Abstract：
UNASSIGNED: The rate of worldwide mass shootings increased almost 400% over the last 40 years. About 30% are followed by the perpetrator\'s fatal or nonfatal suicide attempt.
UNASSIGNED: We examined the rate of fatal and nonfatal attempts among 528 mass shooters over the last 40 years and their relationship to detected mental illness to better understand this specific context of suicide. We collected information on U.S.-based, personal-cause mass murders that involved one or more firearms, from online sources.
UNASSIGNED: A greater proportion of mass shooters from 2000 to 2019 took or attempted to take their own lives (40.5%) compared with those from 1980 to 1999 (23.2%, p < 0.001). More than double the proportion of perpetrators who made a fatal or nonfatal suicide attempt had a history of non-psychotic psychiatric/neurologic symptoms (38.9%), compared with perpetrators who did not make a fatal or nonfatal suicide attempt (18.1%; p < 0.001). Among mass shooters who made fatal or nonfatal suicide attempts, 77 of 175 (44%) did not have any recorded psychiatric, neurologic, or substance use condition. Of the 98 mass shooters who made fatal or non-fatal suicide attempts and had a psychiatric, substance use, or neurologic condition, 41 had depressive disorders.
UNASSIGNED: It is possible that a lack of information about the perpetrators\' mental health or suicidal ideation led to an underestimation of their prevalence. These data suggest that suicide associated with mass shootings may represent a specific context for suicide, and approaches such as psychological autopsy can help to ascertain when psychiatric illness mediates the relationship between mass shootings and suicide.
We examined 528 mass shootings.A greater proportion of mass shooters from 2000-2019 made a fatal or nonfatal suicide attempt (123/304, 40.5%) compared with mass shooters from 1980-1999 (52/224, 23.2%), χ2 = 17.3, p<.001.More than double the proportion of perpetrators who made a fatal or nonfatal suicide attempt had a history of non-psychotic psychiatric/neurologic symptoms (38.9%), compared with those who did not (18.1%; p < 0.001).Among mass shooters who made a fatal or nonfatal suicide attempt, 77 of 175 (44%) did not have any recorded psychiatric, neurologic, or substance use condition. However, it is possible that a lack of information about the perpetrators’ mental health or suicidal ideation led to an underestimation of their prevalence.These results suggest that perpetrators may have considered suicide a potential outcome of such an event, and/or that the perpetrators’ high levels of aggression and anger, accompanied by an impaired capacity for restraint, resulted in homicide followed by suicidal behavior.Psychological autopsies can clarify the role of psychiatric illness and more extreme aggressive traits in homicide-suicide instances of mass shootings.
UNASSIGNED: We examined the rate of fatal and nonfatal attempts among 528 mass shooters over the last 40 years and their relationship to detected mental illness to better understand this specific context of suicide. We collected information on U.S.-based, personal-cause mass murders that involved one or more firearms, from online sources.
UNASSIGNED: A greater proportion of mass shooters from 2000 to 2019 took or attempted to take their own lives (40.5%) compared with those from 1980 to 1999 (23.2%, p < 0.001). More than double the proportion of perpetrators who made a fatal or nonfatal suicide attempt had a history of non-psychotic psychiatric/neurologic symptoms (38.9%), compared with perpetrators who did not make a fatal or nonfatal suicide attempt (18.1%; p < 0.001). Among mass shooters who made fatal or nonfatal suicide attempts, 77 of 175 (44%) did not have any recorded psychiatric, neurologic, or substance use condition. Of the 98 mass shooters who made fatal or non-fatal suicide attempts and had a psychiatric, substance use, or neurologic condition, 41 had depressive disorders.
UNASSIGNED: It is possible that a lack of information about the perpetrators\' mental health or suicidal ideation led to an underestimation of their prevalence. These data suggest that suicide associated with mass shootings may represent a specific context for suicide, and approaches such as psychological autopsy can help to ascertain when psychiatric illness mediates the relationship between mass shootings and suicide.
We examined 528 mass shootings.A greater proportion of mass shooters from 2000-2019 made a fatal or nonfatal suicide attempt (123/304, 40.5%) compared with mass shooters from 1980-1999 (52/224, 23.2%), χ2 = 17.3, p<.001.More than double the proportion of perpetrators who made a fatal or nonfatal suicide attempt had a history of non-psychotic psychiatric/neurologic symptoms (38.9%), compared with those who did not (18.1%; p < 0.001).Among mass shooters who made a fatal or nonfatal suicide attempt, 77 of 175 (44%) did not have any recorded psychiatric, neurologic, or substance use condition. However, it is possible that a lack of information about the perpetrators’ mental health or suicidal ideation led to an underestimation of their prevalence.These results suggest that perpetrators may have considered suicide a potential outcome of such an event, and/or that the perpetrators’ high levels of aggression and anger, accompanied by an impaired capacity for restraint, resulted in homicide followed by suicidal behavior.Psychological autopsies can clarify the role of psychiatric illness and more extreme aggressive traits in homicide-suicide instances of mass shootings.
