In school shootings, patterns and warning signs
By Katherine Newman, Special to CNN on December 17, 2012
Katherine S. Newman, author of "Rampage: The Social Roots of School Shootings" reports that bucolic country towns are locus for most school shootings in U.S. Newman goes on to say that shootings are often planned far in advance and that attackers often hint at plans. Newman states that shooters long to fit in, and may perform mass killings in an attempt to gain peers' attention and acceptance. Consequently, Newman suggests that we must provide settings for children to confide in adults.
Replaying the game: hypnagogic images in normals and amnesics.
By Stickgold R, Malia A, Maguire D, Roddenberry D, O'Connor M. for Science on 2000 Oct 13;290(5490):350-3.
Participants playing the computer game Tetris reported intrusive, stereotypical, visual images of the game at sleep onset. Three amnesic patients with extensive bilateral medial temporal lobe damage produced similar hypnagogic reports despite being unable to recall playing the game, suggesting that such imagery may arise without important contribution from the declarative memory system.
The Perfect Storm for a Killer: Video game addiction and violent video games
By Andrew Doan, MD, PhD for MedRounds on December 22, 2012
The perfect storm for the formation of a killer is mental illness combined with violent video games. A child addicted to anything is mentally ill, whether it is an addiction to drugs, alcohol, or video games.
Effects of Prosocial, Neutral, and Violent Video Games on College Students' Affect
By Saleem M, Anderson C, Gentile D for Aggressive Behavior, May 1, 2012
Prosocial games reduced state hostility and increased positive state affect. Violent video games had the opposite effects. These effects were moderated by trait physical aggression.
A longitudinal study of the association between violent video game play and aggression among adolescents.
Willoughby T, Adachi PJ, Good M. for Developmental Psychology, 2012 Jul;48(4):1044-57
Sustained violent video game play was significantly related to steeper increases in adolescents' trajectory of aggressive behavior over time. Moreover, greater violent video game play predicted higher levels of aggression over time, after controlling for previous levels of aggression, supporting the socialization hypothesis.
Longitudinal effects of violent video games on aggression in Japan and the United States.
Anderson CA, Sakamoto A, Gentile DA for Pediatrics 2008 Nov;122(5):e1067-72.
These longitudinal results confirm earlier experimental and cross-sectional studies that had suggested that playing violent video games is a significant risk factor for later physically aggressive behavior and that this violent video game effect on youth generalizes across very different cultures. As a whole, the research strongly suggests reducing the exposure of youth to this risk factor.
The effects of violent video game habits on adolescent hostility, aggressive behaviors, and school performance.
Gentile DA, Lynch PJ, Linder JR, Walsh DA. For Journal of Adolescence 2004 Feb;27(1):5-22.
Six hundred and seven 8th- and 9th-grade students from four schools participated. Adolescents who expose themselves to greater amounts of video game violence were more hostile, reported getting into arguments with teachers more frequently, were more likely to be involved in physical fights, and performed more poorly in school.
Violent video game effects on aggression, empathy, and prosocial behavior in eastern and western countries: a meta-analytic review.
Anderson CA, Shibuya A, Ihori N for Psychology Bulletin on 2010 Mar;136(2):151-73
The evidence strongly suggests that exposure to violent video games is a causal risk factor for increased aggressive behavior, aggressive cognition, and aggressive affect and for decreased empathy and prosocial behavior.
Metastudy: Violent video games raise aggression
By Elizabeth Armstrong Moore for CNET on March 2, 2010
A study out of Iowa of 130 research reports on more than 130,000 subjects worldwide concludes that exposure to violent video games results in more aggressive, less empathetic youths.
1972 Surgeon General warning about violent media content causing antisocial behaviour
In 1972, the Surgeon General issued the following warning on violent TV programs: "It is clear to me that the causal relationship between televised violence and antisocial behavior is sufficient to warrant appropriate and immediate remedial action...There comes a time when the data are sufficient to justify action. That time has come."
