IMBECILITY, IMBECILES. — Imbeciles or “biopathic feebleminded” (v.) are individuals in whom mental insufficiency, more or less severe but always less than that of idiots (v.), is due particularly to hereditary neuropathic defects, though toxic or infectious factors of such importance in the genesis of idiocy are not excluded, albeit to a lesser degree.
Organically, imbeciles do not exhibit the severe anomalies and malformations characteristic of idiots, nor do they show the manifest neurological symptomatology of the motor sphere so evident in idiocy. Often, however, they present a defective and insufficient physical development, small skull size (submicrocephaly), dysmorphisms of the head, face, teeth, ears, etc., morphological atypias revealing a familial degenerative tendency. Some authors (S. De Sanctis) describe intermediate forms not easily classifiable in either group (“imbecile-idiots” or “bio-cerebropathic feebleminded”).
The degree of intellectual development in imbeciles is greater than that of idiots but does not exceed, roughly, that of a child approaching puberty. Deficiency is evident in the sluggishness of perception, such as the activity of the sensory organs, and in the lability of attention; particularly poor are the higher powers of the mind, which manifest as an inability to grasp abstract concepts, to form new connections between them, or to evaluate reasoning. In some imbeciles, unilateral development of certain faculties (musical ear, redundant verbosity, memory for dates and numbers, extreme ease in mental calculation, etc.) may reach a high degree, though these faculties are not organically integrated into coherent mental constructions.
In terms of temperament, imbeciles may be of the torpid or excited type. The former display an indifferent and apathetic attitude toward their environment, with a tendency toward automatic reflex behavior; their facial expression is inexpressive, gestures slow and heavy, and they remain docile without taking any initiative. Excited imbeciles appear restless, aggressive, inconsistent, and capricious in their will, often exhibiting continuous and unceasing external activity that, however, betrays the illogicality and incoherence of the motives driving it; hence they are also called unstable, especially when the character of aggressiveness gives way to a dispersal of psychic activity and dissipation in practical conduct. Due to the tumultuous and logically incoherent nature of their ideas, excited imbeciles tend toward fantasy, mental constructions, and speech in which memory is distorted by imagination, objectivity is entirely absent, and judgment is deficient; hence they often distort facts and are prone to lying—not in the sense of deliberate deceit for personal gain, but due to the disorder of their imagination and the lack of fidelity and tenacity in memory. Thus, similar to what occurs in other psychically and psycho-neurotic abnormal individuals, they may produce coherent and plausible testimonies and narratives entirely devoid of correspondence to reality (“fantastic psychology,” “pseudologia fantastica”).
The moral consciousness of imbeciles matches their intellectual level, often being abnormal and perverted due to the complete absence of higher sentiments; hence the majority of such individuals must be considered asocial and amorally inclined. Sexually, a severe or complete lack of modesty often manifests in shameless forms of abuse and perversion. In a certain category of these patients, the absence of moral sentiments is so pronounced that the individual takes on the character of the so-called “moral imbecile” or “moral madman,” while some speak even of “constitutional immorality,” characterized by absolute insensitivity to higher motives in regulating actions, intolerance of restraint and social bonds, suggestibility, affective dullness, insensitivity to others’ suffering, a tendency to associate with or be dominated by others in delinquent activities, and a propensity to slide into sexual aberrations and crimes. The so-called “positive criminal school,” with advocates such as C. Lombroso and E. Ferri, sought to create the type of the “born criminal,” characterized also by particular somatic anomalies that, according to the proponents of this anthropological type, would have the value of ancestral degenerative traits, indicative of arrested or regressive stages in the normal phylogenetic evolution of the human species. Such an individual, due to the noted characteristics of unteachability and constitutional irresponsibility, would benefit from absolute non-imputability.
Currently, the classic Lombrosian concept has lost its value, tied as it was to the materialistic conception of the human person prevalent in its time. On the one hand, a criminal constitution in the strict anthropological sense is no longer admitted; instead, great importance is given, alongside the neuropsychological characteristics of the subject, to education and environment as determining factors in crime. On the other hand, statistical research shows that the vast majority of inmates in penal institutions are ordinary individuals, not somatically predestined to criminality (v. criminal anthropology; delinquent). It is clear that this does not exclude the possibility of the criminally insane.
The educability of imbeciles cannot be determined absolutely, as it depends on the subject’s degree of mental development. Within the family, it often reduces to a work of social isolation, which may be useful from a prophylactic standpoint, especially in cases where the clinical particularity of the condition renders the individual dangerous to society. Apart from prudent isolation in asylum institutions, some development of the limited and educable faculties present in individual imbeciles may be achieved through modern scientific methods, administered by technically trained personnel in suitable institutions, particularly in less severely affected subjects—those on the borderline with milder feeblemindedness or minor psychic disabilities (v. MINORATI PSICHICI).
Imbecility, given its deep-seated degenerative causes and any more or less evident anatomical alterations of the brain, particularly in the cortical region, is not amenable to medical cure. When congenital syphilis is involved, a very early specific treatment may be justified, from which, in some cases, a halt to the condition and less severe impairment of the individual may be hoped for. Otherwise, treatment remains symptomatic, particularly sedative (bromides, luminal, etc.) in cases of excitation.
In the genesis of imbecility, as noted, the hereditary factor plays a strong role—not in the erroneous sense that the repetition of the condition occurs identically and inevitably in all descendants, but rather in the manner of a reappearance with those characteristics of return and percentage typical of Mendelian heredity, sometimes dominant (mild forms) and sometimes recessive (severe forms). Strictly speaking, the so-called blastophthoria cannot be considered hereditary; this refers to the action of particular harmful agents (alcohol, syphilis, etc.) extrinsic to the individual that have affected the germinal plasma, altering its integrity. Through this means, feebleminded individuals may be born to parents of normal intellectual development.
With regard to the administration of the Sacraments, the level of mental development of the subject must be taken into account, as well as the corresponding degree of understanding and deliberation that can be attributed to his conscience and actions. Therefore, while Baptism must always be administered, the other Sacraments will be denied, or given conditionally or otherwise, in those cases where a minimum of disposition can be relied upon (see the respective entries for the various Sacraments).