IMBECILITY, IMBECILES. - Imbeciles or "biopathic frenasthenics (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 taints, although those toxic or infectious factors of such importance in the genesis of idiocy are not excluded, though to a less severe degree.
On the organic side, imbeciles do not present those severe anomalies and malformations proper to idiots, nor that neurological symptomatology of the motor sphere so manifest in idiocy; often, however, there is present in them a defective and insufficient bodily development, smallness of the skull (submicrocephaly), dysmorphies of the head, face, teeth, ears, etc., morphological atypies revealing the familial degenerative tendency. Intermediate forms not easily classifiable in either group ("imbecile-idiots" or "bio-cerebropathic frenasthenics") are described by some (S. De Sanctis).
The degree of intellectual development of imbeciles is greater than that of idiots, but does not on the whole surpass that of a child approaching puberty. The deficiency appears from the torpidity of perception, such as is the activity of the sense organs, and from the lability of attention; particularly poor are the higher powers of the mind, which manifest themselves in the incapacity for abstract concepts, for establishing new connections among them, for weighing their value in reasoning. In some imbeciles there stands out a unilateral development, of a mechanical type, even to a very high degree, of certain faculties (musical ear, redundant verbosity, memory for dates and numbers, extreme facility in mental calculation, etc.); elements, however, not organically utilized in reasonable mental constructions.
With regard to temperament, imbeciles appear under the torpid type or the excitable type. The former maintain toward their environment a disinterested and apathetic demeanor, with a tendency to reflex automatism; the expression of the face is inexpressive, the gestures slow and heavy, the subject remains docile without taking any initiative. Excitable imbeciles appear restless, aggressive, inconstant and capricious in their will, manifesting an external activity that is often continuous and unceasing, which nevertheless betrays, in the discontinuity and incoordination of its object, the illogicality and incoherence of the motives that animate it; for which reason they are also called unstable, particularly when, the character of aggressiveness passing into second place, that of dispersion in psychic activity and dissipation in practical conduct prevails. Excitable imbeciles, by the inclination of their ideas to tumult and logical incoherence, tend to fantasy-spinning, to mental constructions and to a manner of speaking in which the mnemonic activity is falsified by fantasy, the stamp of objectivity completely absent, the judgment deficient; hence the tendency to distortion of facts and to being very often liars, not in the sense of a lie deliberately willed for the purpose of deceiving or deriving advantage, but because of the disorder of the fantasy, because of the lack of fidelity and tenacity of memory. Thus, similarly to what happens in other psychic and psycho-neurotic abnormals, one can arrive at testimonies and accounts that are concatenated and plausible, yet completely devoid of correspondence to reality ("fantastic pseudologia," "mythomania").
The moral conscience of imbeciles marks the same level as their intellectual conscience, very often anomalous and perverted because of the complete absence of the higher sentiments, for which reason the majority of such subjects must be considered amoral and antisocial. Sexually, the severe or complete deficiency of modesty often manifests itself in shameless forms of abuse and perversion. In a particular category of such patients, the lack of moral sentiments comes so much to the fore as to give the individual the tonality of the so-called "moral imbecile" or "moral lunatic," while some speak outright of "constitutional immorality," characterized by absolute insensitivity to higher motives in the regulation of actions, intolerance of restraint and of social bonds, ineducability, affective dullness, insensitivity to the sufferings of others, tendency to associate with others or to let oneself be dominated (henchman) by others in delinquent activities, to slide into aberration and sexual crimes. The so-called "positive criminal school," with C. Lombroso and E. Ferri as its proponents, sought to create the type of the "born criminal," characterized also by particular somatic anomalies which, according to the supporters of such an anthropological type, would have had the value of ancestral degenerative characters, a mark of arrests or returns in the normal phylogenetic evolution of the human race. Such an individual, because of the known characteristics of ineducability and constitutional irresponsibility, would have benefited from the most absolute non-imputability.
At present the classic Lombrosian concept has lost the value dear to the materialistic conception of the human person, proper to the era in which it arose; on the one hand, a delinquent constitution in the strict anthropological sense of the word is no longer admitted, great importance being given, alongside the neuropsychological characteristics of the subject, to education and environment as determining factors of crime; on the other hand, statistical investigation shows that the great majority of those confined in penal institutions is made up of ordinary individuals, not somatically predestined to delinquency (v. ANTROPOLOGIA CRIMINALE; DELINQUENTE). It is clear that this is not intended to exclude the eventuality of the insane delinquent.
The educability of imbeciles cannot be traced in an absolute manner, given that it is subordinate to the degree of mental development of the subject; within the family, it is reduced most often to a work of social isolation that may be useful from the prophylactic side, especially in those cases in which the clinical particularity of the illness renders the individual dangerous to society. Apart from prudential isolation in mental institutions, some work of developing whatever measure of faculties is present and educable in individual imbeciles can be accomplished only with modern scientific methods, implemented by personnel technically trained in suitable institutions, particularly in those less affected subjects, a group transitional to the less severe or minor frenasthenics (v. MINORATI PSICOLOGICI).
Imbecility, in relation to the profound degenerative causes and to the possible more or less manifest anatomical alterations of the encephalon, particularly of the cortical zone, is not susceptible of medical cure; when congenital syphilis enters into the picture, a very early specific treatment will be justified, from which one may hope, in some cases, for an arrest of the disease and less damage to the individual. Apart from this, treatment will remain symptomatic, particularly sedative (bromides, luminal, etc.) in the forms with excitation.
In the genesis of imbecility, as has been said, the hereditary factor plays a strong role; this not understood in the erroneous sense that the repetition of the disease occurs similarly and fatally in the totality of descendants, but in the manner of reappearance with those characteristics of return and of percentage proper to alternating Mendelian heredity, at times of a dominant type (mild forms), at times recessive (severe forms). On the other hand, the so-called blastophthoria cannot be considered hereditary in the strict sense, in relation to the action of particular harmful agents (alcohol, syphilis, etc.) extrinsic to the individual, which have acted on the plasma of the germ cells altering their integrity; through this path, the birth of frenasthenic individuals from parents of normal intellectual development may occur.
With regard to the administration of the Sacraments, the subject's level of mental development must be kept in mind, and correspondingly the degree of understanding and deliberateness attributable to his conscience and his actions; therefore, while Baptism must always be administered, the other Sacraments will be denied, or given under condition or else in those cases in which a minimum of disposition can be counted upon (v. the respective entries on the various Sacraments).
Bibliography4 works
Giuseppe de Ninno