Suicidal Mass Murderers: A Criminological Study of Why They Kill, 1st Edition (Paperback) book cover

Suicidal Mass Murderers

A Criminological Study of Why They Kill, 1st Edition

By John Liebert, William J. Birnes

CRC Press

335 pages

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On April 16, 2007, Cho Seung-Hui, a student at Virginia Tech with a history of mental illness, became the perpetrator of the most infamous school shooting in the history of the United States. In the aftermath of the killings and Cho’s subsequent suicide, one primary question emerged: Why? Suicidal Mass Murderers: A Criminological Study of Why They Kill explores the answer to this and related questions.

Detailing Cho’s descent into madness that culminated in this tragic event, the book asks how we can:

  • Identify and red flag the potentially dangerous
  • Intervene early in their lives to prevent violence
  • Mitigate potential damage
  • Sequester, even involuntarily, the violent mentally ill
  • Treat the dangerously mentally ill to being them back into meaningful lives
  • Do all of this while protecting the patient’s constitutional rights

Exploring the concept of whether such violent acts can be predicted, the book reveals the potential warning signs to look for in suspect individuals. First responders, public health authorities, and clinicians must learn to detect these early indicators if there is any hope in preventing a catastrophe such as what occurred at Virginia Tech from ever happening again.

John Liebert maintains a website with additional information. In 2013, he received the Perciball Pott Virtuous Surgeon Award from McGill University Faculty of Medicine.


… 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. Dr. Liebert's work in forensic psychiatry is second to none.

— 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 and important book about a dramatic and tragic subject, with which we are all-too-familiar: It is about individuals in our midst who have perpetrated mass murders and then committed suicide. His astute thesis is that these adult killers were 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 very persuasive when he shows that early sensitivity to aberrant behaviors, followed by timely corrective interventions, could have staved off the tragic outcomes which befell the victims, and affected all of us. This significant work should serve as a resource for those who are investigating 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

The authors’ backgrounds give them the ability to provide insight into these events in ways that are especially useful to security practitioners.

Security Management, April 2012

Table of Contents


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


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



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


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


Warnings to Individuals

Enabling Violent Behavior

Community Education

Municipal and State Child Services and Juvenile Services

Emergency Room Training



Change Makers



States of Mental Disorganization


Appendix A

Appendix B: Richard McBeef

Appendix C: The Sodini Transcript

About the Authors

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.

Subject Categories

BISAC Subject Codes/Headings:
LAW / Forensic Science
MEDICAL / Psychiatry / General