School Shooters: Patterns of Adverse Childhood Experiences, Bullying, and Social Media.

Introduction: Since 2013 there have been at least 421 recorded incidents of gunfire on school grounds METHOD: This study used a critical review of national and local media news reports of 25 American male school shooter cases from 2013 to 2019.

Results: Approximately 88% of school shooters had at least one social media account, and 76% posted disturbing content of guns and threatening messages. Over 72% of shooters had at least one reported adverse childhood experience, and 60% reported being bullied in-person or online DISCUSSION: Professionals who work with adolescents are front-line providers who routinely assess student safety. Social media use is often underassessed, demonstrating a knowledge gap that may reveal insights into the perspective and well-being of adolescents. Inclusion of questions on social media, adverse childhood experiences, and experiences of bullying by pediatric nurses and others may be proactive measures that can help identify, protect, and intervene with at-risk students.