Seven missing women have been linked to the house that was shared by 44-year-old Eugene Horsch and his late father, Raymond “R.C.” Horsch, in the Olney section of Philadelphia.

With five of the seven women feared dead, Philadelphia police and the FBI are conducting a massive investigation of the home. Law enforcement has said Raymond Horsch, who died in 2025 at the age of 82, is the suspected killer. Eugene Horsch has not been charged with any homicides or missing-person offenses related to the missing women.

The Horsch house investigation raises questions about serial killers and whether mental health professionals can identify a person at risk of becoming one. The early identification of psychopathy can potentially prevent an escalation of antisocial behavior.

As a forensic psychologist, I conduct psychological evaluations to help courts make decisions when someone’s mental health is relevant. I’ve conducted hundreds of forensic psychological evaluations, including dozens with individuals with psychopathic characteristics.

I’m not surprised that a previous psychological evaluation of R.C. Horsch, done in the mid-1980s, did not identify him as a potential psychopath. That’s because reliable tools for identifying psychopathy were not available at that time.

What is psychopathy?

Psychopathic personality disorder, or psychopathy, is not an officially recognized disorder in the current version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, or DSM. This is the primary diagnostic resource used by mental health professionals in the United States.

Although a version of psychopathy was included in prior editions of the DSM, more recent editions have eliminated the diagnosis. This is because of the difficulty in assessing some of the emotional characteristics of psychopathy.

Instead, the DSM includes a diagnosis for antisocial personality disorder, which focuses primarily on the behavioral aspects of psychopathy. Psychopathy is generally considered to be a more extreme variant of antisocial personality disorder.

While psychopathy is no longer in the DSM, it has been vigorously researched and written about for decades.

It is characterized by a distinct group of personality, behavioral and emotional traits. It has been defined in slightly different ways over the years, but some of the traits commonly associated with psychopathy include pathological lying, extreme narcissism, shallow affect, impulsivity and lack of empathy and remorse.

Psychopathy is also characterized by a persistent pattern of antisocial or manipulative behaviors. These can range from infidelity and intimidation to aggression and extreme violence.

Psychopathy and serial killers

The link between serial killers – individuals who kill several people in separate, unrelated events over a period of time – and psychopathy is not new. Several well-known American serial killers, including Ted Bundy and Jeffrey Dahmer, are suspected to have had psychopathic personality disorder.

To be clear, most individuals with psychopathic personality disorder are not serial killers. In fact, people with psychopathic characteristics can be found among corporate executives, elected officials and attorneys.

But some traits associated with extreme psychopathy, including the ability to engage in violent behavior with little remorse or guilt, are typically found among serial killers.

Given that psychopathic characteristics are common among serial killers, one might wonder: Can mental health professionals identify psychopathy when conducting a psychological evaluation and possibly thwart a future serial killer?

Assessing psychopathy

Mental health professionals are frequently asked to conduct evaluations of people involved in the criminal justice system who’ve been accused or convicted of serious crimes. For example, we might evaluate someone to help a court determine whether the person is competent to stand trial, or whether they should be found not guilty by reason of insanity.

Identifying whether a person has psychopathic characteristics may also be relevant to how a court sentences them after conviction. Individuals with more psychopathic characteristics typically present a higher risk for future criminal behavior. As such, because of the discretion given to judges and juries when it comes to sentencing in most states, courts are more likely to give a longer sentence because of the increased risk to public safety.

One of the most widely used psychopathy assessment tools, the psychopathy checklist-revised, or PCL-R, has been the subject of tremendous research over the past few decades.

Most studies find that the PCL-R can reliably identify psychopathic characteristics in both research and clinical settings. Individuals with higher PCL-R scores are more psychopathic and, therefore, at higher risk of engaging in future criminal behavior.

Horsch house of horrors

In 1985, R.C. Horsch was convicted in federal court of charges related to counterfeiting and methamphetamine manufacturing. As part of the federal sentencing proceedings, he underwent a lengthy psychological evaluation, which the Philadelphia Inquirer obtained through a federal records request.

The psychologist described Horsch as “grandiose, mistrustful, suspicious and excessively controlling,” and noted that he was “consumed by anger.” He concluded that Horsch likely had bipolar disorder and paranoid personality disorder.

The psychological evaluation found that Horsch had several characteristics associated with psychopathy, but he was not identified as psychopathic. Why?

One answer is that the tests used to identify psychopathic characteristics had not yet been developed in 1985. Although a precursor to the PCL-R was developed in 1980, it was not commercially available, and the PCL-R was not commercially released until 1991. Other psychopathy assessment tests were not developed until after the PCL-R.

Latest research on psychopathy

An astonishing level of research regarding psychopathy has been conducted since the early 1990s.

Some research has found that the introduction of psychopathy evidence in both American and Canadian courts has increased dramatically over the past few decades. In these cases, psychopathy evidence is primarily used by the prosecution to argue for a more severe punishment of a convicted defendant.

There is also evidence that psychopathy evidence is being inappropriately relied on in death penalty cases. The PCL-R has not been proven to predict violence among inmates on death row or in highly restrictive prison settings. However, it can reliably predict violence among inmates in less secure correctional settings and among individuals about to be released from incarceration.

Other research has focused on the brain structure and function associated with psychopathy. Studies have found that the brain region associated with thrill-seeking and impulsive behavior is larger among people with psychopathic characteristics, while regions associated with emotional regulation and fear processing are smaller.

Identifying psychopathic characteristics before someone engages in violence is the ideal. However, most psychological evaluations of people involved in the criminal justice system take place only after the person has been arrested or convicted.

But if a psychological evaluation is conducted after an individual has been arrested for or convicted of a less serious crime, or when someone is showing early signs of antisocial behavior, the identification of psychopathic characteristics could help courts and treatment providers intervene before there is an escalation to violence.

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David DeMatteo does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.