Many children who feel helpless, especially if they have been bullied, lash out at friends and family members or become self-destructive. But not every child has the capacity to commit acts of violence, according to mental health experts who study such events.
To become enraged enough to try to stab multiple people, as 16-year-old Franklin Regional High School sophomore Alex Hribal is accused of doing last Wednesday, requires a predisposition to harm others coupled with particular outside factors, said forensic psychiatrist Phillip Resnick of Case Western Reserve University School of Medicine in Cleveland.
"I think it takes a perfect storm rather than that any kid who is bullied is going to commit" violence, said Dr. Resnick, a psychiatry professor who has provided consultation in many high-profile cases, including those of Jeffrey Dahmer, Timothy McVeigh, Andrea Yates, Scott Petersen, Theodore Kaczynski, Casey Anthony and Chardon High School shooter T.J. Lane. "It's a cluster of factors; there isn't a single formula."
One person might be inarticulate and need to become more physically aggressive in an effort to show his frustration, he said. Another might be suffering from paranoid psychosis, in which he would hear voices and endure hallucinations urging violence.
And while there is no single formula for predicting whether someone will try to harm others, there are some common denominators among the children who have committed, or attempted to commit, violent acts in the past, Dr. Resnick said.
In a 2001 study published in the Journal of the American Academy of Child & Adolescent Psychiatry, researchers found that the 34 teenagers who had committed 27 mass murders between 1958 and the Columbine High School shootings of 1999 were all males, with a median age of 17.
A majority were described as "loners" and abused alcohol or drugs. Almost half had been bullied, were preoccupied with violent fantasy and had a violent history. Although more than 20 percent had a documented psychiatric history, only 6 percent were judged to have been psychotic at the time of the incidents, according to the study.
"Depressive symptoms and historical antisocial behaviors were predominant," the study states. "There was a precipitating event in most cases -- usually a perceived failure in love or school -- and most subjects made threatening statements regarding the mass murder to third parties."
The question of whether any child, including one whose behavior sends up a warning flag to observers, can be pushed to commit a violent crime against multiple victims doesn't have a clear answer, said Carl Baughman, a marriage and family counselor and the executive director of the Samaritan Counseling Center of Western Pennsylvania.
Many things can determine the outcome, including the strength of the child's support system and sense of self-worth, he said.
"Do they have people who care for them and listen to them?" Mr. Baughman said. "Do they feel loved? Do they respect themselves, and were they taught to respect other peoples' rights?"
Children who are bullied often feel backed into a corner, where they can't see other options for their lives and begin to feel anger, rage, frustration and hopelessness they don't know how to deal with, he said.
But if an adult -- such as a parent, teacher, guidance counselor, pastor or principal -- takes the time to ask the child what has upset him, listen to those concerns and take those concerns seriously, it can begin to offer a productive way out of the situation, according to Mr. Baughman.
Adults should consider getting a child professional help if they observe consistent patterns of that child isolating himself from peers, demeaning himself or accepting inappropriate amounts of blame, acting pessimistically "doom and gloom" about the future, as well as showing marked changes in behavior, eating, sleeping and social interaction that can signal depression, he said.
And any threats toward others should be taken seriously, Mr. Baughman said.
"If someone says, 'I'm going to kill my teacher,' that could mean they're having a bad day, but you don't hear a comment like that and ignore it these days," he said. "It's kind of like saying 'bomb' in the airport -- you have to pay attention to it."
Amy McConnell Schaarsmith: firstname.lastname@example.org or 412-263-1719.