Within-Person Variability in Firearm Carriage Among High-Risk Youth

Examining the Relation Between Early Violence Exposure and Firearm-Related Experiences in Emerging Adulthood: A Longitudinal Cohort Study

Firearms are a leading cause of death among adolescents and young adults in the United States. Early exposure to violence, as a victim or witness, is associated with increased risk of firearm-related experiences, including carrying and threatening others with a gun. These experiences, in turn, increase the risk of both fatal and non-fatal firearm injuries. Using an ethnically diverse sample of emerging adults, we build on prior research by examining the link between early violence exposure at multiple contexts of the social-ecological model and multiple firearm-related experiences (i.e., firearm-threatening victimization, firearm-threatening perpetration, and firearm carriage). We analyzed data from a 10-year longitudinal study of 1042 youth in the Southern United States. Experiencing childhood physical abuse was associated with both firearm-threatening victimization and perpetration in emerging adulthood. Additionally, exposure to neighborhood and interparental violence were linked to threatening others with firearms and carrying firearms, respectively. Counter to expectations, bullying victimization did not emerge as a predictor of any firearm-related experiences. Findings highlight the importance of cross-cutting violence prevention efforts to prevent high-risk firearm-related behaviors among emerging adults. Programs for children and adolescents that address these types of violence exposure should highlight coping skills and sources of positive social support to bolster protective factors against firearm-related outcomes.

Exploring Firearm Access, Carriage, and Possession among Justice-Involved Youth

Firearm carriage and possession predicts youth firearm violence victimization and perpetration. This study describes self-reported factors associated with firearm access, carriage, and possession among justice-involved youth. We conducted an exploratory, mixed-methods study. Participants were recruited from May 2022 to February 2023 from the Juvenile Justice Collaborative, a diversion program for justice-involved youth. We used online anonymous surveys to investigate exposures related to firearm access, carriage, and possession. We performed semi-structured interviews using the phenomenology framework. We used descriptive statistics to examine firearm exposures by participant demographics. We performed qualitative analyses using an iterative approach with constant comparison to identify key themes. We completed 28 surveys and 5 interviews. Most survey participants identified as male (57%) and Black (61%) with a median age of 18 years. Interview participants described the socialization and cultural normalization of firearms, most prominently among peers. Survey participants reported whether they had ever carried (25%) or possessed (21%) a firearm. Survey and interview participants endorsed protection in the context of increasing violence exposure over time as the primary motivation for firearm possession. Interview participants describe accessing firearms primarily through social networks while survey participants also reported access from strangers (25%) and licensed sellers/gun dealers (18%). In conclusion, justice-involved youth believe firearm carriage and possession may be needed for protection due to increasing violence exposure. Further investigation is necessary to determine interventions that may decrease firearm access, carriage, and possession among justice-involved youth.

Curbing the Epidemic of Community Firearm Violence after the Bruen Decision

The Supreme Court's decision in New York State Rifle & Pistol Association Inc. v. Bruen undermines the ability of cities and states to regulate firearms safety. Nonetheless, we remain hopeful that firearm violence can decline even after the Bruen decision. Several promising public health approaches have gained broader adoption in recent years. This essay examines the key drivers of community firearm violence and reviews promising strategies to reverse those conditions, including community violence intervention (CVI) programs and place-based and structural interventions.

Individual- and Peer-Level Risk and Protective Factors for Gun Carriage Among Adolescents Living in Low-Income Urban Communities

Carrying a handgun is an established risk factor for firearm violence, with detrimental and too often irreversible consequences for adolescents including injury and mortality. Although researchers identified a number of risk factors for adolescent handgun carriage, little is known regarding the role of strengths or developmental assets in buffering against risk. The goal of this study was to identify both risk and protective factors for handgun carriage among a predominantly African American (88%) community-based sample of adolescents (Mage = 14.3) who resided in urban communities with high rates of poverty and exposure to violence. Consistent with prior work, we found that adolescents with access to a handgun or with friends who had carried a handgun had higher odds of carrying a handgun themselves in the past 3 months. Handgun access, friends' handgun carriage, and beliefs supporting reactive aggression were identified as risk factors for handgun carriage. Although personal and social assets and positive outlook moderated these relations, the direction was contrary to our hypotheses. We believe that these findings are in part due to structural inequities and social norms impacting adolescents in urban communities characterized by concentrated poverty and high rates of violence. Our findings highlight the value of moving beyond a deficit-oriented framework to gain a more nuanced understanding of the dynamics among both positive and negative factors that alter risk for handgun carriage among African American youth living in low-income urban areas.

