1
|
Bauder CR, Rooney EA, Hay JM, Long CM, Bryan CJ. Associations Between PTSD Features and Firearm Ownership and Storage: Results From the PRImary Care Screening Methods (PRISM) Study. Mil Med 2024:usae342. [PMID: 38970431 DOI: 10.1093/milmed/usae342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 07/08/2024] Open
Abstract
INTRODUCTION Veterans and active duty service members are significantly more likely to die by suicide using firearms compared to the general population. Not-secure firearm storage (e.g., keeping guns loaded/in an unlocked location) is associated with greater risk for suicide and a third of veteran firearm owners store at least 1 personal firearm unsecured. Veterans and active duty service members are also significantly more likely to be diagnosed with posttraumatic stress disorder (PTSD) than the general population. Symptoms of PTSD are divided into 4 criteria: reexperiencing, avoidance, negative affect, and hyperarousal. Research has suggested that endorsement of hyperarousal symptoms is positively associated with unsecure firearm storage and that avoidance symptoms might be negatively associated with unsecure storage practices. The present study examined the relationship between self-reported firearm ownership and storage practices among each item from the Primary Care PTSD Screening for DSM-IV-TR (PC-PTSD-IV) to explore associations between PTSD features and firearm ownership and storage. MATERIALS AND METHODS Participants were recruited from primary care clinics across 5 military installations in the United States as part of a larger study (Mage = 45.4, SD = 16.9). Among participants (n = 2,685), most of our sample identified as male (51.3%) and white (67.3%) with 61.6% currently serving in the military, 16.8% retirees, and 21.6% family members. PTSD symptoms were assessed using the PC-PTSD-IV and a quarter met the clinical threshold for PTSD. Binomial and multinomial logistic regression analyses were used. RESULTS Among completed responses, 989 (38.1%) people reported owning guns; among gun owners, 386 (39.0%) reported that they were loaded, and 352 (35.6%) reported they were loaded and unlocked. Endorsement of specific items on the PC-PTSD-IV, including those specific to hyperarousal and avoidance, was not significantly associated with storing firearms loaded and/or in nonsecure locations when controlling for military service. Non-responses to items around firearm storage practices were significantly associated with those individuals meeting the clinical threshold for PTSD according to the PC-PTSD-IV and participants currently serving had higher odds of storing at least 1 personal firearm loaded and both loaded and unlocked. CONCLUSIONS Results from our study highlight similarities and departures from the previous literature on the connection between PTSD and non-secure firearm storage practices. Further research may examine (1) the relation between PTSD symptoms and firearm storage between active duty service members, retirees, and family members and (2) whether non-response to items regarding firearm ownership is systematic.
Collapse
Affiliation(s)
| | - Emily A Rooney
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | | | | | | |
Collapse
|
2
|
Nichter B, Hill ML, Fischer I, Panza KE, Kline AC, Na PJ, Norman SB, Rowcliffe M, Pietrzak RH. Firearm storage practices among military veterans in the United States: Findings from a nationally representative survey. J Affect Disord 2024; 351:82-89. [PMID: 38280567 DOI: 10.1016/j.jad.2024.01.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Unsafe storage of firearms is associated with increased risk of suicide.. However, contemporary population-based data on the prevalence and correlates of firearm storage practices among veterans are limited. METHODS Data were from the 2022 National Health and Resilience in Veterans Study, a nationally representative sample of 2441 veterans. Analyses examined: (1) the prevalence of firearm storage practices; (2) sociodemographic, psychiatric, and clinical characteristics associated with storing firearms loaded and/or in non-secure location; and (3) associations between types of potentially traumatic events and storage practices. RESULTS More than half of veterans reported owning one or more personal firearms (50.9%). Among firearm owners, 52.9% reported some form of unsafe firearm storage practice (i.e., loaded and/or non-secure location), with 39.9% reporting that they stored one or more firearms loaded. After adjusting for sociodemographic characteristics, major depressive, alcohol and drug use disorders, direct trauma exposures, future suicidal intent, and traumatic brain injury were associated with storing firearms loaded and/or in a non-secure location (ORs = 1.09-7.16). Veterans with a history of specific forms of direct trauma exposure (e.g., physical assault) were more likely to store firearms unsafely. LIMITATIONS Cross-sectional design precludes causal inference. CONCLUSIONS Half of U.S. veterans who own firearms store at least one personal firearm loaded and/or in a non-secure location, with approximately four-in-ten keeping a loaded firearm in the home. These high rates underscore the importance of nationwide training initiatives to promote safe firearm storage for all service members and veterans, regardless of risk status, as well as for healthcare professionals working with veterans.
