Those that know how to be brutally effective in street fighting or on the battlefield in do-or-die situations do so by being mentally committed and driven in the objective of using ruthlessly controlled simple gross motor skills violence to neutralise their adversary in the quickest and most brutal manner possible. They choose such methods because they know the effect they can achieve.
At close quarters body contact range, eye gouging, biting, attacking the genitals and life-support human bodily vitals by means of armed or unarmed options are primary practices of formidable foe threat neutralisation. Those suffering from mental illness when cornered may well rush and attack whoever is in front of them. When contained and controlled instinctively out of self-protection and self-preservation or to escape they may try and injure whoever is stopping them from doing what they want to do. Sometimes they will attack and cause injury by brutally primitive means that can cause serious injury and incapacitate even the highly trained.
This shows how some, both sane and insane, will use instinctive or deliberate primitive brutally destructive gross motor skills methods of threat neutralisation that can make even an underdog dangerous. It also identifies the fact that some of the most basic brutal ways to cause injury to an adversary at extreme close quarters body contact range are not by highly trained fine to medium motor skills techniques.
Children can, when agitated, angry or under threat, resort to some very similar primitive but immediate means of stopping being hurt, getting even, or getting away, like scratching and biting. Just like adults with bad deliberate intentions and those with mental illness when cornered and contained children under threat can resort to primitive instincts and actions.
Such skills provide the capability to injure incapacitate or even kill adversaries of greater skills and physical attributes and capabilities. An aggressor with a ruthless mentality, bent on doing you grievous bodily harm, for whatever reason, by the most primitive brutal means is extremely dangerous.