(brand new lurker here - hope its okay to drop in some thoughts) I've not yet read the book - so I'll start by saying thank u - I love coming across good reading suggestions.)
I grew up in South Africa which is meant to be 3rd in the world of highest serial killers (I know technically Gein isn't classed as one) and that fact always surprises because of the sheer brutality which passes for the 'norm' (rape, murder, human trafficking animal cruelty)
So we have our fair share of serial killers and rapists (if interested Moses Sithole, the ABC killer ; is worth reading - very violent) their acts - in my opinion - a reflection of the widespread violence and depravity experienced by millions.
I have moved to the UK - and while I know there is no such thing as a perfect country - I'm always stunned by how much the 'average everyday person' genuinely doesn't have ill will against another and its recently got me interested in the psychology of a society and how the 'big stuff' going on up top reflects in the every day person - for example shortly after the Russian state took over farms and caused wide spread famine in the USSR the world was gifted Andrei Chikatilo
....
would love to hear other's thoughts - I completely agree with the other factors as well (mental illness, brain injury, childhood and having the right mix that would make a person want to make nipple belt) but am also curious about how a society can be 'diagnosed' (in a sense) based on the crimes their people commit