Ecological promotive and protective factors deterring gun carriage for young adults living in communities with high rates of community violence

This study identified promotive and protective factors that lessened the likelihood of handgun carriage in a sample of 141 predominantly Black (97%) young adults (ages 18-22) living in high burden communities experiencing elevated rates of violence. Participants completed surveys assessing overall risk and protective factors for violence across ecological contexts (e.g., individual/peer, family, school, and community). A series of regression and moderation analyses were conducted to ascertain direct (promotive) and indirect (protective) relations between factors across the ecological model and likelihood of gun carriage. Results indicated that (1) consistent with previous studies, both witnessing violence and violence victimization were significant risk factors for handgun carriage, (2) ethnic identity was a significant promotive factor related to a lower likelihood of handgun carriage, and (3) lack of family conflict, student status, and community assets were significant protective factors where higher levels of these factors attenuated the relation between exposure to community violence and likelihood of gun carriage. This is one of the first strengths-based studies examining factors that may mitigate the likelihood of gun carriage for young adults in high risk contexts. Our findings suggest that gun violence prevention efforts for high burden communities should support young adults by strengthening factors across the ecological model (e.g., individual, family, school, and community).

Understanding factors associated with firearm possession: Examining differences between male and female adolescents and emerging adults seeking emergency department care

Firearm possession increases the likelihood of hospital visits among adolescents and emerging adults for both males and females. To better inform prevention practices, we examine data among adolescents and emerging adults (A/EAs; ages 16 to 29) presenting to an urban emergency department for any reason to understand the differences in firearm possession between males and females (N = 1312; 29.6% male; 50.5% Black). Regression identified firearm possession correlates, such as male sex (AOR = 2.26), firearm attitudes (AOR = 1.23), peer firearm possession (AOR = 9.84), and community violence exposure (AOR = 1.02). When stratified by sex (e.g., male vs female), regression results yielded differences in correlates for firearm possession: in males, peer firearm possession (AOR = 8.96) were significant, and in females, firearm attitudes (AOR = 1.33) and peer firearm possession (AOR = 11.24) were significant. An interaction between sex and firearm attitudes demonstrated that firearm attitudes were differentially associated with firearm possession between female and male A/EAs (AOR = 1.28). Overall, we found that females are more likely to endorse retaliatory firearm attitudes, and both males and females are highly influenced by their perception of peer firearm possession. These results help inform prevention strategies across multiple settings, especially for hospital-based violence interventions, and suggest that tailored approaches addressing differences between male and female A/EAs are appropriate when addressing firearm violence and injury risk among A/EAs.

State Firearm Legislation and Youth/Young Adult Handgun Carrying in the United States

PURPOSE

To examine the association between state firearm legislation and youth/young adult handgun carrying in the United States and to identify policy priority areas for intervention.

METHODS

We linked person-level gun carrying data from a nationally representative sample of U.S. youth and young adults with state-level gun policies over a 15-year period. Cross-classified mixed effects logistic regressions estimated the associations between state gun policies and handgun carrying and explored whether the associations varied by person-level demographic characteristics.

RESULTS

Youth and young adults in states with a greater number of gun policies were less likely to carry a handgun than youth and young adults in states with fewer gun policies. Regulations on gun purchasing, concealed carrying permitting, and domestic violence-related laws were particularly important in reducing youth/young adult gun-carrying behavior. In addition, these associations varied by gender and race/ethnicity.

DISCUSSION

State firearm legislation may be an effective mechanism to reduce youth and young adult gun carrying and ultimately mitigate gun-related mortality and morbidity.

A trauma-informed approach to understanding firearm decision-making among Black adolescents: Implications for prevention

Firearm violence remains a public health crisis in marginalized, urban communities, with Black adolescents bearing the burden of firearm homicides and injuries. As such, the prevention of firearm violence among adolescents has moved to a high priority of the U.S. public health agenda. The current paper reviews recent literature to highlight the heterogeneity in firearm behavior among Black adolescents and underscore the need for additional research on decision-making and firearm behavior to better understand how adolescents make decisions to acquire, carry, and use firearms. Through a discussion of the disproportionate levels of trauma exposure and trauma symptoms experienced by Black adolescents, the current paper also proposes a trauma-informed approach to understanding decision-making for risky firearm behavior. We discuss the broader impacts of this approach, including the development of a more comprehensive and contextually relevant understanding of the variability in risky firearm behavior and improvements in risk screening capabilities and preventive intervention strategies.

Retaliatory attitudes as mediator of exposure to violence and firearm aggression among youth: The protective role of organized activity involvement

Firearm injury is a significant public health concern among youth living in the United States. Youth with exposure to violence (ETV) are more susceptible to carrying and using a firearm. Few researchers, however, have examined psychological mechanisms undergirding the association between ETV and firearm aggression. Retaliatory attitudes have been discussed as a potential mediator linking ETV with firearm aggression. Moreover, organized activity participation may disrupt direct and indirect pathways connecting ETV to firearm aggression. We tested: (a) the mediating role of retaliatory attitudes in the ETV-firearm aggression link, and (b) the moderating role of organized activity participation among 570 youth with past year illicit drug use and seeking emerging department care in an urban emergency department (ages 14-24; 58.8% males). Using multigroup path analysis, ETV indirectly influenced firearm aggression through retaliatory attitudes for youth not involved organized activities. Organized activities also buffered the association between retaliatory attitudes (mediator) and firearm aggression (outcome). Organized activities may, therefore, prevent firearm aggression by reducing retaliatory attitudes among youth contending with ETV. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Developmental Comorbidity of Substance Use and Handgun Carrying Among U.S. Youth

INTRODUCTION

This study identifies the longitudinal trajectories of multiple forms of substance use and handgun carrying and examines their comorbidity over time.

