The text draws on public and private records, including the killers' diaries and confessions, correspondence, photographs, police documents, psychiatric interviews, and court testimony, to show that despite the best efforts of psychiatrists, it is almost impossible to prove these killers clinically insane. These killers, generally, are found on the margins of the lower middle class, and their victims tend to represent the classes a tier or two above that have excluded them. Any sexual satisfaction derived from these murders is never the primary objective. Rather, the rapes, tortures, and murders appear to be meant as a kind of primitive rebellion against the social order that nets the killer revenge, identity, and celebrity. All invariably derive a great personal fulfillment from their bloody crusades against society, and this is their major motivation for killing. Rather than insanity, these killers are driven by the central themes of modern culture: success and failure, worldy ambition, and avenging violence. Chapter footnotes and 117 references. (Publisher's summary modified)