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Science about Mass Violence

The following articles have been selected by the Research and Evaluation Division at the National Mass Violence and Victimization Resource Center from the overall literature on mass violence and its consequences. The articles provide valuable information on a variety of topics relating to - and affected by - mass violence. These areas include the mental health characteristics and consequences of mass violence, as well as planning for - and intervention after - a mass violence incident. New articles will be added to this page regularly, and we will routinely feature themes and specific areas of interest.

Please check back for updates and the latest scientific research in the field of mass violence, and reach out to us if you have specific questions or requests about specific topics of interest.

What Happens to the Survivors?

Novotney, A. (September 2018). What Happens to the Survivors? Monitor on Psychology, 40(6), 36-44.

This article published in the American Psychological Association’s Monitor on Psychology focuses on the long-term outcomes for survivors of mass shootings and how they’re improved with the help of community connections and continuing access to mental health support.

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Emotion regulation and PTSD following mass shooting

Bardeen, J. R., et al., (2013). Emotion regulation difficulties as a prospective predictor of posttraumatic stress symptoms following a mass shooting. Journal of Anxiety Disorders, 27, 188-196.

Bardeen and associates examined the relationship between emotion regulation difficulties (ERD) and posttraumatic stress symptoms (PTSS) before and after a campus mass shooting at Northern Illinois University. The study found intense emotional reactions to trauma-related cues post-event. While immediate effects of increased PTSS levels were common, only a small percent of participants reported sustained levels of PTSS months after the incident. ERD was found to prospectively predict PTSS severity after exposure to traumatic events. Results suggest that ERD has a role in the development of posttraumatic stress disorder (PTSD) after traumatic events. These findings may have important clinical implications and support the idea that exposure therapy may be an effective treatment for PTSD.

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Social and contextual influences on mental health after mass violence

Felix, E. D., et al. (2017). Social and Contextual Influences on Mental Health Following an Episode of Mass Violence. Journal of Interpersonal Violence.

Researchers examined how media coverage, family reactions, and disappointment in social support affect mental health after a mass violence incident. Researchers found that females were more affected by negative perceptions of media coverage than males and across the sample, negative perceptions of media coverage were correlated with higher levels of PTSS. The study reported that negative family reactions were correlated with higher levels of PTSS, avoidance, and anxiety symptoms. The majority of respondents expressed no disappointment in regards to how individuals in their social support network responded to the tragedy. Researchers concluded that the media need to be more sensitive when covering traumatic events and that information on how to positively support those affected should be available and easily accessible to the community.

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PTSD and narrative structure following terrorist attacks (adolescents)

Filkukova, P., et al. (2016). The relationship between posttraumatic stress symptoms and narrative structure among adolescent terrorist-attacked survivors. European Journal of Psychotraumatology 7(1), 29551.

This study looked at the relationship between narrative structure of a traumatic event and posttraumatic stress symptoms (PTSS). Researchers compared the narratives of two groups of adolescents who were exposed to a mass violence incident in Norway. The participants were grouped based on reported levels of PTSS. Individuals reporting high levels of PTSS were more likely to recount the incident using external events (specific actions and dialogues) as opposed to the low-level group who tended to use internal events such as thoughts and feelings to describe the event. Filkukova and colleagues suggested that description of external and internal events in a narrative may be important indicators of PTSS level.

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Essential elements to intervention following a mass trauma event

Hobfoll, S. E., et al. (2007). Five Essential Elements of Immediate and Mid-Term Mass Trauma Intervention: Empirical Evidence. Journal of Psychiatry, 70(4), 283-315.

Researchers identified five principles to be used as a guide in developing sound practices and programs following a disaster or mass violence event. The five core elements were: a sense of safety (real or perceived), calming, self- and community-efficacy, individual and community connectedness, and promoting hope. Using empirically supported data, each principle suggested appropriate inventions at the individual and community level. These suggestions can help guide community leaders, emergency management, and public health efforts in the early and mid-term stages following a mass trauma.

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Definitions, statistics, and mental health characteristics related to mass violence

Krouse, W. J. & Richardson, D.J. (2015). Mass Murder with Firearms: Incidents and Victims, 1999-2013. Congressional Report Service.

