Man, I remember watching a film about serial killers in psychology class. Some of these guys just get twitches they can't explain and go on a spree.
No, but the guy did mention that all that had to happen was for someone to randomly bump into him or that he'd just see a random woman and profile her on race and if she dressed like a hooker or not. Then, he'd lose it. Most likely, it had to do with the wiring of his brain.