Could We Phenotype Mass Killers and Prevent Murder-Suicides?

No one can accurately predict who will be the next American mass killer. Not you, not I, not schoolteachers or psychologists, not police officers, not Governor Abbott, not Wayne LaPierre, not parents, not priests, not spouses, probably not even forensic psychiatrists. Mass killers aren’t even typically classifiable as “mentally ill,” so general calls for better mental health, although always welcome, are unlikely to prevent such human slaughter events as Columbine, Charleston, Sandy Hook, Parkland, El Paso, Las Vegas, Buffalo, or Uvalde.

None of us can predict when or where, but we can predict (sadly with certainty) that there will be another, and another…

Criminology and criminal justice professors Jillian Peterson and James Densley, funded by the National Institute of Justice, compiled life histories of 180 American mass public-place shooters since 1966 and all mass shootings in schools, workplaces, and places of worship since 1999, in their 2021 book The Violence Project: How to Stop a Mass Shooting Epidemic.

They identified shooter characteristics: male, early childhood trauma (violence in the home, sexual assault, parental suicide, extreme bullying), hopelessness, despair, isolation, self-loathing, rejection by peers, previous suicide attempts. Self-hate turned outward to blame a group: a race, a religious congregation, women, school classmates. A quest for fame, notoriety, or a desire to perform a copy-cat act — a form of social contagion. Almost all planned to commit violent suicide along with mass homicide as their final act.

Labelling the climax of this experiential psychopathologic cascade as “pure evil,” “terrorism,” “hate crime,” or “the acts of monsters” explains, solves, and prevents nothing. Before they were shooters, they were sons, grandsons, neighbors, and classmates. Shortly before the mass killing, many shooters gave out signals, possibly “cries for help,” such as purchasing assault weapons and a plethora of ammunition soon after attaining an age of eligibility, hinting or boasting to acquaintances, making a call to a mental health facility, or posting on social media.

If those motivated to commit mass murder and suicide had access only to baseball bats, switchblades, garrotes, nooses, cyanide, gasoline and matches, SUVs, fentanyl, anthrax, kitchen knives, single-shot long guns, long shotguns, pistols and revolvers, even bayonets, swords and machetes, kill they would, but in big numbers in one fell swoop? Nope, unless perhaps by means of a bomb, a large fire in a crowded building, or by intentionally crashing a large airplane.

For a single individual to kill many humans quickly requires weapons of modern warfare. As I wrote in Medscape in 2017:

Please help me understand why any American not in the military, organized law enforcement, or who is not a museum collector should have a right to own live functional bazookas, hand grenades, mortars, rocket-propelled grenades, land mines, nuclear bombs, napalm, automatic rapid-fire machine guns (1200 rounds per minute [RPM]), submachine guns and machine pistols (1000 RPM), automatic assault rifles (900 RPMs), or semiautomatic (fires one round per trigger pull; 150 RPMs in theory but must reload) with 30-round ammunition carriers, Colt AR 15s, Kalashnikov AK-47s, and so on.

The 2nd Amendment of the US Constitution, enacted in 1789 and ratified in 1791, reads “A well-regulated Militia, being necessary to the security of a free state, the right of the people to keep and bear Arms, shall not be infringed.”

No way did those writers imagine “Arms” to refer to weaponry as described above. I mean, really?

For more than 200 years that Amendment was interpreted by scholars and judges to mean “Militia” like it says. In the past 30 years, sustained political efforts, backed by money and political clout, have successfully striven to interpret the 2nd Amendment to refer to individual (not Militia) rights. Associate Justice Scalia wrote the deciding opinion to that end not long before he died. Our country, in contrast to all other developed countries, seems hopelessly divided on that interpretation.

We need a fresh start. We need to phenotype mass killers before they kill.

Social and demographic “profiling” as a screening tool seems to have fallen out of favor. On the other hand, a phenotype is the set of observable characteristics of an individual resulting from the interaction of its genotype with the environment.

From Peterson’s and Densley’s work, might the characteristics listed earlier be enough to begin to identify individuals at high risk of perpetrating suicide and mass homicide and introduce mental health measures to intervene before it is too late?

What we are doing now is certainly not working. Let’s try something new.

That’s my opinion. I’m Dr George Lundberg, at large at Medscape.

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