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Slowerfaster — Dorothea was a classic head study. Here’s a lengthy answer to your question, from the book’s Chapter 20:

Her personal psychiatrist, Dr. Thomas Doody, once described Dorothea as a “seriously disturbed woman.” Several specialists, including a psychologist familiar with criminal behavior, suggested in official reports that Dorothea exhibited schizophrenia dominated by histrionic, narcissistic, and antisocial personality disorders. Her actions during the past thirty years, particularly those of her last few days of freedom, indicate the doctors may be right.

According to many criminal psychologists, personality disorders differ significantly from most psychological disorders, the latter generally being traceable to one (or a few) specific incidents in one’s life. Personality disorders, on the other hand, involve an identifiable pattern of lifelong development that permeates both behavior and thought. This in turn colors an individual’s whole sense of being, self-image, and internal rules for dealing with fellow human beings. A person thus afflicted has a completely distorted view, both of self and society.

Dr. Lunde notes that “some psychotic conditions have a known organic cause.” One such condition is hyperthyroidism, and Dorothea is known to suffer from, and has been treated for, thyroid problems.

Some of Dorothea’s more visible affectations were her preference for bright, boldly colored clothing; her abundance of flashy (but real) jewelry; and her tendency toward grandiose descriptions of herself and her activities. A person displaying elements of histrionic personality disorders tends to be overly dramatic and excitable, exaggerating almost everything and insisting upon being center stage. Many more women than men are diagnosed as having this disorder. Easily provoked to sudden fits of temper, histrionic people form friendships quickly but soon begin to make unrealistic demands on others.

Dorothea’s narcissistic tendencies were manifested in her flamboyant behavior (buying drinks for everyone in the bar with a fat wad of cash), her constant exaggerations (claiming to be a surgeon or nurse), and her overwhelming concern about how she was perceived by others.

The narcissist’s concern for him- or herself all but eliminates the capacity to feel any emotion for people. For this reason, it is possible that the apparent empathy Dorothea showed for certain tenants, such as John Sharp and Bert Montoya, was feigned.

Dorothea’s antisocial behavior was evident from the time she was nineteen years old. That was when she was first arrested and convicted of forgery, an activity she not only continued throughout her lifetime, but accelerated.

In most aspects of life, criminal psychologists contend, antisocial people are amoral, often flagrantly violating the rights of others and usually breaking the law. These people will admit to no culpability when caught in their transgressions, as they inevitably are. They are completely incapable of feeling guilty. They find it easy to concoct complex schemes but always lose control of those schemes. They minimize their errors, are incapable of learning from past mistakes, and have great trouble forming personal attachments.

Over years of psychoanalysis, Dorothea has made a habit of minimizing her transgressions, and once told a police officer who was arresting her that she often forgot committing the criminal acts of which she was accused.

Individuals afflicted with personality disorders may lead outwardly normal lives, and become the last to admit that they might need professional treatment.

Because antisocial behavior so often involves criminal activity, it is the most studied personality disorder. An outdated term for an antisocial criminal, psychopath, has been supplanted by the term preferred in modern analysis, sociopath. If the actions of a sociopath are reinforced during his or her life (resulting, for example, in financial success), the behavior dominates.

Dorothea does seem to deviate from the classic antisocial pattern in one important way: Most of the crimes for which she has been convicted were committed for the purpose of financial gain. (If present charges against her stand up in court, the pattern will have continued to an almost predictable conclusion.)

Her repeated forays into the board-and-care business reflect a taste for risk that was satisfied by undertaking bold actions she knew were forbidden to her. She flaunted her behavior in front of her own parole agents, perhaps daring them to catch her.