Multiple Vantage Points on the Mental Health Effects of Mass Shootings

Abstract

The phenomenon of mass shootings has emerged over the past 50 years. A high proportion of rampage shootings have occurred in the United States, and secondarily, in European nations with otherwise low firearm homicide rates; yet, paradoxically, shooting massacres are not prominent in the Latin American nations with the highest firearm homicide rates in the world. A review of the scientific literature from 2010 to early 2014 reveals that, at the individual level, mental health effects include psychological distress and clinically significant elevations in posttraumatic stress, depression, and anxiety symptoms in relation to the degree of physical exposure and social proximity to the shooting incident. Psychological repercussions extend to the surrounding affected community. In the aftermath of the deadliest mass shooting on record, Norway has been in the vanguard of intervention research focusing on rapid delivery of psychological support and services to survivors of the "Oslo Terror." Grounded on a detailed review of the clinical literature on the mental health effects of mass shootings, this paper also incorporates wide-ranging co-author expertise to delineate: 1) the patterning of mass shootings within the international context of firearm homicides, 2) the effects of shooting rampages on children and adolescents, 3) the psychological effects for wounded victims and the emergency healthcare personnel who care for them, 4) the disaster behavioral health considerations for preparedness and response, and 5) the media "framing" of mass shooting incidents in relation to the portrayal of mental health themes.

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“…EDs are high-stress environments and workers are often exposed to violent acts during their regular work. 29 Their reported coping mechanisms were consistent with prior research about how protective skills and resilience develop after traumatic events. 30 Some described ways they were increasing their personal safety independent of work, including possible gun acquisition.…”

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“…The uniform and comprehensive reporting of major incidents, requiring an agreed nomenclature, needs to be improved, and will facilitate progression in research [74]. A reporting tool for this purpose has recently been created [5].…”

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“…There are many theories and explanations offered by the literature to understand the precipitating factors behind the mass shootings. According to the "Trinity of Violence" theory, the availability of firearms, a motivated murderer, and random targets are the risk factors behind violent massacres [6]. This theory suggests that while mental illness and anger are factors that precipitate a mass attack, it is more related to the perpetrator's personal experiences of tarnished self-worth that leads them to act aggressively [6].…”

“…According to the "Trinity of Violence" theory, the availability of firearms, a motivated murderer, and random targets are the risk factors behind violent massacres [6]. This theory suggests that while mental illness and anger are factors that precipitate a mass attack, it is more related to the perpetrator's personal experiences of tarnished self-worth that leads them to act aggressively [6]. Apart from mental illness, other factors that contribute to the violent mass shootings include substance abuse, anger issues, impulsive behavior, and discrimination in society [6].…”