What psychiatrists think of the "affluenza" defense

Ethan Couch (with hair dyed black) in image released by Mexican authorities; and right, his mother Tonya Couch in previous photo.
CBS News

Last Updated Dec 30, 2015 9:17 PM EST

"Affluenza" is back in the news -- and the term has many mental health experts shaking their heads.

Ethan Couch, the Texas teen who gained notoriety after avoiding jail time following a fatal drunk driving crash in 2013 by using a defense of "affluenza," was captured along with his mother in Mexico on Monday. The pair fled the country in early December as authorities investigated whether Couch had violated the terms of his probation.

Couch's light sentencing was highly criticized at the time of his trial. His defense lawyer argued that his wealthy parents coddled him into a sense of irresponsibility -- a condition an expert witness referred to as affluenza.

Though the argument helped keep Couch, now 18, out of prison, affluenza is not a recognized medical diagnosis by the American Psychiatric Association.

"First and foremost, this is not a psychiatric diagnosis," Dr. Jeffrey L. Metzner, a forensic psychiatrist at University of Colorado Denver, told CBS News.

Metzner said the characteristics described in the defense, such as entitlement, lack of empathy, and lack of boundaries, sound similar to narcissistic personality disorder, which is a recognized mental health condition described in the latest edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the official system for diagnosing mental health disorders.

"But even if it were narcissistic personality disorder, when it comes to responsibility or non-responsibility, that's not an accepted excuse," Metzner said. "If that were an accepted excuse, we wouldn't be seeing a lot of guilty people in these cases."

The term affluenza gained popularity in the late 1990's with the release of "The Golden Ghetto: The Psychology of Affluence," a book written by Jessie O'Neill, the granddaughter of a past president of General Motors. It describes the condition in which children, generally from wealthy families, have a sense of entitlement, make excuses for bad behavior, and can have addictive or compulsive behaviors, including drug and alcohol problems.

O'Neill's website, The Affluenza Project, bills itself as a resource for the public and professionals to help address the problem of affluenza, and it offers services including consultations and in-person and phone therapy.

During Couch's trial, psychologist Gary Miller testified that the boy grew up in a house where his parents were preoccupied with arguments that led to a divorce.

Miller told the judge that the boy's father "does not have relationships, he takes hostages." He said the boy's mother was indulgent: "Her mantra was that if it feels good, do it."

Metzner, who was not involved in the case, acknowledged that this type of behavior can certainly affect children. "Problematic parenting causes a ton of problems," he said. "It can certainly lead to issues with limits and boundaries and appropriate behavior."

However, he emphasized that this is by no means a legitimate defense in court.

As Dr. Gary Buffone, a Jacksonville, Fla., psychologist who does family wealth advising, told the Associated Press in 2013: "The simple term would be spoiled brat."

Authorities tracked down Couch and his mother Tonya, 48, in the resort town of Puerto Vallarta on Monday after one of their phones was used to order delivery from Domino's Pizza. CBS News legal analyst Rikki Klieman says Couch is unlikely to face much jail time after he is returned to the U.S., but his mother could face felony charges.

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