How can we become better able to Identify People at Increased Risk to become Violent

Everyone has a vested interest in and ever increasing desire to improve our ability to accurately recognize increased risk of violent behavior in any given individual. While there is a tendency to rely on putative experts to perform such assessments it is important to realize every citizen can become better prepared to spot “ticking time bombs”. allowing them to alert local authorities to unusual or suspicious behavior.

Our knowledge base and list of factors that are predictive of increased risk of violence is better than most think though not as good as we want. After the eruption of each national or local dramatic incident of violence careful investigations reveal a broad range of red flags apparent to a range of people who knew the perpetrator. It is rarely ever the case that an episode of serious violence “just seemed to come out of the blue. So, the good news is ordinary citizens can increase their skills allowing them to alert local first responders and ancillary professionals. This type of communication and coordination permits all involved to put together pieces of the puzzle..

So, let’s lay out the pieces of the puzzle. Research indicates that the top three indicators of violent behavior are (1) excessive alcohol intake; (2) a history of violent acts, with arrests or criminal activity; and (3) a history of childhood abuse. It is a truism that excessive alcohol use increases the risk of people behaving badly as judgment and self-control become increasingly impaired. Perhaps the single best predictor we all know is: “The best predictor of future behavior is past behavior”. Similarly, any information about childhood abuse is critical given the high correlation between being victims of violent behavior as youth and becoming perpetrators of violence in their teens and beyond. Males between the ages of 15-24 from low socioeconomic backgrounds, and minimal social supports present the highest risk to become violent as compared to older people.

Along with the top three risk factors there is a long list of things used to assess dangerousness and potential for violence. Very recent acts of violence, including property violence that strongly suggest more violence is coming unless interrupted. Verbal and physical threats (menacing or aggressive movements) should be taken at face value. Anyone carrying traditional weapons such as a knife or gun are obvious signs though carrying forks, rocks, ashtrays, or anything that could be used as a weapon warrants close attention. The presence of emotional lability and physical agitation or increased erratic movements are cues not to be ignored. Any type of substance intoxication including alcohol to prescription medications heighten the risk for violent behavior. There are a fair number of medical problems that predispose people to exhibit uncharacteristic personality changes and violence.

Certain psychological testing batteries coupled with clinical interviews with possible perpetrators, family and friends, can be quite helpful in identification of individuals at increased risk to become violent. That said, there are no psychological assessment tools or procedures that can provide unequivocal proof that any given individual will behave in a violent manner. Psychotic patients who are feeling paranoid and a subset of schizophrenics experiencing command auditory hallucinations and people with Bipolar illness in manic or mixed states are at increased risk to behave in violent ways. People diagnosed with certain personality disorders known to include episodes of rage, violent behavior, and poor impulse control are also at increased risk. People experiencing serious psychosocial stressors, are at increased risk, such as those who have experienced recent job loss, death of loved one, divorce, ostracism from social groups, and most anything the average person would identify to be very stressful.

Medical and mental health professionals can contribute an extraordinary amount to such risk assessments if given information about or opportunities to evaluate a potential perpetrator. Patients may be violent for many reasons, and the interview with a violent patient must attempt to ascertain the underlying cause of the violent behavior, because cause determines intervention. Some of the more common psychiatric and medical diagnoses associated with increased risk for violent behavior include psychoactive substance-induced organic mental disorder, antisocial personality disorder, catatonic schizophrenia, medical infections, cerebral neoplasms, decompensating obsessive-compulsive personality disorder, dissociative disorders, impulse control disorders, sexual disorders, alcohol idiosyncratic intoxication, delusional disorder, paranoid personality disorder, schizophrenia, temporal lobe epilepsy, bipolar disorder, and uncontrollable violence secondary to interpersonal stress. However it is critical to state that mentally ill people as a group are no more prone to violence than the typical citizen.

It is important to elicit information about a potential perpetrator’s wishes and intentions to commit violent act, the degree to which they have developed an executable plan,and have access to weapons or posses weapons to help determine how serious or imminent violent behavior may become. Again, we tend to leave such questions to putative experts. However, there is no way to overstate the role an average citizen can play in interrupting a ticking time bomb. .

Truth be told, it takes a community to identify troubled individuals with whom we cross paths in our daily lives. Everyone has a responsibility to educate themselves on this subject so they can pass information onto designated authorities. A school janitor or university employee might play a biggeer role as compared to most respected expert in violence prediction. Individuals, teachers, employees, students, a passer-by, medical and mental health professionals, animals, co-workers, neighbors, and law enforcement officers share common ground and equal respect in community efforts to provide assistance or neutralize anyone moving toward perpetrating a tragedy. It is essential that every person and designated individuals from university or community first responders develop ever more effective methods of communication, coordination, and action plans to stop or interrupt the unthinkable.

The world is much safer than the media lead us to believe. There is no reason to walk around in a guarded and fearful state of mind. Learning the fundamentals, maintaining awareness of one’s surroundings, trusting your gut and common sense to alert authorities to unusual or suspicious behavior ought become a fundamental life skill. Divided we become easy prey. United in a sense of Solidarity and community we increase the odds that today will be a good day.

There is an old Chinese proverb worth some careful thought and reflection as it relates to identification of people at increased risk to become violent.: “Deal with a big problem while it is still small”