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What are the long-term consequences of youth exposure to firearm injury, and how do we prevent them? A scoping review

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Abstract

The long-term consequences of exposure to firearm injury—including suicide, assault, and mass shootings—on children’s mental and physical health is unknown. Using PRISMA-ScR guidelines, we conducted a scoping review of four databases (PubMed, Scopus, PsychINFO, and CJ abstract) between January 1, 1985 and April 2, 2018 for articles describing long-term outcomes of child or adolescent firearm injury exposure (n = 3582). Among included studies (n = 31), most used retrospective cohorts or cross-sectional studies to describe the correlation between firearm injury and post-traumatic stress. A disproportionate number of studies examined the effect of mass shootings, although few of these studies were conducted in the United States and none described the impact of social media. Despite methodologic limitations, youth firearm injury exposure is clearly linked to high rates of post-traumatic stress symptoms and high rates of future injury. Evidence is lacking on best practices for prevention of mental health and behavioral sequelae among youth exposed to firearm injury. Future research should use rigorous methods to identify prevalence, correlates, and intervention strategies for these at-risk youth.

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Acknowledgements

The authors wish to acknowledge Lynn Massey for assistance with the literature search, organizing data abstraction, and manuscript preparation. We would also like to acknowledge Gurpreet Kaur Rana, Informationist at the Taubman Health Sciences Library, University of Michigan, for creating the search strategies for the scoping review; and Zahra Asghar for her assistance with initial literature reviews.

Funding

This review was funded by NIH/NICHD 1R24HD087149-01A1. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies.

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Authors and Affiliations

  1. Department of Emergency Medicine, Alpert Medical School, Brown University, 593 Eddy Street, Claverick 2, Providence, RI, 02903, USA

    Megan Ranney, Rebecca Karb & Kira Bromwich

  2. Department of Health Services, Policy, and Practice, School of Public Health, Brown University, 121 South Main Street, Providence, RI, 02903, USA

    Megan Ranney

  3. American Foundation for Firearm Injury Reduction in Medicine, PO Box 503, Williamstown, MA, 01267, USA

    Megan Ranney

  4. Department of Surgery, Section of Pediatric Surgery, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA

    Peter Ehrlich

  5. Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA

    Rebecca Cunningham

  6. School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA

    Rebecca Cunningham

  7. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA

    Rinad S. Beidas

  8. Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Rinad S. Beidas

  9. Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk #210, Philadelphia, PA, 19104, USA

    Rinad S. Beidas

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Appendix: PubMed search strategy

Appendix: PubMed search strategy

Date Searched: April 2, 2018

Final number of results: 590

(((((gun[tiab] OR guns[tiab] OR handgun*[tiab] OR firearm*[tiab] OR firearms[MeSH Terms] OR gunshot*[tiab] OR shooting*[tiab] OR “gun violence”[tiab] OR “gun safety”[tiab]))) AND ((“wounds, gunshot”[MeSH Terms] OR “Wounds and Injuries”[Mesh] OR injury[tiab] OR injuries[tiab] OR mortality[tiab] OR intentional[tiab] OR unintentional[tiab] OR accidental[tiab] OR accident*[tiab]))) AND ((adolescent[MeSH Terms] OR youth[MeSH Terms] OR child[MeSH Terms] OR teenager[Title/Abstract] OR teen[Title/Abstract] OR adolescen*[Title/Abstract] OR child[Title/Abstract] OR youth[title/abstract] OR children[Title/Abstract] OR minor[Title/Abstract] OR minors[title/abstract] OR delinquent[Title/Abstract] OR delinquency[Title/Abstract] OR pediatric*[Title/Abstract] OR parent*[tiab]))) AND (“Recurrence”[Mesh] OR recurren*[tiab] OR “Recidivism”[Mesh] OR recidivism[tiab] OR “Follow-Up Studies”[Mesh] OR “follow-up”[tiab] OR “follow up”[tiab] OR “Exposure to Violence”[Mesh] OR “Life Change Events”[Mesh] OR “Patient Readmission”[Mesh] OR readmission[tiab] OR rehospitalization[tiab] OR “Secondary Prevention”[Mesh] OR “Tertiary Prevention”[Mesh] OR psychosocial[tiab] OR “Mental Health Services”[Mesh] OR “criminal justice” OR “Prisons”[Mesh] OR incarceration[tiab] OR imprisonment[tiab] OR detention[tiab] OR custody[tiab] OR subsequent[tiab])Filters: Publication date from 1985/01/01 to 2018/12/31.

Filters: Publication date from 1985/01/01 to 2018/04/01

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Ranney, M., Karb, R., Ehrlich, P. et al. What are the long-term consequences of youth exposure to firearm injury, and how do we prevent them? A scoping review. J Behav Med 42, 724–740 (2019). https://doi.org/10.1007/s10865-019-00035-2

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