Familicide-suicide following separation is under-researched and remains a poorly understood phenomenon. Findings from previous research are inconclusive in relation to both risk factors and perpetrator motivation. This article explores the relevance of long-term biopsychosocial antecedents in cases of familicide-suicide that occurred in Western Australia between 1986 and 2005. A conceptualisation of the hypothesised risk factors in familicide-suicide is proposed based on attachment theory, personality dysfunction, the neurobiology of trauma and the possible unconscious motivation of perpetrators, which may prove helpful in assessing the risk of familicide-suicide in family court cases. The research identified and articulated a number of warning signs to familicide-suicide that are often not identified, or appreciated, by decision makers. Suggestions are offered for changes to practice that may be helpful in identifying and responding to high-risk cases in a way that enhances safety. Copyright (c) 2014 John Wiley & Sons, Ltd. <boxed-text content-type="pullQuote" id="car2317-blk-0001" position="float"> A conceptualisation of the hypothesised risk factors in familicide-suicide is proposed' Clinicians need to be aware of the dynamic psychosocial risk factors associated with violent acting out such as: <list list-type="bulleted"> <list-item id="car2317-li-0021">The combination of Cluster B personality diagnoses. <list-item id="car2317-li-0022">A history of domestic violence. <list-item id="car2317-li-0023">Early childhood trauma requires good interagency communication and cooperation. Key Practitioner Messages
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Derbyshire Mental Hlth Serv NHS Trust, Mental Hlth Res Unit, Derby DE22 3LZ, EnglandDerbyshire Mental Hlth Serv NHS Trust, Mental Hlth Res Unit, Derby DE22 3LZ, England
Clarke, Martin
Davies, Steffan
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Northamptonshire Healthcare NHS Trust, Countywide Mentally Disordered Offender Serv, Northampton, EnglandDerbyshire Mental Hlth Serv NHS Trust, Mental Hlth Res Unit, Derby DE22 3LZ, England
Davies, Steffan
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Hollin, Clive
Duggan, Conor
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Univ Nottingham, Div Psychiat, Nottingham NG7 2RD, England
Arnold Lodge MSU, Leicester, Leics, EnglandDerbyshire Mental Hlth Serv NHS Trust, Mental Hlth Res Unit, Derby DE22 3LZ, England
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Uppsala Univ, Dept Med Sci Occupat & Environm Med, Uppsala, SwedenUppsala Univ, Dept Med Sci Occupat & Environm Med, Uppsala, Sweden
Hogstedt, Carl
Forsell, Yvonne
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Karolinska Inst, Dept Publ Hlth Sci, Stockholm, SwedenUppsala Univ, Dept Med Sci Occupat & Environm Med, Uppsala, Sweden
Forsell, Yvonne
Hemmingsson, Tomas
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Karolinska Inst, Occupat & Environm Med, Stockholm, Sweden
Stockholm Univ, Ctr Social Res Alcohol & Drug, Stockholm, SwedenUppsala Univ, Dept Med Sci Occupat & Environm Med, Uppsala, Sweden
Hemmingsson, Tomas
Lundberg, Ingvar
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Karolinska Inst, Occupat & Environm Med, Stockholm, SwedenUppsala Univ, Dept Med Sci Occupat & Environm Med, Uppsala, Sweden
Lundberg, Ingvar
Lundin, Andreas
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Karolinska Inst, Dept Publ Hlth Sci, Stockholm, SwedenUppsala Univ, Dept Med Sci Occupat & Environm Med, Uppsala, Sweden
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Jawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Jawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry 605006, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Menon, Vikas
Kar, Sujita Kumar
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King Georges Med Univ, Psychiat, Lucknow, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Kar, Sujita Kumar
Ransing, Ramdas
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All India Inst Med Sci, Dept Psychiat, Gauhati, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Ransing, Ramdas
Sharma, Ginni
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King Georges Med Univ, Lucknow, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Sharma, Ginni
Pattnaik, Jigyansa Ipsita
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Kalinga Inst Med Sci, Dept Psychiat, Bhubaneswar, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Pattnaik, Jigyansa Ipsita
Varadharajan, Natarajan
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Jawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Varadharajan, Natarajan
Kaliamoorthy, Charanya
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Jawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Kaliamoorthy, Charanya
Mukherjee, Srijeeta
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MKCG Med Coll, Dept Psychiat, Brahmapur, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Mukherjee, Srijeeta
Agrawal, Aditya
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King Georges Med Univ, Dept Psychiat, Lucknow, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Agrawal, Aditya
Padhy, Susanta Kumar
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All India Inst Med Sci, Dept Psychiat, Bhubaneswar, IndiaJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India
Padhy, Susanta Kumar
Arafat, S. M. Yasir
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Enam Med Coll & Hosp, Dept Psychiat, Dhaka, BangladeshJawaharlal Inst Postgrad Med Educ & Res JIPMER, Dept Psychiat, Pondicherry, India