Current Psychiatry Reports

, 16:469 | Cite as

Multiple Vantage Points on the Mental Health Effects of Mass Shootings

  • James M. ShultzEmail author
  • Siri Thoresen
  • Brian W. Flynn
  • Glenn W. Muschert
  • Jon A. Shaw
  • Zelde Espinel
  • Frank G. Walter
  • Joshua B. Gaither
  • Yanira Garcia-Barcena
  • Kaitlin O’Keefe
  • Alyssa M. Cohen
Disaster Psychiatry (CS North and B Pfefferbaum, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Disaster Psychiatry


The phenomenon of mass shootings has emerged over the past 50 years. A high proportion of rampage shootings have occurred in the United States, and secondarily, in European nations with otherwise low firearm homicide rates; yet, paradoxically, shooting massacres are not prominent in the Latin American nations with the highest firearm homicide rates in the world. A review of the scientific literature from 2010 to early 2014 reveals that, at the individual level, mental health effects include psychological distress and clinically significant elevations in posttraumatic stress, depression, and anxiety symptoms in relation to the degree of physical exposure and social proximity to the shooting incident. Psychological repercussions extend to the surrounding affected community. In the aftermath of the deadliest mass shooting on record, Norway has been in the vanguard of intervention research focusing on rapid delivery of psychological support and services to survivors of the “Oslo Terror.”

Grounded on a detailed review of the clinical literature on the mental health effects of mass shootings, this paper also incorporates wide-ranging co-author expertise to delineate: 1) the patterning of mass shootings within the international context of firearm homicides, 2) the effects of shooting rampages on children and adolescents, 3) the psychological effects for wounded victims and the emergency healthcare personnel who care for them, 4) the disaster behavioral health considerations for preparedness and response, and 5) the media “framing” of mass shooting incidents in relation to the portrayal of mental health themes.


Mental health Mental disorders PTSD Stress disorders/post-traumatic Shooting Mass shooting Shooting massacre Rampage shooting Weapons Firearms Guns Gunshot wounds Violence Firearm violence Workplace violence Homicide Gun control Media framing 


Compliance with Ethics Guidelines

Conflict of Interest

James M. Shultz, Siri Thoresen, Brian W. Flynn, Glenn W. Muschert, Jon A. Shaw, Zelde Espinel, Joshua B. Gaither, Yanira Garcia-Barcena, Kaitlin O’Keefe, and Alyssa M. Cohen declare that they have no conflict of interest.

Frank G. Walter has financial relationship with and has received paid travel expenses from Heyltex Corp.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • James M. Shultz
    • 1
    • 12
    Email author
  • Siri Thoresen
    • 2
  • Brian W. Flynn
    • 3
  • Glenn W. Muschert
    • 4
  • Jon A. Shaw
    • 5
  • Zelde Espinel
    • 6
  • Frank G. Walter
    • 7
  • Joshua B. Gaither
    • 8
  • Yanira Garcia-Barcena
    • 9
  • Kaitlin O’Keefe
    • 10
  • Alyssa M. Cohen
    • 11
  1. 1.Center for Disaster & Extreme Event Preparedness (DEEP Center)University of Miami Miller School of MedicineMiamiUSA
  2. 2.Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorway
  3. 3.Department of Psychiatry, Center for the Study of Traumatic StressUniformed Services University of the Health SciencesBethesdaUSA
  4. 4.Sociology, Criminology, and Social Justice Studies; Faculty Affiliate, Comparative Media StudiesMiami UniversityOxfordUSA
  5. 5.Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral HealthUniversity of Miami Miller School of Medicine and Jackson Memorial HospitalMiamiUSA
  6. 6.Department of Psychiatry and Behavioral HealthUniversity of Miami Miller School of Medicine and Jackson Memorial HospitalMiamiUSA
  7. 7.Department of Emergency Medicine, Arizona Emergency Medicine Research CenterThe University of Arizona College of MedicineTucsonUSA
  8. 8.Department of Emergency Medicine, Arizona Emergency Medicine Research CenterThe University of Arizona College of MedicineTucsonUSA
  9. 9.Department of Health Informatics, Louis Calder Memorial LibraryLeonard M. Miller School of MedicineMiamiUSA
  10. 10.Department of Health SciencesCalifornia State University, NorthridgeNorthridgeUSA
  11. 11.TallahasseeUSA
  12. 12.Sunny Isles BeachUSA

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