METHODS

In a cohort study of 6,748 youth from a U.S. nationally representative sample (51% male, 49% female; 69% White, 16% Black, 14% Hispanic, and 1% other race/ethnicity; born between 1980 and 1984), individuals self-reported their substance-use status (i.e., smoking, drinking, marijuana use, and hard drug use), handgun carrying, and other covariates between 1997 and 2013. Group-based trajectory modeling was used to identify distinct patterns of substance use and handgun carrying over time. Chi-square tests were used to determine the bivariate associations between substance-use and handgun-carrying trajectories, and a multinomial logistic regression examined the associations while adjusting for covariates. Analyses were conducted in 2020.

RESULTS

Trajectories of all the 4 forms of substance use were associated with handgun-carrying trajectories. Specifically, the risk of being in the declining trajectory of handgun carrying (compared with that of being in the very-low trajectory) was higher for participants who were in the decreasing trajectories of smoking, drinking, marijuana use, and hard drug use and lower for those who were in the increasing trajectory of drinking. Inversely, the risks of being in the low and high-increasing trajectories of handgun carrying (compared with that of being in the very-low trajectory) were higher for participants who were in the increasing trajectory of hard drug use.

CONCLUSIONS

Both substance use and gun carrying are developmentally heterogeneous phenomena. Varied forms of substance use should be targeted to counter the distinct gun carrying patterns.

Addressing Key Gaps in Existing Longitudinal Research and Establishing a Pathway Forward for Firearm Violence Prevention Research

The main purpose of this article and this special section is to encourage greater attention to the key gaps that exist in our understanding of the epidemiology of adolescent firearm violence and to provide a pathway forward for future longitudinal research that will inform prevention efforts. This increased attention is especially salient given: (a) firearms are the leading cause of death for adolescents and emerging adults in the United States, with the majority of these deaths due to interpersonal violence; (b) significant health and social disparities with regards to the populations that are most affected by interpersonal firearm violence have been documented; and, (c) limitations in federal research funding during the past 30 years have created a deficit of knowledge about key risk and protective factors necessary to inform evidence-based prevention efforts. We discuss the implications of the articles in this special edition for existing and novel prevention programs. We also identify key considerations for future epidemiological research, including the need for a greater focus on collecting longitudinal data among nationally representative samples enriched with subgroups of at-risk youth, the need to examine the role of protective factors and mediating variables within existing and novel theoretical models of firearm risk behaviors, the need to examine key factors across all levels of the socio-ecological model, and the need to incorporate novel and innovative research designs, methods and analyses.

Within- and between-person associations with drug use disorder among adolescents and emerging adults presenting to an urban emergency department

BACKGROUND

The distinction between within- and between-person associations with drug use disorder (DUD) has implications for intervention targets and content. We used longitudinal data from youth entering an urban emergency department (ED) to identify factors related to changes in DUD diagnosis, with particular emphasis on alcohol use.

METHODS

Research staff recruited youth age 14-24 (n = 599) reporting any past six-month drug use from a Level-1 ED; participants were assessed at baseline and four biannual follow-ups. Participants self-reported validated measurements of peer/parental behaviors, violence/crime exposure, drug use self-efficacy, and alcohol use. Research staff performed diagnostic interviews for DUD with nine substances, post-traumatic stress disorder (PTSD), and major depressive disorder (MDD). We used repeated measures logistic regression models with person-level covariate means, and person-mean-centered covariates, as separate variables, to separate within- and between-person covariate effects.

RESULTS

Among 2,630 assessments, 1,128 (42.9 %) were DUD diagnoses; 21.7 % were co-diagnoses with multiple drugs. Positive (aOR = 0.81, 95 %CI:[0.70, 0.94]) and negative (aOR = 1.73, 95 %CI:[1.45, 2.07]) peer behaviors related to DUD, primarily through between-person effects. Parental support (aOR = 0.92, 95 %CI:[0.83, 0.99]), community violence/crime (aOR = 1.28, 95 %CI:[1.14, 1.44]), PTSD/MDD diagnosis (aOR = 1.36, 95 %CI:[1.04, 1.79]), and alcohol use quantity (aOR = 1.06, 95 %CI:[1.02, 1.11]) were associated with DUD, showing primarily within-person effects. Other factors, such as interpersonal violence involvement (aOR = 1.47, 95 %CI:[1.21, 1.78]), showed both within- and between-person effects.

CONCLUSIONS

DUD is prevalent in this population, and within-person changes in DUD are predictable. Within-person effects suggest the importance of addressing escalating alcohol use, enhancing parental support, crime/violence exposure, and other mental health diagnoses as part of DUD intervention.