Police in St. Johns, Ariz., allege that an 8-year-old boy gunned down his father, Vincent Romero, and his father's co-worker, Timothy Romans, using a .22-calibre rifle. They say the crime was planned and methodically carried out. Prosecutors have not yet announced whether they will seek to try the 8-year-old as an adult.

First things first_ Without access to the information that police have at this time, the public should withhold judgment about the veracity of the 8-year-old boy's confession. False confessions are common enough in traumatized, eager-to-comply adults, let alone kids. Three other children between the ages of 7 and 8 have confessed to murder since 1958; none of them committed the killings.

Assuming that the boy in Arizona is indeed the perpetrator, mental health professionals will have the task of trying to ascertain why he committed two murders. Already, neighbors and friends and school officials have commented that the boy seemed perfectly normal, seemed to have a good relationship with his dad and had no history of violence.

As a forensic psychiatrist I have evaluated many killers and testified about them in court, not to mention treating dozens of very violent people. And I promise you that, if responsible for these murders, there is indeed a psychological explanation why the boy committed them.

Possible explanations include the boy suffering an underlying mental illness causing a delusion (a fixed and false psychotic belief) or hallucinations. Conditions like bipolar disorder, for example, can (in a great minority of cases) trigger paranoia and even voices commanding one to carry out actions that would normally be abhorrent to the afflicted individual. No one has suggested that Romero's son suffered such a condition, but clinicians will need to rule out the possibility.

If the boy has been under treatment for any psychiatric symptoms with medications, the possibility of a medication side effect has to be explored. Some psychoactive medications can, in rare cases, prompt violence against oneself or others. The same is true, by the way, for some medicines used to treat medical conditions, like asthma.

Even in an 8-year-old, the remote chance that a mind-altering substance could be involved - perhaps belonging to someone else who was present at his school or in his home - has to be excluded. That should be relatively easy to do by taking a detailed history from the boy and testing his blood and urine.

Neurological explanations have to be entertained. An MRI or CT scan of the alleged killer's brain can tell investigators whether or not pathology like a brain tumor could be responsible. The possibility is small, but can't be dismissed out of hand. Even an infection of the 8-year-old's cerebrospinal fluid - the fluid that bathes the spinal cord and the brain-has to be formally eliminated as a possibility.

Chances are, however, that the why for these killings would reside in the emotional pathology of the alleged killer, not his brain pathology. Some trauma or series of traumas, near or far in time, has to have occurred, in order to make this child either desperate enough to kill or cold-blooded enough to kill. In sixteen years practicing psychiatry, I have never met a murderer who was born evil. In every case, I eventually learned the circumstances that extinguished that person's empathy.

So if this 8-year-old boy is indeed a murderer, the search will be for the roots of his violence. We have only a hint which questions to ask from the news coverage to date. But here are a few: Why was the boy's father awarded sole custody of him? Why is his mother residing in Mississippi, rather than closer to him? What are the details of the boy's living arrangement, including the fact that his father had rented out a room in the house to his co-worker?

The truth of this 8-year-old and his alleged violence is knowable. The key to finding it is in asking enough questions and never buying into the myth that killers are born. They are made. And when one is made by age 8, enough bad has happened in eight years to make the unthinkable actually occur.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement. Check out Dr. Ablow's website at

livingthetruth.com

or e-mail him at

info@keithablow.com

.

Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team.