A Sequence Analysis of the Behaviors and Experiences of the Deadliest Public Mass Shooters.

Researchers of public mass shooters are increasingly focusing on the pre-attack behaviors and experiences of these offenders. Varying in scope from consideration of individual factors to more generalized life course and threat assessment analyses, their scholarship has identified behavioral and experiential factors associated with public mass shooters. However, what is generally missing from this body of research is consideration of the order in which the offender encounters these factors, and prior related research has shown that analyzing sequences allows for insights not available from a catalogue of common characteristics. To address this shortcoming, we use a sample of offenders from 1999 to 2020 for whom the most detailed data is available and conduct a sequence analysis of their stressors, antisocial behaviors, mental health issues, and planning and preparation activities. We calculate proximity coefficients for each variable in relation to all others, capturing both local and distant connections between and among them. Our findings reveal relatively coherent phases in the lives of attackers, highlight the centrality of family problems and interest in past mass killings in the overall sequence, and provide new context to understanding the effect of mental health issues and firearms acquisition in the lives of offenders. A discussion of findings illustrates potential intervention points that may have been overlooked, as well suggestions for future research.

Similar crimes, similar behaviors? Comparing lone-actor terrorists and public mass murderers.

This article adds to the growth in data-driven analyses seeking to compare samples of violent extremists with other violent populations of interest. While lone-actor terrorists and public mass murderers are frequently treated as distinct offender types, both engage (or attempt to engage) in largely public and highly publicized acts of violence and often use similar weapons. This article investigates the (dis)similarities between both offender types. We use a series of bivariate and multivariate statistical analyses to compare demographic, psychologic and behavioral variables across 71 lone-actor terrorists and 115 public mass murderers. The results show little distinction in sociodemographic profiles, but significant differences in (a) the degree to which they interact with co-ideologues (b) antecedent event behaviors and (c) the degree to which they leak information before the attack. Overall, our data inform the emerging idea that lone-actor terrorists and public mass shooters are not distinct offender types. There is more that unites them than divides them. Although the over-arching focus of our results are on the few variables that distinguish them, the vast majority (80%+), of the 180+ variables showed no significant difference. We discuss implications for threat assessment and management in the context of these results.

Plasma nitrite as an indicator of cerebral ischemia during extracranial/intracranial bypass surgery in moyamoya patients.

BACKGROUND AND PURPOSE: Nitric oxide (NO) plays a key role in ischemia and shows potential as a biomarker for ischemia. We measured mixed venous nitrite (NO2-) as a proxy for NO, during controlled cerebral ischemia in patients with moyamoya disease (MMD) during direct extracranial/intracranial (EC/IC) bypass surgery with temporary occlusion of the M4 branch of the middle cerebral artery (MCA) to permit anastomosis with the superficial temporal artery (STA). This small, focal ischemic event is not reliably detected using cerebral oximetry, somatosensory evoked potentials (SSEPs) or electroencephalography (EEG). METHODS: We enrolled nine adult MMD patients (n=8 female, n=1 male) undergoing direct EC/IC bypass surgery. Nitrite was measured at least one hour prior to MCA occlusion, and before, during and after anastomosis. Cortical function was monitored using either multi-lead EEG and SSEPs, or frontal EEG activity. RESULTS: Mixed venous NO2- was significantly elevated (p<0.05) within 12 min following arterial occlusion vs. baseline. An M4 branch of the MCA was cross clamped for a median duration of 18 (IQR = 5) minutes during anastomosis. One patient with elevated NO2- showed a transient neurologic deficit that resolved 3 days post-operatively. CONCLUSIONS: Mixed venous NO2- was significantly elevated shortly following cerebral artery occlusion vs. baseline in a majority of the study subjects, suggesting that NO2- is a potential biomarker for ischemia. Since all patients received identical burst suppression anesthesia and vasopressors, the fact that NO2- was not elevated during cross-clamp in all patients supports the conclusion that the NO2- elevation is likely due to ischemia.

Shooting Alone: The Pre-Attack Experiences and Behaviors of U.S. Solo Mass Murderers.

This paper outlines the sociodemographic, developmental, antecedent attack, attack preparation, and commission properties of 115 mass murderers between 1990 and 2014. The results indicate that mass murderer attacks are usually the culmination of a complex mix of personal, political, and social drivers that crystalize at the same time to drive the individual down the path of violent action. We specifically focus upon areas related to prior criminal engagement, leakage, and attack location familiarity. Whether the violence comes to fruition is usually a combination of the availability and vulnerability of suitable targets that suit the heady mix of personal and political grievances and the individual's capability to engage in an attack from both a psychological and technical capability standpoint. Many individual cases share a mixture of unfortunate personal life circumstances coupled with an intensification of beliefs/grievances that later developed into the idea to engage in violence.

Preventing Persons Affected by Serious Mental Illnesses from Obtaining Firearms: The Evolution of Law, Policy, and Practice in Massachusetts.

A history of commitment to a mental health facility disqualifies applicants for gun licenses. Identifying such a history has become increasingly complex as the locus of confinement has become more diversified and privatized. In Massachusetts, prior to 2014, the databases used to identify individuals who would be disqualified on such grounds had not contemporaneously matched the evolution of the state's mental health systems. A survey of Massachusetts police chiefs, who, as in many jurisdictions, are charged with certifying qualification, indicates that some have broadened the scope of their background checks to include the experience of their officers with respect to certain applicants. The survey identifying these patterns, conducted in 2014, preceded by one month significant legislative reforms that mandate the modification of the reporting into a centralized database commitments to all types of mental health and substance use facilities, thus allowing identification of all commitments occurring in the state. The anticipated utilization of a different database mechanism, which has parallels in several other states, potentially streamlines the background check process, but raises numerous concerns that need to be addressed in developing and using such databases.

Continuous monitoring of changes in plasma nitrite following cerebral ischemia in a rabbit embolic stroke model.

In this proof-of-concept study, we investigated direct, continuous monitoring of plasma nitrite as an indicator of cerebral ischemia following clot embolization of rabbits via an indwelling carotid catheter. Two groups of rabbits were studied to compare the effects of embolization on nitrite levels. In the control group, blood was continuously obtained from a jugular venous catheter. The blood was immediately passed through an ultrafiltration filter; the filtrate was chemically reduced to convert free nitrite to nitric oxide (NO) and then measured using a NO-specific electrode. In the embolized group, after a baseline nitrite level was achieved, blood clots were injected into the brain via the carotid artery catheter, and then nitrite levels were continuously measured from jugular venous blood. The stroke group showed a significantly greater increase in nitrite as compared to controls (p=0.017). Using the area-under-the-curve (AUC) method, results reached statistical significance (p<0.05) within 3 min of embolization. In embolized rabbits, NO(2) levels increased 424±256% compared to baseline. This study shows that nitrite can be measured immediately following a stroke and that our system measures nitrite independent of the extent of the stroke. This study provides evidence for the feasibility of using nitrite as a marker of ischemic stroke.