The report focuses on definitions and forms of mass murder, statistics of mass shootings, and the mental health of the offender on a policy level. For the purpose of this report, mass shooting was defined as “a multiple homicide incident in which four or more victims are murdered with firearms, within one event, and in one or more locations in close proximity." The report examines mass shooting occurrences within a 15-year period from 1999 to 2013, and also presents a 44-year dataset of firearms-related mass murders that could be considered as mass shootings. The data in this report suggest that the prevalence of mass public shootings increased over the 44-year period. From 1999 to 2013, an average of 31 mass murders took place per year in the United States, with 21 of those incidents being committed using solely a firearm. To prevent mass murders with a firearm, congress and other policymakers have relied on policy change. For example, a policy that aims to keep track of those who may be at risk of committing such a crime with a firearm. In addition, they track and regulate the records of those who fall under the specifically defined categories of mentally defective, mentally incompetent, mentally unstable, or those who have a serious criminal history record. One thing remains consistent among researchers – the need to develop a standardized set of definitions for mass shootings in order to move forward with empirically valid research on mass murder.

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Mental health consequences of mass shooting

Lowe, S. R. & Galea, S. (2017). The Mental Health Consequences of Mass Shooting. Trauma, Violence, & Abuse, 18(1), 62-82.

Forty-nine studies on 15 different mass shooting incidents that took place between 1984 and 2008 were analyzed. The purpose of the study was to review the mental health impacts of mass shooting incidents on survivors and members of the communities in which they took place. They concluded that there are long-term and short-term mental health consequences for victims and those in the community following a mass shooting incident, including posttraumatic stress disorder (PTSD), major depression and various other psychiatric disorders. Researchers identified several risk factors for adverse outcomes. The most prevalent risk factors included female gender, a lower socioeconomic status, and higher direct exposure. Researchers concluded that further research is necessary to dig deeper into the risk and protective factors that contribute to the long-term outcomes of mass shootings.

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Grief and mass violence

Smith, A. J., et al. (2015). Persistent Grief in the Aftermath of Mass Violence: The Predictive Roles of Posttraumatic Stress Symptoms, Self-Efficacy, and Disrupted Worldview. Psychological Trauma: Theory, Research, Practice, and Policy, 7(2), 179-186.

This study reported on posttraumatic stress symptoms (PTSS) on students 3-4 months after the Virginia Tech shootings, and severity of grief one year following the shooting. Researchers found that higher PTSS severity 3-4 months after the incident was correlated with higher PTSS severity one year later. The model showed that the higher PTSS at one year was influenced by lower self-efficacy and a disrupted worldview. Researchers suggested that interventions to address PTSS and increase self-efficacy can help decrease the chance of negative long term mental health outcomes.

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PTSD and mass violence

Sullivan, C. P., et al. (2018). Network Analysis of PTSD Symptoms Following Mass Violence. Psychological Trauma, 10(1), 58-66.

Approximately three months following the Virginia Tech shootings, researchers collected data via an internet survey to understand the relationship between different symptoms of posttraumatic stress disorder (PTSD). Network analyses showed that intrusive symptoms (e.g., intrusive thoughts) had the greatest influence on other symptoms and that concentration problems were the most extensively connected to all other symptoms. This study examines how different symptoms can affect the development and severity of other symptoms. This approach could be applied clinically by identifying key symptom(s) that are highly influential and likely to affect the manifestation of other symptoms. For example, anger was found to be a key symptom and PTSD and may quickly influence the manifestation or severity of other symptoms.

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Planning for mass violence incidents

Turris, S. A., Lund, A., & Bowles, R. R. (2014). An analysis of mass casualty incidents in the setting of mass gatherings and special events. Disaster Medicine and Public Health Preparedness, 8, 143-149.

This study examined the characteristics of 290 mass violence incidents, including those inside and outside of the United States, to help responders prepare for potentially risky settings. The most common settings for mass violence incidences included movement of people in crowded conditions, special hazards, structural failures, deliberate events, and toxic exposures.

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