: The degree of aggressiveness expressed during the episodes is grossly out of proportion to any precipitating psychosocial stressors.
C: The aggressive episodes are not better accounted for by another mental disorder (e.g. Antisocial Personality Disorder) and are not due to the direct physiological effects of a substance or a general medical condition.
Analysis of Criteria
Kratos appears to meet criteria A due to his frequent acts of explosive anger, including an act where he killed his wife and daughter and subsequently regretted. Many of Kratos' episodes of aggressiveness may be considered to be proportionate to antecedent events. For example, it may be considered proportionate to respond with violence when attacked violently. As noted earlier, however, there are some instances where Kratos responds with intense anger towards neutral, non-violent individuals, and these instances would meet criteria B. Criteria C requires a clinician to determine if another mental health disorder better accounts for the failure to resist aggressive impulses. Due to Kratos meeting the exacting criteria required for Antisocial Personality Disorder, it seems this is a more appropriate diagnosis in explaining Kratos' assaultiveness. For example, Kratos does not often (if more than once) express remorse for his acts, which is characteristic of APD and not characteristic of IED. Additionally, Kratos' aggressiveness appears purposeful and goal-oriented, which is not characteristic of IED.
POSTTRAUMATIC STRESS DISORDER
The essential feature of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate.
Diagnostic Criteria:
A: The person has been exposed to a traumatic event in which both of the following were present:
(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
(2) the person's response involved intense fear, helplessness, or horror
B: The traumatic event is persistently reexperienced in one (or more) of the following ways:
(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, and perceptions
(2) recurrent distressing dreams of the event
(3) acting or feeling as if the traumatic event were recurring
(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
C: Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma,) as indicated by three (or more) of the following:
(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect
(7) sense of a foreshortened future
D: Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigillance
(5) exaggerated startle response
E: Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.
F: The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Analysis of Criteria
Kratos has had many difficult experiences. The one that appears to affect him most significantly is the death/murder of his wife and daughter. In short, Kratos, driven by bloodlust, accidentally killed his wife and daughter while razing a village (criteria A1 and A2). As punishment, the ashes from their burned bodies permanently adhered to his skin, giving him a very white appearance. Kratos has dreams and flashbacks of the event that are very troubling to him (criteria B1 and B2). After the trauma Kratos seems to enjoy nothing, including social interactions and activities that are normally pleasurable (criteria C5 and C4). He also has a very restricted range of affect (criteria C6), displaying little more or less than intense anger - this is despite strong feelings of depression, as evidenced by his very serious suicide attempt. Kratos often has difficulty staying asleep and has frequent outbursts of anger (criteria D1 and D2). Kratos has experienced these symptoms for many years following the event (criteria E), and it appears to have significant impacted his ability to function socially (criteria F). It should be noted that much of Kratos' behavior cannot be understood by PTSD alone, and these issues are addressed in the analysis of other diagnoses.
ADJUSTMENT DISORDER
The essential feature of Adjustment Disorder is a psychological response to an identifiable stressor or stressors that results in the development of clinically significant emotional or behavioral symptoms.
Diagnostic Criteria:
A: The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
B: These symptoms or behaviors are clinically significant as evidenced by either of the following:
(1) marked distress that is in excess of what would be expected from exposure to the stressor
(2) significant impairment in social or occupational functioning
C: The stress-related disturbance does not meet the criteria for another specific Axis I disorder and is not merely an exacerbation of a preexisting Axis I or Axis II disorder..
D: The symptoms do not represent bereavement.
E: Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months.
Analysis of Criteria
Many of Kratos' behavioral problems (but not all) appear to occur following the incident where his wife and daughter were killed (criteria A). Following this event, Kratos' mood seemed significantly intense, and though such an intense event would warrant an intense response, the killing of hundreds of thousands of people is in excess of what would be expected (criteria B1). Kratos' response to the killing of his family seems better accounted for by both Posttraumatic Stress Disorder and Antisocial Personality Disorder (criteria C). As noted previously, Kratos has experienced a disturbance in his mood and conduct for many years - much longer than the maximum 6 months outlined in criteria E.
Final Diagnosis:
Axis I: 309.81 Posttraumatic Stress Disorder, Chronic
Axis II: 301.7 Antisocial Personality Disorder
Axis III: Deferred to medical personnel
Axis IV: Problems with primary support group, Occupational problems, Exposure to war
Axis V: GAF=42