ArticleJournal of affective disorders2026
Pre-attack crisis indicators in mass shooters: Differences across no-, single-, and dual-harm groups.
Article in Journal of affective disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
introductionEvidence suggests that a non-negligible number of mass violence perpetrators experience psychological distress or crisis before the attack. Prior research comparing histories of self- and other-harm suggested that those who engaged in both face elevated risks of adverse outcomes. However, despite its potential, this framework has not been used to examine pre-attack crisis signs among mass shooters.
methodsUsing The Violence Project Database, we analyzed data from 197 U.S. mass shooters in public incidents (1966-2023). Participants were classified into harm-level groups: no-harm, single-harm (either self- or other-harm), and dual-harm (both). We conducted a latent class analysis (LCA) using eight crisis indicators from the months preceding the shootings to identify unobserved profiles.
resultsOne-third had a history of suicidality, over half had harmed others, and 20.3 % met the criteria for dual-harm. The LCA identified four classes: (1) Depressed and agitated, (2) No-crisis, (3) Psychotic symptoms, and (4) Emotionally labile and aggressive. The Emotionally labile and aggressive class showed a significant overrepresentation of dual-harm individuals and was marked by abusive behavior, mood instability, and agitation. The No-crisis group, the largest class, showed low levels of crisis indicators, even though many members had histories of harm.
conclusionsFindings suggest that mass shooters vary in the pre-attack crisis indicators and can be classified into distinct groups. Although three-fifths of mass shooters had no pre-attack crisis indicators, a non-trivial number did exhibit identifiable signs of crisis, highlighting the heterogeneity in pre-attack crisis indicators and suggesting the need for prevention strategies that account for different profiles and needs. A harm-based trichotomy framework (no-harm, single-harm, and dual-harm) may help identify those with more acute emotional and behavioral risk.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.