'Warning behaviors' sought to stop killings

It can seem all but impossible to understand why anyone would commit a mass murder as Jared Loughner did near Tucson last year, as James Holmes is accused of doing in Aurora, Colo., last month, as Wade Michael Page did at a Sikh temple in Wisconsin last Sunday, and as happens, on a smaller scale, about 20 times a year in the United States.

Often, the specific "why" for a murderous rampage stays hidden within the twisted delusions or obscure psychosis of a particular killer. But forensic psychologists and other behavioral scientists are increasingly identifying reasons that can predispose someone to commit mass violence, and "warning behaviors," such as a fast- growing fascination with weapons and violence, that should signal the need for intervention.

PDF: Loughner's competency report

"We'll never be able to predict which individual, out of many, will carry out an act of targeted violence," says J. Reid Meloy, a forensic psychologist and professor of clinical psychiatry at the University of California-San Diego.

But, Meloy said, it's often possible to identify people who fall into high-risk groups and to take some action to intervene -- from requiring counseling to restricting someone's access to weapons to seeking involuntary commitment, or many other steps in between.

"These strategies are being applied all over the country every day now, by mental-health professionals, teams in corporate settings and universities, by law-enforcement officers," he said. While he declined to offer specific examples, citing privacy concerns, he said there are many cases where the risk is being reduced, though it's impossible to say whether an act of violence is actually being stopped.

After Seung-Hui Cho killed 32 people and shot 17 others at Virginia Tech in April 2007, Virginia began requiring all universities across the state to create threat-assessment teams, groups including security or law enforcement, psychologists, counselors and administrators. The teams identify when an individual could pose a risk and consider how to respond. Many large corporations also have established threat-assessment teams or policies.

Meloy said he's working on a case now in which he's helping to plan a strategy to handle a person engaged in threatening behavior in a workplace setting "where a mass shooting could be carried out relatively easily."

Intervening often isn't simple or easy. People in schools or workplaces may report worrisome behavior, but the information may not get to the right authorities, or they may not take what, in retrospect, may seem like the right steps. Or there may be other limitations.

Before the Virginia Tech shooting, Cho had been identified as stalking women and setting a fire in a dorm, both potential "warning behaviors" of further danger, said clinical psychologist and attorney Brian Russell of Lawrence, Kan. Campus police took Cho to a mental-health agency, which sent him to state court for an involuntary-commitment hearing. But when Cho's attorney asked to keep his record clean by letting him go to outpatient mental-health treatment voluntarily, the judge agreed.

"He checks in, he immediately checks out, and gets guns he couldn't have gotten with a court order for inpatient mental treatment or a judicial commitment," said Russell.

Loughner, who pleaded guilty Tuesday to last year killing six people and wounding 13, including then-Rep. Gabrielle Giffords, had been suspended from Pima Community College after a series of run-ins with police and college administrators. On Oct. 7, 2010, three months before his attack outside a Tucson-area Safeway, police delivered a letter to the home of Loughner's parents, saying he couldn't return to college until a mental-health professional confirmed that he didn't pose a danger to himself or others.

Well before James Holmes was arrested on charges of killing 12 people and wounding 58 at an Aurora, Colo., movie theater on July 20, University of Colorado psychiatrist Lynne Fenton raised concerns about his behavior with members of the university's behavioral-evaluation and threat-assessment team. The team reportedly never investigated Holmes, though, because he had dropped out of the university.

"The problem is that most people who are seriously mentally ill aren't going to do anything violent, and our ability to predict dangerous behavior is not that great," said Richard Cooter, an associate professor of forensic psychology at George Washington University in Washington, D.C. "If you tried to commit everybody who said something odd or weird or pick your term, you'd be locking up a lot of people."

Richard S. Adler, a clinical and forensic psychiatrist in Seattle, agreed. "It is exceptionally hard to predict who will be violent. The fact of the matter is I could see you today and you're relatively safe and tomorrow you could be not safe."

Focusing on behaviors

In trying to understand what leads someone to commit mass murder, forensic psychologists sometimes focus on specific behaviors that show a growing or accelerating risk of violence. They also analyze the psychiatric and personality traits common to different types of mass killers.

Politically motivated terrorism aside, most mass murderers fall into one of three broad categories, many researchers say:

Those exhibiting psychopathic behavior. "At the core of the psychopath is always a profoundly malignant narcissism," said Russell. "They focus on what they need, and feel an entitlement to get what they need at the cost of anything to anyone else." In a 2004 study of 64 mass murderers, forensic psychologist Meloy said the pathological, narcissistic belief that they had a "right" to kill was ubiquitous.

