After the Newtown, Conn., tragedy in December 2012, I wrote about my understanding of “ suicide preceded by mass murder ” and my supposition that an element of contagion was involved with the dynamics of such events.

I highlighted David Phillips ’ seminal research in the area of “contagion suicides,” and noted that when an individual commits suicide and the media give that suicide a lot of coverage, shortly afterward, “copycat” or “contagion” suicides seem to occur.

The association is so strong that the American Foundation for Suicide Prevention, the American Association of Suicidology, and the Annenberg Public Policy Center have provided “Reporting on Suicide: Recommendations for the Media.” These guidelines suggest that the media not give a great deal of attention to the phenomenon of suicide, and they begin with the assertion that “suicide contagion is real.”

The problem is that suicide preceded by mass murder and such events are so “newsworthy” that it is difficult for the media to avoid reporting on them. Researchers at Arizona State University’s Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Tempe, and Northeastern Illinois University, Chicago, have done probability studies indicating that the patterns of many such events are bunched in time rather than occurring randomly (indicating contagion). Specifically, the researchers found “significant evidence that mass killings involving firearms are incented by similar events in the immediate past” (PLOS One. 2015 Jul 2. doi: 10.1371/journal.pone.0117259 ). “We also find significant evidence of contagion in school shootings, for an incident is contagious for an average of 13 days, and incites an average of at least 0.22 new incidents (P = .0001),” they noted.

The researchers also identified patterns among mass shootings in the United States involving firearms and school shootings: “Mass killings involving firearms occur approximately every 2 weeks in the United States, while school shootings occur on average monthly,” they wrote.

They used the same methodology that Phillips used in his studies, but the more recent research had to use a wider data base (Phillips used local newspapers; pre-Internet, most news was local), and relied on USA Today mass killings data and Brady Campaign data as the media coverage of these events is widespread and ubiquitous. The authors’ study shows that 20%-30% of the suicides preceded by mass murder stem from contagion.

Still, those of us who are in the business of prevention and treatment must wonder who is susceptible.

One empirically based observation about school shootings has come to my attention, thanks to Jody Allen Crowe, a lifelong educator who has studied many of the school shootings and written a book on the topic called, “ The Fatal Link ” (Denver: Outskirts Press, 2008).

In this book, he addresses a simple question: “What would cause a person to have such poor judgment as to go into a school, kill a bunch of innocent people, and then often kill themselves?” Mr. Crowe’s answer is simple: “fetal alcohol exposure.” He has been an educator on several Native American reservation schools and has seen firsthand the classical dysfunctional emotional and behavioral patterns of children who were exposed to alcohol as fetuses – poor social skills and affect regulation, intellectual challenges, difficulty learning from experience, and so on.

He has taken the time to gather information about the 69 school shooters from 1966 to 2008. He was able to cull enough information on 66% of the shooters to determine that they probably had prenatal exposure to alcohol. In 25%, there was not enough information, and 9% did not have the five factors used to determine probable exposure, according to Mr. Crowe, founder and president of a nonprofit organization called Healthy Brains for Children .

My question is: When is America’s media going to learn that inundating American citizens with stories of “suicide preceded by mass murder” leads to more casualties? Such stories are just not healthy. Of course we want our First Amendment freedoms, but I doubt if any of us want violent ideas being planted in those most vulnerable to being influenced to perpetrate a school shooting.

The difficulty is getting the media’s frontal lobes awake enough to stop being imprisoned by their amygdalae and their urge to follow the maximum, ‘If it bleeds, it leads,” and to help them understand, based on research, that they are promoting 20%-30% of the school shootings – maybe even more.

If Jody Allen Crowe is right, and, based on my own clinical experience and research, I believe he is, the medical community needs to do something about the root cause of school shootings – fetal alcohol exposure. As former Surgeon General David Satcher always reminds us , “There is a terrifying gap between what we do know and how we act.”

Dr. Bell is staff psychiatrist at the Jackson Park Hospital Family Medicine Center and former president/CEO of the Community Mental Health Council, both in Chicago. He is former director of the Institute for Juvenile Research and former professor of psychiatry and public health at the University of Illinois at Chicago.

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