Background
Methods
Setting
Variables
Psychiatric symptoms
Stressful life events in family during the last 6 months before the index threat | ||
---|---|---|
yes | 44 | 57 |
parental mental disorders | 18 | 23 |
parental substance use problems | 16 | 21 |
divorce process | 7 | 9 |
severe disease of parent/s | 7 | 9 |
severe problems related to sisters | 7 | 9 |
domestic violence | 4 | 5 |
(suspected) sexual abuse | 2 | 3 |
bereavement | 1 | 1 |
Current symptoms in the adolescent psychiatric evaluation
| ||
symptoms of anxiety | 50 | 65 |
depressive symptoms | 48 | 62 |
problems with impulse control | 46 | 60 |
aggressive outbursts/tantrums | 40 | 52 |
suicidal ideation | 35 | 45 |
destroying property | 32 | 42 |
non-physical aggression towards other people | 31 | 40 |
violence against other people | 31 | 40 |
attention problems | 30 | 39 |
harmful use of alcohol | 19 | 25 |
isolation | 19 | 25 |
psychotic symptoms | 18 | 23 |
truancy/school refusal | 9 | 12 |
use of illicit drugs | 6 | 8 |
symptoms of eating disorders | 6 | 8 |
running away | 6 | 8 |
suicide attempt | 2 | 3 |
manic behavior | 1 | 1 |
property crimes | 0 | 0 |
inappropriate sexual behavior | 0 | 0 |
self-harming behaviors | 0 | 0 |
Delinquency prior the index threat
| ||
no | 45 | 58 |
yes | 21 | 27 |
pilfering/theft/burglary | 15 | 19 |
traffic offence | 14 | 18 |
robbery/assault/attempted homicide | 9 | 12 |
drug offence | 3 | 4 |
sex offence | 2 | 3 |
not clear from files | 11 | 14 |
Adverse family events
Psychiatric diagnoses
The characteristics of the threat expressed and the risk posed by the adolescent
Psychopathic traits
Comparisons to other Finnish adolescent psychiatric samples
Statistics
Results
Background, symptoms and previous delinquency
n | % | |
---|---|---|
F0-09 Organic, including symptomatic, mental disorders | 0 | 0 |
F10-19 Mental and behavioral disorders due to psychoactive substance use | 0 | 0 |
F20-29 Schizophrenia, schizotypal and delusional disorders | 9 | 12 |
F30-39 Mood disorders | 16 | 21 |
F40-49 Neurotic, stress-related and somato form disorders | 8 | 10 |
F50-59 Behavioral syndromes associated with physiological disturbances and physical factors | 2 | 3 |
F60-69 Disorders of adult personality and behavior | 3 | 4 |
F70-79 Mental retardation | 1 | 1 |
F80-89 Disorders of psychological development | 13 | 17 |
F84 Pervasive developmental disorders | 8 | 10 |
F90-98 Behavioral and emotional disorders | 18 | 23 |
F99 Unspecified mental disorder | 1 | 1 |
No psychiatric diagnosis | 6 | 8 |
The threat expressed
n | % | |
---|---|---|
How the index threat was expressed
| ||
orally expressed to a teacher/school friends/therapist | 43 | 56 |
in a letter/note/essay/exam paper | 17 | 22 |
via Internet | 17 | 22 |
A - Action
| ||
Positive attitudes towards aggressive behavior in general
| ||
yes | 58 | 75 |