Collapse
Affiliation(s)
- Brandon Nichter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Melanie L Hill
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Ian Fischer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Kaitlyn E Panza
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA
| | - Alexander C Kline
- Naval Health Research Center, San Diego, CA, USA; Leidos, Reston, VA, USA
| | - Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Sonya B Norman
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA; National Center for PTSD, White River Junction, VT, USA
| | - Mara Rowcliffe
- 321(st) Special Tactics Squadron, U.S. Air Force Special Operations Command, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| |
Collapse
|
3
|
Bond AE, Stanley I, Bandel SL, Anestis M. Law enforcement and firearms: understanding firearm ownership and storage habits. Inj Prev 2024; 30:132-137. [PMID: 37875335 DOI: 10.1136/ip-2023-044919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/08/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE This study seeks to better understand firearm ownership among law enforcement officers (LEO), with the goal of informing future firearm injury and suicide prevention efforts. We describe the frequency and sociodemographic correlates of firearm ownership and storage practices among, and examine the association between suicidal ideation and current firearm storage practices. METHODS The present study used data from a large online study (n=6410) and included data from individuals who were currently or previously being employed as an LEO (n=369; M (SD) age=39.2 y (15.8 y), 75.2% male, 66.7% white). Self-report measures were used to assess for firearm ownership, storage habits and suicidal ideation. Descriptive statistics were used to describe the frequency of firearm ownership and logistic regressions were used to examine the extent to which demographic characteristics and suicidal ideation were associated with firearm ownership. RESULTS Overall, 70.5% (n=261) of the sample reported firearm ownership. LEO who were older had significantly lower odds of reporting firearm ownership. Those who were married and those who reported lifetime suicidal ideation had significantly greater odds of reporting firearm ownership. Whereas firearm-owning LEO who reporting storing a firearm locked had significantly lower odds of reporting lifetime suicidal ideation, those who reported storing a firearm unloaded had significantly greater odds of reporting lifetime suicidal ideation. CONCLUSION Findings have important public health implications and can be used to increase adherence with secure storage recommendations. Increasing secure storage may help reduce suicide risk among LEO, a sample at heightened risk for suicide.
Collapse
Affiliation(s)
- Allison E Bond
- Psychology, Rutgers University, Piscataway, New Jersey, USA
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
| | - Ian Stanley
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Shelby L Bandel
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
- Department of Psychology, The State University of NJ, Piscataway, New Jersey, USA
| | - Michael Anestis
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
| |
Collapse
|
4
|
Kennedy SR, Buck-Atkinson J, Moceri-Brooks J, Johnson ML, Anestis MD, Carrington M, Baker JC, Fisher ME, Nease DE, Bryan AO, Bryan CJ, Betz ME. Military community engagement to prevent firearm-related violence: adaptation of project safe guard for service members. Inj Epidemiol 2024; 11:7. [PMID: 38355727 PMCID: PMC10867994 DOI: 10.1186/s40621-024-00490-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Suicide, especially by firearm, remains a leading cause of death in military populations in the USA. Reducing access to firearms, especially during high risk times, may help prevent suicide and other forms of violence. The purpose of this study was to adapt a promising existing lethal means safety intervention (Project Safe Guard, PSG) for cross-cutting violence prevention and peer support in active-duty service communities using community engagement methods. METHODS A two-pronged community-engaged research approach was employed, including the Community Translation (CT) process that engaged 15 Service Members from one installation to help adapt PSG successfully. In addition, qualitative data was collected from 40 active-duty service members and military violence prevention specialists through in-depth interviews and focus group discussions. RESULTS Qualitative data and CT feedback led to site-specific PSG adaptations. Participants emphasized the importance of peer-to-peer discussions and highlighted resource allocation, leadership support, and stigma on firearm ownership as potential implementation challenges. CONCLUSIONS Findings demonstrate the feasibility of community-engaged research to adapt lethal means safety interventions within military populations. PSG implementation should consider resource allocation, leadership support, and addressing stigma. This study has implications for future policies and standards for performing research on sensitive topics, particularly among military populations.