摘要：
■在过去的40年中，全球大规模枪击事件的发生率增加了近400%。大约30％的人随后是肇事者的致命或非致命的自杀企图。
我们研究了过去40年中528名大规模射击者的致命和非致命尝试率，以及他们与发现的精神疾病的关系，以更好地理解自杀的具体情况。我们收集了美国的信息，涉及一个或多个枪支的个人大规模谋杀，从网上来源。
■与1980年至1999年（23.2％）相比，2000年至2019年的大规模射击者中有更多的人自杀或试图自杀（40.5％），p<0.001)。有致命或非致命自杀企图的犯罪者有非精神病性精神/神经症状史的比例增加了一倍以上（38.9％）。与未进行致命或非致命自杀企图的肇事者相比（18.1％；p<0.001）。在进行致命或非致命自杀企图的大规模射击者中，175人中有77人(44%)没有任何精神病记录，神经学，或物质使用条件。在98名致命或非致命自杀企图并患有精神病的大规模射手中，物质使用,或者神经状况，41人患有抑郁症。
■由于缺乏有关肇事者的心理健康或自杀意念的信息，可能导致对其患病率的低估。这些数据表明，与大规模枪击事件相关的自杀可能代表了自杀的特定背景，心理尸检等方法可以帮助确定精神疾病何时调解大规模枪击事件和自杀之间的关系。
我们检查了528起大规模枪击事件。与1980-1999年的大规模射击者（52/224，23.2％）相比，2000-2019年的大规模射击者中有更多的人进行了致命或非致命的自杀企图（123/304，40.5％）。χ2=17.3,p<.001。有致命或非致命自杀企图的犯罪者有非精神病性精神/神经症状史的比例增加了一倍以上（38.9％）。与没有的人相比（18.1%；p<0.001）。在进行致命或非致命自杀企图的大规模射手中，175人中有77人(44%)没有任何精神病记录，神经学，或物质使用条件。然而,缺乏有关肇事者心理健康或自杀意念的信息可能导致对其患病率的低估。这些结果表明，肇事者可能认为自杀是此类事件的潜在结果，和/或肇事者的高度侵略和愤怒，伴随着克制能力受损，导致他杀，然后是自杀行为。心理尸检可以阐明精神疾病的作用和更极端的攻击性特征在大规模枪击的杀人自杀事件中。
我们研究了过去40年中528名大规模射击者的致命和非致命尝试率，以及他们与发现的精神疾病的关系，以更好地理解自杀的具体情况。我们收集了美国的信息，涉及一个或多个枪支的个人大规模谋杀，从网上来源。
■与1980年至1999年（23.2％）相比，2000年至2019年的大规模射击者中有更多的人自杀或试图自杀（40.5％），p<0.001)。有致命或非致命自杀企图的犯罪者有非精神病性精神/神经症状史的比例增加了一倍以上（38.9％）。与未进行致命或非致命自杀企图的肇事者相比（18.1％；p<0.001）。在进行致命或非致命自杀企图的大规模射击者中，175人中有77人(44%)没有任何精神病记录，神经学，或物质使用条件。在98名致命或非致命自杀企图并患有精神病的大规模射手中，物质使用,或者神经状况，41人患有抑郁症。
■由于缺乏有关肇事者的心理健康或自杀意念的信息，可能导致对其患病率的低估。这些数据表明，与大规模枪击事件相关的自杀可能代表了自杀的特定背景，心理尸检等方法可以帮助确定精神疾病何时调解大规模枪击事件和自杀之间的关系。
我们检查了528起大规模枪击事件。与1980-1999年的大规模射击者（52/224，23.2％）相比，2000-2019年的大规模射击者中有更多的人进行了致命或非致命的自杀企图（123/304，40.5％）。χ2=17.3,p<.001。有致命或非致命自杀企图的犯罪者有非精神病性精神/神经症状史的比例增加了一倍以上（38.9％）。与没有的人相比（18.1%；p<0.001）。在进行致命或非致命自杀企图的大规模射手中，175人中有77人(44%)没有任何精神病记录，神经学，或物质使用条件。然而,缺乏有关肇事者心理健康或自杀意念的信息可能导致对其患病率的低估。这些结果表明，肇事者可能认为自杀是此类事件的潜在结果，和/或肇事者的高度侵略和愤怒，伴随着克制能力受损，导致他杀，然后是自杀行为。心理尸检可以阐明精神疾病的作用和更极端的攻击性特征在大规模枪击的杀人自杀事件中。