not clear from files | 12 | 16 |
no | 7 | 9 |
Positive attitudes towards previous school shootings
| ||
yes | 43 | 56 |
no | 19 | 25 |
not clear from files | 15 | 19 |
Felt justification for the attack
| ||
yes | 58 | 75 |
not clear from files | 15 | 19 |
no | 4 | 5 |
Motive
| ||
revenge against identified persons | 34 | 44 |
anger and hatred in general | 27 | 35 |
desire to die (homicide-suicide fantasy) | 24 | 31 |
wanting attention | 4 | 5 |
joke | 3 | 4 |
unclear | 2 | 3 |
C – Capacity to fulfill the threat
| ||
yes | 42 | 55 |
not clear from files | 18 | 23 |
no | 17 | 22 |
T – Thresholdscrossed
| ||
no preparations made | 46 | 60 |
preparations made | 20 | 26 |
not clear from files | 11 | 14 |
I - Intention for the index threat
| ||
passive thinking | 56 | 73 |
clear intention | 14 | 18 |
not clear from files | 7 | 9 |
O – Others’ reactions
| ||
parents took the threat seriously | 38 | 49 |
parents did not take the threat seriously/disparaged the threat | 19 | 25 |
parents were ambivalent | 18 | 23 |
not clear from files | 2 | 3 |
N – Non-compliance to risk reaction
| ||
the adolescent was against psychiatric evaluation/treatment | 44 | 57 |
the adolescent was ambivalent to psychiatric evaluation/treatment | 17 | 22 |
the adolescent was neutral or positive to psychiatric evaluation/treatment | 16 | 21 |
not clear from the files | 0 | 0 |
Psychopathic traits
mean | SD | range | |
---|---|---|---|
PCL-YV total score | 6.5 | 5.30 | 0-26 |
PCL-YV factor I (Affective-Interpersonal) | 2.3 | 2.3 | 0-8 |
PCL-YV factor II (Lifestyle-Antisocial) | 3.7 | 3.4 | 0-14 |
n
|
%
| ||
PCL-YV total score ≥ 30 | 0 | 0 | |
PCL-YV total score 20-29 | 1 | 2 | |
PCL-YV total score 10-19 | 11 | 22 | |
PCL-YV total score 1-9 | 31 | 62 | |
PCL-YV total score 0 | 7 | 14 |
The copycats as compared to previous Finnish clinical adolescent psychiatric samples
Symptom | Copycats | Inpatients | Outpatients | Inpatients vs. Copycats | Outpatients vs. Copycats | ||
---|---|---|---|---|---|---|---|
p | OR (95% Cl) | p | OR (95% Cl) | ||||
suicidal ideation & talk | 45.5 (35/77) | 63.1 (118/187) | 34.8 (69/198) | 0.006 | 1.5 (0.8-2.9) | 0.07 | 0.4 (0.12- 0.7) |
suicide attempt | 2.6 (2/77) | 19.8 (37/187) | 2.5 (5/198) | <0.001 | 3.8 (0.8-17.0) | 0.62 | 0.7 (0.09-5.4) |
self-harming behaviours | - | 40.1 (78/187) | 23.2 (46.198) | <0.001 | n.a. | <0.001 | n.a. |
psychotic symptoms | 23.4 (18/77) | 48.7 (91/187) | 23.7 (47/198) | <0.001 |
2.2 (1.1- 4.3)
| 0.47 | 0.6 (0.3-1.3) |
depression | 62.3 (48/77) | 74.9 (140/187) | 56.9 (118/198) | 0.03 | 1.5 (0.8-2.8) | 0.42 | 0.5 (0.3-1.0) |
manic behaviour | 1.3 (1/77) | 6.4 (12/187) | 0.5 (1/198) |
0.07
|
10.7 (2.2- 98.8)
| 0.48 | 0.2 (0.003-8.2) |
hostile behaviour | 40.3 (31/77) | 26.7 (50/187) | 12.6 (25/198) | 0.02 | 1.0 (0.5-1.9) | <0.001 | 0.6 (0.3-1.3) |