Steinfeld, J. (1972). Statement in hearings before Subcommittee on Communications of Committee on Commerce (United States Senate, Serial #92-52, pp. 25-27). Washington, DC: U.S. Government Printing Office.
Pathological Video-Game Use Among Youth Ages 8 to 18: A National Study
By Douglas Gentile for Psychological Science on December 2012
A Harris poll surveyed a randomly selected sample of 1,178 American youth ages 8 to 18. About 8% of video-game players in this sample exhibited pathological patterns of play. Pathological gamers spent twice as much time playing as nonpathological gamers and received poorer grades in school; pathological gaming also showed comorbidity with attention problems. Pathological status significantly predicted poorer school performance even after controlling for sex, age, and weekly amount of video-game play.
Substance-induced psychotic disorder
Gale Encyclopedia of Mental Disorders 2003
Prominent psychotic symptoms (i.e., hallucinations and/or delusions) determined to be caused by the effects of a psychoactive substance is the primary feature of a substance-induced psychotic disorder. A substance may induce psychotic symptoms during intoxication (while the individual is under the influence of the drug) or during withdrawal (after an individual stops using the drug).
Prescription psychotropic medication histories of shooters prior to 2012 (excerpted from www.ssristories.com).
Jeff Weise, age 16, was taking 60 mg of Prozac (three times the average starting dose for adults!) when he shot his grandfather, his grandfather's girlfriend and many fellow students at Red Lake, Minnesota. He then shot himself. 10 dead, 12 wounded.
Eric Harris, age 18, was on Luvox when he killed twelve classmates and a teacher in Littleton, Colorado. Both Eric Harris and Dylan Klebold shot themselves. 15 dead, 23 wounded. Klebold's medical records were sealed.
Kip Kinkel, age 15, was withdrawing from Prozac when he shot 22 classmates and both his parents.
Shawn Cooper, age 15, was taking Ritalin when he fired a shotgun at school.
Elizabeth Bush, age 14, was on Prozac when she shot at fellow students in Williamsport, Pennsylvania, wounding one.
Mitchell Johnson, age 13, was taking an unspecified psych drug when he shot at fellow students in Jonesboro, Arkansas. 5 dead, many others wounded.
T.J. Solomon, age 15, was taking Ritalin when he shot six classmates in Conyers, Georgia.
Jason Hoffman, age 18, was on Effexor and Celexa when he wounded five students at his Granite Hills high school, El Cajon, California.
Cory Baadsgaard, age 16, was on Paxil (which he said caused him to have hallucinations) when he took a rifle to his high school and held 23 classmates hostage. He has no memory of the event.
Steven Kazmierczak, age 27, shot and killed five people and wounded 16 others before killing himself in a Northern Illinois University auditorium. He had recently been taking Prozac, Xanax and Ambien.
Robert Hawkins, age 19, killed eight people and wounded five before committing suicide in an Omaha mall. He had been on antidepressants and Valium.
Asa Coon, age 14, shot and wounded four students at his school before taking his own life. He was on the antidepressant Trazodone.
Seung-Hui Cho, the shooter in the Virginia Tech Massacre in which 33 were killed and 29 were injured, was on an antidepressant pill but neither his toxicology reports nor his recent medical history were ever released to the public.
Jon Romano, age 16, shot a teacher with a shotgun. He had been taking "medication for depression".
Guns, video games, isolation, and mental illness have all been implicated as causal factors in the recent school shooting by Adam Lanza in Newtown, Connecticut. Intervention initiatives for school shootings, such as arming teachers, or enlisting full time police presence, have been proposed for schools both in the U.S. and Canada without any evidence showing they would keep children safe, and some evidence showing they would to do more harm than good. Prevention initiatives such as improved gun control and video game regulation are now at a Senate level in the U.S. This article will provide readers with historical and current research on the impact of violent media on aggression, report what we already know about past shooters, and propose a number of initiatives for prevention of future mass shootings in our schools and communities. 
