A common view, fostered by multiple mass shootings in the United States, is that violence is often secondary to a mental disorder. However, a new study conducted by the University of California, Berkeley, shows that hallucinatory delusions associated with psychosis are rarely a precursor to aggressive behavior. The study was extensive, reviewing a total of 305 violent incidents in the United States. The results showed that only 12 percent were secondary to psychosis. In contrast, a higher proportion of these bestiality and bloodshed incidents were motivated by anger, exposure to weapons, and substance abuse. This is the first analysis to review psychosis-induced violence, and the results challenge the media-driven public stereotype of homicidal tragedy. The study is published online in Clinical Psychological Science. ”High-profile mass shootings have captured the public’s attention and heightened wariness of people with mental illness. Yet our findings clearly show that mental illness rarely leads directly to violence.” noted lead researcher Jennifer Skeem. Along with co-researchers at the University of Virginia and Columbia University, Skeem focused on patients with a high risk of violence tracked by the MacArthur Violence Risk Assessment Scale Institute. This large-scale study, conducted in 1998, included a total of 1,100 offenders discharged from psychiatric institutions. The researchers looked specifically at a subgroup of 100 high-risk patients who were involved in 2 or more violent incidents within 1 year of discharge from a psychiatric facility. The researchers sought to understand the mental state of these individuals at the time they committed the violent acts. ”We wanted to open a discussion for a small group of patients with recurrent violent behavior to explore whether these violent events are always caused by hallucinatory delusions.” Skeem noted. In the study, violent behaviors included physical injury, sexual assault and assault or threat with a weapon, and psychiatric disorders spanned schizophrenia and bipolar disorder to severe anxiety and depression. In addition to reviewing the records, the researchers interviewed patients to understand their thoughts and feelings in the immediate aftermath of the violence and obtained information from the perspective of their friends and family. The results showed that only 12% of violent acts were secondary to psychosis and that although psychosis contributed to an incident of violence, it was almost never associated with subsequent violence. Mental health workers and advocates warn that high-profile mass homicides promote discrimination against mental illness and discourage people with mental disorders from disclosing their conditions and seeking help. In fact, people with mental illness are more likely to be the victims of violence than the perpetrators. A study published in the American Journal of Public Health in February found that less than 5 percent of the 120,000 gun-related homicides in the United States between 2001 and 2010 were committed by people with mental disorders, yet this group is at significantly higher risk of being victims of violence than the average. ”Nothing can take away the fact that people with mental illness need psychiatric treatment,” Skeem noted, “but it’s important to remember that the real risk factors for violence, such as substance abuse, childhood maltreatment and neighborhood disadvantage, are normal people. neighborhood disadvantage) that are common to both normal people and people with mental disorders, and that’s what we should be looking at in order to maximize public safety.”