The analysis includes clinical viewpoints, existing theory, socioenvironmental influences, and actual case histories. The serial murderer is examined in the context of the "Diagnostic and Statistical Manual of Mental Disorders." The theory developed consists of three separate stages. Stage 1, called the "foundation of pathology," involves biological predisposition, environmental trauma and stressors, the development of esteem and control problems, and sexual dysfunction. Stage 2, called the "path of stressors and development to first murder," focuses on the development of maladaptive coping skills, retreat into a fantasy world, the commission of lesser crimes, the dissociative process, and finally the first kill. The third stage, called the "obsessive-compulsive and ritualistic cycle," involves the renewed urge to kill after the first killing, a cooling-off period, and the continuation of the cycle. The study concludes with a discussion of the theory's limitations and suggestions for further research and theoretical development. 4 figures, appended case briefs, 162 references, and a subject index