Table of Contents

Introduction The Virginia Tech Killings Prevention of Apocalyptic Mass Murder/Suicide Author Bio Cho Seung-Hui The Virginia Tech Shootings The Shootings Begin Norris Hall The Manifesto Who was Cho Seung-Hui? Cho's Childhood Cho's Problems Worsen The Middle School Years High School College Cho's Psychosis Worsens The Fatal Spring Semester, 2007 What We Have Learned from the Virginia Tech Massacre Emergency Medicine in America Prediction of Violence: Who Is Dangerous to Whom, Why, and What Can Be Done about It? Predicting Future Behavior The Neuropsychiatric Assessment of Violence Principles of Triage The Gathering Storm No Exit, Not Even for Doctors Medical Receptionists as Gatekeepers Validity of Diagnosis for Service Optimization Innovation for Service Optimization via Progressive Computer-Assisted Screening Computer Software Can Model the Clinician's Triage Decision Process Diagnostic Specificity Necessary for Documentation and Service Optimization Emergency Med-Surg States of Mental Disorganization Impairment Emergency Screens Violence toward Staff Assessing Dangerousness Other Violent Crime Statistics Assessing Suicide Intent Medical Screens Neuropsychiatric Screen Med-Surg Screen Screens for States of Mental Disorganization Psychosis Substance Abuse Traumatic Stress Disorders Psychiatric Impairment Dysphoria and DSM IV Screen Psychosocial Maladjustment The Virginia Panel and Campus Safety Treatment Advocacy Kurt Entsminger An Epidemic of Campus and Workplace Suicidal Mass Murder The Psychotic Modern Psychiatry and the Psychotic Cho Seung-Hui, Attachment Disorders, and Pathological Narcissism The Paul Keller Case Origins of Rage in Pathological Narcissism Best Clinical Practices First Encounter: Clinical Assessment in the New Millennium The 9/11 Anthrax Case Potential Signs for Dangerous Behavior and Best Practice Solutions Prevalence of Violence Sodini's Videos Warning Signs of Violence Ideations of Violence and Violent Fantasies Actual Warnings of Impending Violence Auditory Hallucinations Bullies and Victims of Bullying Previous Acts of Violence or Sexual Violence Chronic Drug or Alcohol Abuse Cumulative Rage Dramatic Mood Swings Violent Sexual Fantasies and Insatiable Sex Drives Abnormal Fascination or Obsession with Blood, Gore, and Death Indifference to Life, to Suffering, and to Pain of Other Creatures History of Arson and Fire Starting History of Homicidal Behavior or Manifested Homicidal Intent as a Child Gathering and Possession of Weapons Best Practice Solutions Education Warnings to Individuals Enabling Violent Behavior Community Education Municipal and State Child Services and Juvenile Services Emergency Room Training Telemedicine Telepsychiatry Change Makers Emergency Med-Surg States of Mental Disorganization Impairment Appendix A Appendix B: Richard McBeef Appendix C: The Sodini Transcript

About the Author

John Liebert, M.D., is a Diplomat of the American Board of Psychiatry and Neurology and is in the private practice of neuropsychiatry, with special interests in both psychopharmacology and forensic problems of children, adults, and the elderly. His career has been focused on the association of trauma and human destructiveness, about which he has extensively lectured and written. He served as special forensic psychiatry consultant to the Ted Bundy, Green River, Atlanta Child Murders, and Charmer cases. William J. Birnes, J.D., Ph.D. is a New York Times bestselling author. With Robert D. Keppel, he co-authored the CRC Press book Serial Violence: Analysis of Modus Operandi and Signature Characteristics of Killers. He is currently the Chairman of Sunrise Community Counseling Center in Los Angeles.

Reviews

! the definitive book on mass murderers, written by the man who knows more about interviewing and profiling violent offenders than anyone else in his field.a Dr. Liebert's work in forensic psychiatry is second to none.a -- Robert D. Keppel, Ph.D., author of The Riverman and Serial Violence No better person could have been chosen ! than John Liebert, America's psychiatric expert on serial killings and mass murder, who is frequently called to assist the law enforcement in such cases as Green River, the Atlanta Child Murders, and the Ted Bundy cases. -- Steven Hirsch, M.D., Forensic Psychiatrist and leading international researcher in the field of schizophrenia ! an excellent presentation of the Virginia Tech incident, definitely some lessons to be learned. --Marvin Skeen, Chief Criminal Investigator, Criminal Justice Division, HITS Unit, Washington State Office of the Attorney General Dr. John Liebert, a well-known and highly respected psychiatrist, has written an eye-opening, timely andaimportant bookaabout a dramatic and tragic subject, with which we are all-too-familiar: It is aboutaindividuals in our midst who have perpetrated mass murders and then committed suicide. His astute thesis is that theseaadult killersawere showing clues early in their development that we in the education, corrections and mental health professions should have, and indeed could have, picked up. Dr. Liebert is veryapersuasive when he shows that early sensitivity to aberrant behaviors,afollowed byatimely corrective interventions, could have staved off the tragic outcomes which befell the victims, and affected all of us.aThis significantawork should serve as a resource for those who areainvestigating these terrible occurrences, as well as for those who are interested in preventing such tragedies in the future. --Dr. Saul Levine, Professor of Clinical Psychiatry, University of California, San Diego, international expert on factors reducing the risk of adolescent violence Dr. Liebert is a nationally known and respected psychiatrist. His expertise assessing human behavior and dangerousness have contributed to our understanding of those individuals who perpetuate mass homicide and suicide. Dr. Liebert's discussion of these individuals, and their actions, offer insights to help identify and deter future tragedies. --Dr Robert Johnson, Clinical Psychologist, FORCCOM, US Army, Baghdad, Iraq When I was in charge of the Missing and Murdered Children case in Atlanta, Georgia during the late 70s and early 80s, John Liebert was one of my psychiatric advisers. He provided valuable insight into the possible motives of the person or persons responsible for the killing of Atlanta's children. Now he has written a book that explains to the reader why mass murderers kill. By examining actual cases, he provides the reader with a clear insight into the phenomenon of mass violence. It is a must read for anyone associated with criminal justice education as well criminal justice and medical practitioners. --Dr. Lee P. Brown, Chairman and CEO, Brown Group International ... Chapter 2, which I think is excellent ! [the book raises] many interesting issues. I never knew where least restrictive alternative came from, so I learned something. --Dr Bill Holliday, Police Psychiatrist of Washington State I was eager to read Dr. Liebert's Suicidal Mass Murderers -- A Criminological Study of Why They Kill and found the chapters on "Prediction of Violence" and "Potential Signs for Dangerous Behavior" to be the most useful, from a law enforcement point of view. If we can identify and interdict a mass murderer BEFORE a massacre occurs, we will have provided an extremely valuable service. I can assure the reader that every murder victim would have preferred the PREVENTION of that murder to a detailed police investigation AFTER the fact! Dr. Liebert's splendid contribution toward that goal will be welcomed by all concerned and will help to save lives that might otherwise be lost. -- D.P. Van Blaricom, MPA, Chief of Police (Retired), Bellevue, Washington