European Journal of Public Health, Vol. 19, No. 6, 578579 The Author 2009.

. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. doi:10.1093/eurpub/ckp144 Advance Access published on 18 September 2009

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Media running amok after school shooting in Winnenden, Germany!

ran Hajak, Helmut Hausner bner-Liebermann, Go Tanja Neuner, Bettina Hu

ccording to the The Sun, a TEEN shooter went on bloody rampage at a German high school today killing 15 people before shooting himself during a gunfight with cops. Police said the classrooms were running with blood. Smiling happily for the camera, these are three of the girls shot dead by a crazed gunman at a German school. I was shot 3 times . . . Chantal slumped dead by the door. Click here to see the latest pictures from the scene!1 In the morning of 11 March, a 17-year-old teenager went on a shooting spree at his former secondary school in Winnenden near Stuttgart, southwest Germany. The amok2 resulted in 15 deaths, followed by the suicide of the perpetrator, who had graduated from this school 1 year before. Beneath the speculation thatgiven the wrong circumstancesany of us is capable of running amok,3 from a psychiatric point of view, it seems that the dynamics of school shooting are similar to the mechanics that govern suicide with hostile intent or murder-suicide, whereby the individual expresses its desire and personal identity only by destroying others and itself.46 The tragic happening in Winnenden was steadily accompanied by live broadcast of both nationwide and international media, spiked beneath others with sensation seeking pictures, guesswork about subjective reasons and family background of the perpetrator. Yellow press and Twitter successfully share the first place of the media coverage cup. The former for good-style mock-up graphics showing the perpetrator with black combat gear firing in a classroom or storming school corridors, the latteran online social network and micro-blogging servicefor bringing the catastrophic news by far earlier than television crews into the living rooms, not holding back with snapshot misinformation oreven more unluckilywith correct information overrunning privacy. More than 1 week after the incident, media interest barely peaked off. Beneath pointing out to former school massacres and blood baths in Dunblane (1996, Great Britain), Columbine (1999, USA), Erfurt (2002, Germany), Emsdetten (2006, Germany), Jokela (2007, Finland) and Kauhajoki (2008, Finland), private pictures of and information about the perpetrator and the victims were continuously published in crossborder competition. Accusing voices have been raised, also amongst the medias midst including the German Union of Journalists, condemning the way of coverage and pointing with admonishing forefinger towards the danger of imitation. Indeed, for suicides, the so-called Werther effect, i.e. the increase of suicide rates due to copycat suicide after wide media coverage, has already been proved in various studies.79 More than likely, also sensational publicity about a violent crime like school shooting may cause an increase in similar behaviours.10 Thereby, copycat killing might be

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the mechanism underlying the spreading of school shootings.4 Media coverage of school shootings has been reported to be followed by an increase of threats against schools,4,11 exactly as it could be observed in Germany during the past days. An analysis of reports of national and international newspapers about 143 amok events showed that the majority of amok events is not distributed by chance over time, but occurs shortly after the first coverage.10 As there is an evidence for a strong similarity between the events with regard to the modus operandi and person variables, reporting might trigger the same attitude and behaviour in persons who find themselves in a similar state.10 In some school shootings, the perpetrator recorded a message and disseminated it via the internet, indicating the desire that other people understand the reasons for doing so. Thereby, the media and reports on the internet could facilitate the diffusion of these potentially lethal norms.4 The development of a code of rules to report on these episodes is postulated, which could prevent the dissemination of the norms that might encourage this behaviour.4 Identification with or even desire to out-herod former perpetrators has often been stated by later perpetrators before the episode. Thereby, the publicity and number of victims of the former perpetrator seem to be a stimulus which has to be topped. Ideally, similar principles as for coverage about suicide have to be considered for media coverage about amok.4,10 For example, when there is evidence for a mental disorder of the perpetratorwhich is present in >50% of amok runners12it is recommended to mention this in the same breath as addresses for help. Furthermore, not only glorification but also demonization should be avoided as well as simplification of the motive to prevent identification by persons at risk. Information on methods of killing or acquisition of arms should never be given in detail. If media coverage was done in a responsible, refraining way and frequency as well as content were changed in an effort to reduce copycat effects, further amok-suicides might be prevented as successfully as it had been proved for suicides.7,9 But where to look for the balance between public interest against the risk of harm? It seems like the media have shot it off. Conflict of interest: None declared.

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References
1 The Sun, extracts from articles and headlines between Mar 11th and Mar 13th 2009. Available at: http://www.thesun.co.uk/sol/homepage/ (accessed on 23 March 2009). Kon Y. Amok. Br J Psychiatry 1994;165:6859. Turner TH. Running amok. The Lancet 1988;1:124. Preti A. School shooting as a culturally enforced way of expressing suicidal hostile intentions. J Am Acad Psychiatry Law 2008;36:54450. Preti A. Suicide to harass others: clues from mythology to understanding suicide bombing attacks. Crisis 2006;27:2230. Marzuk PM, Tardiff K, Hirsch CS. The epidemiology of murder-suicide. JAMA 1992;267:317983.

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Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany Correspondence: Tanja Neuner, Department of Psychiatry and tsstr. 84, 93053 Psychotherapy, Bezirksklinikum Regensburg, Universita Regensburg, Germany, tel: +49 941/941-1623, fax: +49 941/941-1605, e-mail: tanja.neuner@medbo.de

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Stack S. Media coverage as a risk factor in suicide. J Epidemiol Community Health 2003;57:23840. fner H. The Werther effect after television films: new Schmidtke A, Ha evidence for an old hypothesis. Psychol Med 1988;18:66576. Sonneck G, Etzersdorfer E, Nagel-Kuess S. Imitative suicide on the Viennese subway. Soc Sci Med 1994;38:4537.

11 Kostinsky S, Bixler EO, Kettl PA. Threats of school violence in Pennsylvania after media coverage of the Columbine high school massacre: examining the role of imitation. Arch Pediatr Adolesc Med 2001;155:9941001. t des Amokla ufer-Syndroms. 12 Adler L, Marx D, Apel H, et al. Zur Stabilita ber Kontentanalytische Vergleichsuntersuchung von Pressemitteilungen u ufer der Dekaden 19801989 und 19912000 [Stability deutsche Amokla of the amok runner syndrome. content analytic comparison of press reports of the decades 19801989 and 19912000 on amok in Germany]. Fortschr Neurol Psychiat 2006;74:58290.

ller I, et al. Imitation von Amok und 10 Schmidtke A, Schaller S, Mu Amok-Suizid [Imitation of amok and amok-suicide]. Suizidprophylaxe 2002;29:97106.

Received 20 July 2009, accepted 19 August 2009

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