Those who are delusional. They maintain a persistent, irrational belief in the face of contrary facts, said forensic psychologist David Bernstein of New York City. "Those beliefs become their reality. There's an arrogance involved," he said. Particularly of someone with paranoid delusions, "you believe people are conspiring against you; there is something about you that is so special, people are plotting against you in some way."

Those who are severely depressed and suicidal. Loughner can be included in this category, though he also is severely delusional and heard voices, according to his psychologist, Christina Pietz. She diagnosed Loughner as schizophrenic, a type of psychosis, and spent more than a year treating his illness with medications and therapy before U.S. District Court Judge Larry Burns ruled Loughner mentally competent last week, clearing the way for him to plead guilty.

Adolescent mass killers, such as Columbine High School shooters Eric Harris and Dylan Klebold, who killed 12 students and a teacher in April 1999, differ from adult mass murderers in some ways. One study, in 2000, found that adolescents are more likely to collaborate with others, are more likely to reveal clues -- Facebook postings, for example -- that they are planning something, and are less likely than adult killers to commit suicide. A 1999 study found that, in common with adults, youthful killers often were seen as loners, showed strong interest in violence and violent fantasies, and spent a lot of time planning the mass murder, which was usually triggered by some perceived rejection or disciplinary action.

Among the traits that many mass murderers -- adolescent or adult -- share are anger and a delusional sense of self-justification.

"Most of us learn to let things go, to see when something happens that it's not that big a deal in the scheme of things," said Bernstein. "These people focus and ruminate on their perceived wrongs; it becomes all-consuming. They feel they're correcting an injustice -- they're not the monster, the other people are the monsters."

On Aug. 3, 2010, for example, after he was forced to resign for stealing beer from the Hartford Distributors' warehouse where he worked, Omar Thornton pulled two Ruger semiautomatic pistols out of his lunch box and shot eight people to death. He called 911 before committing suicide, ranted about racism no other worker there perceived, and said "these people here are crazy," adding that he wished he'd shot more of them.

"All these guys are angry about something," said Cooter. Speaking of Page, the Sikh temple killer, he said that "from what I can tell, he wasn't psychotic; he was just an angry guy." Holmes, who dyed his hair to resemble the movie character The Joker, "obviously has a massive delusional system revolving around Batman, is probably schizophrenic too, and was very angry," possibly about failing in his studies at the University of Colorado, said Cooter, who emphasized that he doesn't have personal, direct knowledge of either case.

Signaling intentions

Some "warning behaviors" seem obvious, like a growing fascination with weapons, a focus on violent fantasies or previous mass killers, and expressed threats that may be subtle or direct.

A Secret Service study in 2002 found that in 81 percent of school-shooting cases, at least one person knew about the plans in advance; and in 93 percent, people around the attackers noted disturbing behaviors ahead of time, such as acquiring guns or writing poems or essays on homicidal themes.

A study last year said most adult mass killers, too, signal their intent in some way, though not to their actual target.

Often, too, there's what psychologists call an "energy burst warning," a sudden jump in activities relating to the target.

Loughner, who is due to be sentenced to multiple life terms on Nov. 15, was a prime example, according to a citation in a recent study in the journal Behavioral Sciences and the Law.

In the dozen hours before the shooting, Loughner dropped off film at a Walgreens with photos of himself in a red g-string holding a Glock pistol next to his crotch; he checked into a Motel 6; left a phone message with a friend; posted a photo of the Glock to his MySpace page and wrote "Goodbye friends." He did several Web searches on "assassins" and "lethal injections." He tried to buy ammunition at a Walmart but left when a clerk expressed concern about his behavior. He went to another Walmart and bought ammunition and a black diaper bag, was stopped by a police officer for running a red light, went home but ran away when his father confronted him and asked what was in the bag, then went to a Circle K, from where he took a taxi to the Safeway where Giffords was meeting constituents.

But of course, no single person saw all of these behaviors at the time.

Could any of the people he ran across in those 12 hours have seen a red flag? As the 2011 study notes, "Warning behaviors can only constitute warnings if the behaviors are detected."

In his 2004 study of 64 mass killings, Meloy noted "there was often pre-offense knowledge of specific and generalized threats among third parties, and they failed to act to prevent the killings" and "most people who had overheard a threat seemed to have dismissed it as incredible or implausible."

Though he concedes that in many places mental-health care options are limited and inadequate, Meloy, who calls himself an optimist, makes two observations.

The first is that, for all of the media attention to mass killings, the 20 incidents a year that occur on average means they remain exceedingly rare in a country of more than 311 million people.

The second: "After 9/11, New York came up with a catchy phrase, 'See something, say something.' If you're going to maintain a safe community and social fabric, and if someone is behaving in ways that concern you, you have to say something," says Meloy. "And I think, increasingly, people are willing to do that."