At this point, it appears that James has schizoid personality disorder and is intermittently functioning at a psychotic level. His ability to mentalize about others' states of mind is very impaired and he may on the autism spectrum. He may be shifting insidiously into a frank psychotic disorder such as schitzoprenia, though does not have the more rapid worsening of functioning typical of most psychotic breaks. His fear/hatred of humans has markedly impaired him - though he seems very intelligent it appears he will drop out of grad school program due to his impairrd interactions. (Metzner 2013, s. 24, alaotsikko: "Past medical history")

Mr. Holmes talked about having a Plan A, which involved killing himself and a Plan B, which involved killing others add then killing himself. (Metzner 2013, s. 25, alaotsikko: "Information obtained from Jonathan Woodcock, M.D.")

In undergraduate school at University of California. Riverside. [Mr. Holmes'] fellow students reported that he often preferred to keep to himself. He engaged ia social gaterings that others in the dorm participated in but ondy after receiving much encouragemen from everyone. A fellow student described James as having a "spacing out stare" more often than she could remember. She stated that he appeared this way so much that he would look "sleepy." A former roommate stated that James was a "loner" and liked to go off by himself. He stated that James was usually quiet and did not like to socialize... (s. 44, alaotsikko: "Educational history")

After graduating frokm UC-Riverside, Mr. Holmes applied to many top tier neuroscience schools in 2009 but was rejected by all of them. (s. 44, alaotsikko: "Educational history")

Mr. Holmes struggled in all his research lab rotations. Research assistants reported that James appeared disinterested or distracted from his wvork and they stated that he had difficulty performing the processes he needed to perform for the experiments. Assistants described him as leaving the lab in the middle of experiments to go home, not following through with experiments, and lacking motivation. He did not complete the experiments that were assgned to him by the end of his rotation ... James presented information and results based on literature from the previous 20 years, rather than explaining results he received in his experiments. Dr. Klug and his lab mates described his presentation as "awkward" containing jokes that fell flat on the audience and cartoors inserted into the Powerpoint. (s. 46, alaotsikko: "Educational history")