That photo doesn’t show the story in my opinion. If you look at the video you see him pounding his chest - I’m the king of the hill, nothing can stop me, nothing can get in my way. That’s the way I would read it.
I don’t think the elbow to the head was deliberate per se, but rather he showed complete disregard for anything around him - he was in a frighteningly dangerous state.
Really, he pounded his chest multiple times with his right hand, never borught up his left until the elbow, never brought his left to his chest. It was deliberate. If you slow it down, you can see him shoot a stare at Harden.
If the elbow wasn’t deliberate it’s only because Artest is so egotistical that he couldn’t be bothered to notice the guy walking up to and past him and TOUCHING him before he swung his elbow. It was either a willful level of ignorance or deliberate, and given the frequency of his suspensions deliberate seems likely.