Predicting and preventing tragedy

I read with great interest the excellent article by Dewey G. Cornell, PhD, in the June Monitor, regarding the heartbreaking Virginia Tech tragedy (Virginia Tech: What can we do?). In addition to his excellent suggestions, I would call attention to the impact particularly on children of the extensive media coverage of such horrifying events. As Cornell notes, it is crucial that we keep perspective when these mass shootings occur because they fortunately are rare and isolated.

As parents, teachers or therapists, it is important to recognize that young children, especially preschool children, will often play out their fears and anxieties about such events. They may enact the events in their play, play out funerals and burials, or build forts or places of safety to calm their anxieties. Play provides a safe symbolic haven for children to work out their fears and emotional distress and need not be a cause of concern unless children get stuck in repetitive enactments of the trauma events without relief from tension.

David A. Crenshaw, PhD

New York Association for Play Therapy

Cornell points out that school violence is a misnomer, given that mass killings can occur anywhere, such as restaurants. Instead he turns our attention to motive and method.

But what we fail to identify and name in these situations is that the problem is male violence. If a girl shot up her high school, or if a women were involved in a mass killing, we would immediately express concern about female violence. But, because male violence is the norm in our society, we fail to identify and address the issue.

Psychologists should be asking what are the cultural norms that tell men and boys that violence is a way to solve their problems? and how can male culture be changed so violence is not an acceptable solution to problems?

Rachel T. Hare-Mustin, PhD

Amherst, Mass.

Cornell stated that saying school violence is a misnomer because it is not the location that is definitional. In a way it is. The usual locations where these murderous rampages occur are gun-free zones, like Virginia Tech. This glaring object lesson must not be lost. Natures first law is self-preservation. Declawing your cat will not protect it from the pit bull next door.

Man has never found a way to launder society and rid it of criminal elements, and the only tool man has found that empowers a 110-pound woman to protect herself from someone as powerful as O.J. Simpson is a gun.

Those U.S. states that respect their citizens right to carry self-protection see a dramatic decrease in crime. We already have 20,000 gun laws and a special firearms bureau. People want compromise, but, in fact, self-protection has been far too compromised already, as we saw at Virginia Tech.


Edward J. Mike, PhD

Marion, Mich.

Since 1928 when Professor Burgess of the University of Chicago developed the first parole decision-making tool, we began to predict violence or re-offending. Quinsey et al in "Violent Offenders" have two tools in the appendices of their APA Press book. These three, along with 22 others I know of, are useful. Across the 30 tools I found, schizophrenia, depression and mental illness are only one or two of 100 discriminating variables. The same goes for guns. More laws focus on only 1 percent of the problem. After Columbine, the FBI, Secret Service and many professional organizations developed literature reviews and pseudoscientific warning signs instead of a matched control study of a school homicide to develop discriminating variables. We have hundreds of these yearly, yet no empirical work.


Robert John Zagar, PhD



Researchers frequently conclude that violence is a complex problem and not amenable to a simple solution. The contrasting responses to my column offer indirect support for this perspective, and deserve a more thorough analysis than space permits; consequently, I will confine my reply to a few points.

I agree with Hare-Mustin that cultural norms shape and encourage male violence, but we still need to identify the biopsychosocial factors that explain why a small proportion of males commit these acts while most do not.

Zagar refers to the vast research literature on the prediction of violence, and although we have modest predictive accuracy under some conditions, we have a long way to go. Claims of predictive accuracy must be evaluated with regard to sensitivity and specificity, as well as generalizeability across populations and time periods. One clarification: Both the FBI and Secret Service reports on schoolshootings strongly advised against profiles or warning signs, because they could not identify specific characteristics that avoid the problem of massive false positives.Instead, both studies recommended the threat assessment approach that we havebeen studying the past six years (http://youthviolence.edschool.virginia.edu).

Mike is correct that, under the right circumstances, a gun could help a 110- pound woman to protect herself from a much larger man, but guns also permit slightly built males to commit mass murders. According to an extensive review of evidence by the National Research Council (Wellford, Pepper, & Petrie, 2005), questions regarding the advantages and disadvantages of gun ownership are far from settled and are unlikely to be resolved without better data than currently obtainable. Largely, political barriers prevent more definitive gun research from being carried out. Finally, as psychologists, we can recognize that our personal perspective always seems more reasonable and objective than the alternatives.


Dewey G. Cornell, PhD

Programs in Clinical and School Psychology

Curry School of Education

University of Virginia

Schizophrenias cues

I'm disturbed by the article "Motor abnormalities may predict later psychosis," July/August Monitor. Specifically, the author highlights the importance of early identification of the disorder of schizophrenia, based on the fact that antipsychotic drugs can prevent the disorder from taking hold. Without any citation for this fact, Im puzzled as to where the author draws the conclusion.

I have not found any replicated, reliable studies that would allow such a statement of fact.


Robert Foltz, PsyD

Park Ridge, Ill.


Robert Foltz expresses concern about a statement contained in the article written about our recent research on movement abnormalities in youth at clinical risk for Axis I psychotic disorders. Specifically, his comments are directed at the first sentence of the article. As indicated by the fact that the sentence is not in quotes, it was not a statement we have ever made. Moreover, we agree that the statement is not substantiated by research. There is currently no evidence that antipsychotic medications can prevent the onset of psychosis. The empirical studies to date suggest that antipsychotics may delay the onset of psychosis, but this has not yet been established. Moreover, there is no evidence demonstrating prevention of psychosis. Like Fotlz, we believe researchers do not yet have sufficient evidence to draw any conclusions.

Elaine Walker, PhD

AtlantaVijay Mitta lLos Angeles

Loan-repayment caution

In response to the article "Find debt relief" and the NHSC loan repayment in the May Monitor, I caution applicants to talk to other program participants about their experience at specific sites. The National Health Service Corps (NHSC) can be a great experience depending on the site, but if the site is unstable, NHSC has little protection for the clinician and you may find yourself in an uncomfortable or stressful situation. NHSC does not hold the site accountable; rather it is your personal contract with the site that is binding.

I am a NHSC loan-repayment program participant and my site experienced financial difficulties. It was my responsibility to find a new placement within a designated timeframe, otherwise I faced being placed anywhere in the United States at NHSC's discretion. This was a stressful situation for both my husband and me who only 11 months prior had relocated 6,000 miles to a remote area for my NHSC placement.

Audrey Ham, PhD

New York


Psychologists' military roles

In response to recent claims that psychologists have been involved in torture and abusive interrogations, some psychologists are now calling for a complete ban on any involvement in military interrogations. I am troubled by these claims, but I am also troubled by two questions concerning this proposed solution: By extension, shouldn't psychologists withdraw from all coercive interrogations, including those by law enforcement agencies? Don't further restrictions in the diversity of individuals involved in such interrogations increase the potential for abuse even further?


Robert McGrath, PhD

Teaneck, N.J