Threat Assessment Guide

The following is a structured Threat Assessment Guide.  These definitions are an aid to systematically identify individuals at risk for engaging in violent or harmful behaviors, focusing on Extreme Overvalued Beliefs (EOBs) and associated dynamics. Threat assessment should be conducted by trained professionals.

I. Core Criteria for Threat Concerns

A potential threat based on EOBs requires all three core criteria and at least two additional indicators from the supporting criteria:

Core Criteria 

  1. Extreme Overvalued Belief
    • The individual harbors a belief shared by a group, subculture, or online community that becomes increasingly dominant, binary, and resistant to challenge over time.
    • The belief is associated with intense emotional commitment and an amplified sense of moral or ideological justification.
    • The belief may incite or validate actions intended to resolve perceived grievances or achieve ideological goals.
  2. Pathway Behaviors
    • Evidence of research, planning, or incremental actions toward executing a threat or attack.
    • These behaviors are deliberate, rehearsed, or involve procuring means necessary for harm (e.g., weapons acquisition, site surveillance).
  3. Fixation and Identification
    • Persistent preoccupation with a cause, person, or grievance that worsens social or occupational functioning.
    • Symbolic or personal identification as a warrior, savior, or avenger for the belief or cause.

Supporting Criteria (At Least 2 Required)

  1. Last Resort Thinking
    • A triggering event (e.g., personal, professional, or ideological failure) leads the individual to perceive no alternative but to act on a threat.
    • Expressions of hopelessness, desperation, or martyrdom (e.g., “I have no other choice”) are evident.
  2. Social Isolation and Rejection
    • Withdrawal from typical social networks and relationships.
    • History of rejection or disconnection from a radical or extremist group, paradoxically intensifying grievances or risk-taking behaviors.
  3. Cognitive-Affective Dysregulation
    • Presence of cognitive distortions (e.g., catastrophizing, dichotomous thinking) fueling the belief.
    • Emotional states such as anger, despair, or euphoria linked to the belief exacerbate the risk of action.
  4. Cluster B Personality Traits or Disorders
    • Features of narcissistic, borderline, or antisocial personality traits that amplify the likelihood of harm through impulsivity, lack of empathy, or an inflated sense of moral entitlement.
  5. Dynamic and Static Risk Factors
    • Dynamic Factors: Recent life stressors, grievances, or interpersonal conflicts directly related to the belief or threat.
    • Static Factors: History of violence, childhood trauma, or past diagnoses of personality or mood disorders.
  6. Digital Subculture Involvement
    • Participation in online forums or groups that endorse or amplify the belief.
    • Evidence of digital radicalization, such as engagement with harmful content or sharing manifestos or threats online.

II. Cultural and Contextual Considerations

  • Diagnostic evaluations must consider the individual’s cultural, subcultural, and digital context.
  • Behaviors should not be pathologized solely based on unconventional beliefs unless these beliefs are accompanied by identifiable risk behaviors.
  • Emphasis should be placed on assessing whether the belief contributes to functional impairment, fixation, or planning behaviors.

III. Differential Diagnosis

The following must be ruled out before diagnosing a threat based on EOBs:

  1. Delusional Disorder
    • EOBs are distinct from delusions as they are grounded in cultural or subcultural frameworks and are not typically bizarre or idiosyncratic.
    • Evaluate whether the belief is grounded in shared reality or entirely disconnected from evidence.
  2. Obsessive-Compulsive Disorder (OCD)
    • Unlike obsessions, EOBs involve emotional reinforcement and are pursued actively, rather than resisted.
  3. Primary Mental Health Disorders
    • Ensure that behaviors are not better explained by schizophrenia, mania, or other primary psychiatric conditions.
    • EOBs may overlap with other disorders but are not reducible to these conditions.

IV. Behavioral Trajectory Assessment

  • Emphasis should be placed on behavioral trajectories, including escalation of fixation, symbolic identification, and planning.
  • Risk should be re-evaluated at regular intervals or upon identification of last resort triggers.

V. Multidisciplinary Application

  • Use this framework collaboratively with law enforcement, education, social services, and threat assessment teams.
  • Employ structured professional judgment tools alongside this framework for decision-making.

Preliminary Threat Management Recommendations

  1. Early Intervention: Identify and address fixation or planning behaviors before they escalate.
  2. Protective Factors: Strengthen social connections and coping mechanisms while addressing isolation or rejection.
  3. Collaborative Efforts: Ensure alignment between psychiatric assessments, law enforcement actions, and community interventions.

 

Note: The above are the opinions of Tahir Rahman, MD and not any other institution such as Washington University, the APA, or any other organization. Consult with a trained professional or law enforcement if you have concerns an individual.

Coming September 2024