Collapse
Affiliation(s)
- S Rachel Kennedy
- Department of Emergency Medicine, University of Colorado School of Medicine, 12401 E 17th Ave B-215, Aurora, CO, 80045, USA
- Firearm Injury Prevention Initiative, University of Colorado Anschutz School of Medicine, Aurora, CO, USA
- Injury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Jessica Buck-Atkinson
- Firearm Injury Prevention Initiative, University of Colorado Anschutz School of Medicine, Aurora, CO, USA
- Injury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Jayna Moceri-Brooks
- New Jersey Gun Violence Research Center, Rutgers School of Public Health, Rutgers University, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
| | - Megan L Johnson
- Department of Emergency Medicine, University of Colorado School of Medicine, 12401 E 17th Ave B-215, Aurora, CO, 80045, USA
| | - Michael D Anestis
- Firearm Injury Prevention Initiative, University of Colorado Anschutz School of Medicine, Aurora, CO, USA
- New Jersey Gun Violence Research Center, Rutgers School of Public Health, Rutgers University, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
| | - Makala Carrington
- Injury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Justin C Baker
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive, Suite 130, Columbus, OH, 43210, USA
| | - Mary E Fisher
- Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue B215, Aurora, CO, 80045, USA
- Colorado Clinical and Translational Sciences Institute, Community Engagement and Health Equity, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Campus Box B141, Aurora, CO, 80045, USA
| | - Donald E Nease
- Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue B215, Aurora, CO, 80045, USA
- Colorado Clinical and Translational Sciences Institute, Community Engagement and Health Equity, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Campus Box B141, Aurora, CO, 80045, USA
| | - AnnaBelle O Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive, Suite 130, Columbus, OH, 43210, USA
| | - Craig J Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive, Suite 130, Columbus, OH, 43210, USA
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, 12401 E 17th Ave B-215, Aurora, CO, 80045, USA.
- Firearm Injury Prevention Initiative, University of Colorado Anschutz School of Medicine, Aurora, CO, USA.
- Injury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
- Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue B215, Aurora, CO, 80045, USA.
| |
Collapse
|
5
|
Lafferty M, O'Neill A, Cerra N, Maxim L, Mulcahy A, Wyse JJ, Carlson KF. Let's Talk About Firearms: Perspectives of Older Veterans and VA Clinicians on Universal and Dementia-Specific Firearm Safety Discussions. Clin Gerontol 2023:1-11. [PMID: 37665611 DOI: 10.1080/07317115.2023.2254292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
OBJECTIVES Veterans experience high rates of fatal and non-fatal firearm injuries. This risk may be compounded among Veterans who are rural-residing, aging, and/or experiencing cognitive decline or dementia. Firearm safety discussions are not broadly implemented across Department of Veterans Affairs (VA) healthcare settings due, in part, to concerns of causing Veterans to disengage from care. This study examines perceptions about firearm safety discussions to inform healthcare-based harm-reduction efforts. METHODS We conducted interviews with 34 Veterans (median age 70) and 22 clinicians from four VA facilities that treat high rates of rural patients with firearm-related injuries. RESULTS Most Veterans accepted the idea of universal firearm safety discussions at the VA. Some reported they might not be forthright in such discussions, but raising the topic would not stop them from engaging with VA care. Veterans and clinicians unanimously endorsed firearm safety discussions for older patients experiencing cognitive decline or dementia. CONCLUSIONS VA patients and clinicians are amenable to firearm safety discussions during healthcare visits and especially endorse the need for such discussions among high-risk populations. CLINICAL IMPLICATIONS Universal firearm safety discussions could be incorporated into standard VA practice, particularly for Veterans experiencing cognitive decline or dementia, without risking Veteran disengagement from care.
Collapse
Affiliation(s)
- Megan Lafferty
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, USA
| | - AnnaMarie O'Neill
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, USA
| | - Nicole Cerra
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, USA
- School of Public Health, Oregon Health & Science University, Portland State University, Portland, USA
| | - Lauren Maxim
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, USA
| | - Abigail Mulcahy
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, USA
- School of Public Health, Oregon Health & Science University, Portland State University, Portland, USA
| | - Jessica J Wyse
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, USA
- School of Public Health, Oregon Health & Science University, Portland State University, Portland, USA
| | - Kathleen F Carlson
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, USA
- School of Public Health, Oregon Health & Science University, Portland State University, Portland, USA
| |
Collapse
|