temper tantrums | 51.9 (40/77) | 15.0 (28/187) | 9.1 (18/198) |
<0.001
|
0.3 (0.1-0.5)
|
<0.001
|
0.2 (0.08-0.4)
|
violent behaviour | 40.3 (31/77) | 28.3 (53/187) | 14.1 (28/198) | 0.04 | 1.1 (0.6-2.1) | <0.001 | 0.6 (0.3-1.2) |
breaking property | 41.6 (32/77) | 10.2 (19/186) | 7.6 (15/198) |
<0.001
|
0.3 (0.1-0.6)
|
<0.001
|
0.3 (0.1-0.7)
|
inappropriate sexual behaviour | - | 8.0 (15/187) | 10.1 (20/198) | 0.03 | n.a. | 0.001 | n.a. |
alcohol abuse | 24.7 (19/77) | 32.1 (60/187) | 28.8 (57/198) | 0.22 | 1.4 (0.7-2.8) | 0.32 | 1.0 (0.5-2.2) |
substance use | 7.8 (6/77) | 13.9 (26/187) | 7.6 (15/198) | 0.12 | 1.0 (0.3-3.1) | 0.55 | 0.7 (0.2-2.4) |
truancy/school refusal | 11.7 (9/77) | 36.9 (69/187) | 30.3 (60/198) |
<0.001
|
5.7 (2.5- 13.1)
|
0.001
|
3.0 (1.2- 7.3)
|
property crimes | - | 9.6 (18/187) | 6.6/13/198) | 0.002 | n.a. | 0.01 | n.a. |
eating disorder symptoms | 7.9 (6/77) | 23.5 (44/187) | 26.8 (53/198) | 0.002 | 1.6 (0.6-4.5) | <0.001 | 1.2 (0.4-3.8) |
isolation | 24.7 (19/77) | 5.3 (10/187) | 20.2 (40/198) | <0.001 | 1.1 (0.4-1.3) | 0.24 | 0.8 (0.4-1.7) |
impulse control problems | 59.7 (46/77) | 3.2 (6/187) | 21.7 (24/198) |
<0.001
|
0.03 (0.01-0.08)
|
<0.001
|
0.4 (0.2-0.8)
|
running away | 7.8 (6/77) | 13.9 (26/187) | 7.1 (14/198) | 0.12 | 1.4 (0.5-4.1) | 0.50 | 1.2 (0.4-4.3) |
attention problems | 39.0 (30/77) | 0.5 (1/187) | 26.3 (52/198) |
<0.001
|
0.004 (<0.001-0.04)
| 0.02 | 1.0 (0.5-2.0) |
anxiety | 64.9 (50/77) | 9.6 (18/187) | 61.6 (122/198) |
<0.001
|
0.03 (0.01-0.09)
|
0.31
|
0.3 (0.1-0.6)
|
Symptom | Copycats | Inpatients | Outpatients | Inpatients vs. Copycats | Outpatients vs. Copycats | ||
---|---|---|---|---|---|---|---|
p | OR (95% CI) | p | OR (95% CI) | ||||
family violence | 5.2 (4/77) | 16.6 (31/187) | 16.7 (33/198) |
0.009
|
3.8 (1.2- 12.3)
|
0.008
|
3.9 (1.1- 13.7)
|
parental substance use problems | 20.8 (16/77) | 17.1 (32/187) | 12.5 (24/198) | 0.28 | 0.6 (0.3-1.4) | 0.05 | 0.64 (0.26- 1.60) |
divorce or separation | 9.1 (7/77) | 5.9 (11/187) | 6.1 (12/198) | 0.24 | 0.6 (0.2-1.9) | 0.25 | 0.49 (0.13- 1.79) |
bereavement | 1.3 (1/77) | 12.8 (24/187) | 8.1 (16/198) |
0.002
|
10.5 (1.3- 84.4)
| 0.03 | 7.89 (0.88- 68.4) |
parental severe somatic illness | 9.1 (7/77) | 3.7 (7/187) | 9.1 (18/198) | 0.07 | 0.5 (0.1-1.8) | 0.57 | 0.80 (0.24- 2.65) |
parental severe mental disorder | 23.4 (18/77) | 11.8 (22/187) | 15.2 (30/198) |
0.03
|
0.4 (0.2-1.0)*
| 0.11 | 0.84 (0.36- 1.98) |
severe financial difficulties, unemployment etc. | 10.4 (8/77) | 4.8 (9/187) | 12.1 (24/198) | 0.08 | 0.5 (0.2-1.6) | 0.45 | 0.58 (0.19- 1.77) |
severe problems related to siblings | 9.1 (7/77) | 7.0 (13/187) | 15.2 (30/198) | 0.35 | 0.5 (0.2-1.6) | 0.14 | 0.82 (0.27- 2.52) |
(suspected) sexual abuse within the family | 2.6 (2/77) | 3.7 (7/187) | 2.5 (5/198) | 0.49 | 0.5 (0.1-3.9) | 0.62 | 0.30 (0.03-2.88) |