Ladapo Joseph A, Elliott Marc N, Kanouse David E, Schwebel David C, Toomey Sara L, Mrug Sylvie, Cuccaro Paula M, Tortolero Susan R, Schuster Mark A
Departments of Medicine and Population Health, New York University School of Medicine, New York, NY.
RAND, Santa Monica, Calif.
Acad Pediatr. 2016 Nov-Dec;16(8):742-749. doi: 10.1016/j.acap.2016.05.145. Epub 2016 Jun 24.
Recent policy initiatives aiming to reduce firearm morbidity focus on mental health and illness. However, few studies have simultaneously examined mental health and behavioral predictors within families, or their longitudinal association with newly acquiring a firearm.
Population-based, longitudinal survey of 4251 parents of fifth-grade students in 3 US metropolitan areas; 2004 to 2011. Multivariate logistic models were used to assess associations between owning or acquiring a firearm and parent mental illness and substance use.
Ninety-three percent of parents interviewed were women. Overall, 19.6% of families reported keeping a firearm in the home. After adjustment for confounders, history of depression (adjusted odds ratio [aOR], 1.36; 95% confidence interval [CI], 1.04-1.77), binge drinking (aOR 1.75; 95% CI, 1.14-2.68), and illicit drug use (aOR 1.75; 95% CI, 1.12-2.76) were associated with a higher likelihood of keeping a firearm in the home. After a mean of 3.1 years, 6.1% of parents who did not keep a firearm in the home at baseline acquired one by follow-up and kept it in the home (average annual likelihood = 2.1%). No risk factors for self-harm or other violence were associated with newly acquiring a gun in the home.
Families with risk factors for self-harm or other violence have a modestly greater probability of having a firearm in the home compared with families without risk factors, and similar probability of newly acquiring a firearm. Treatment interventions for many of these risk factors might reduce firearm-related morbidity.
近期旨在降低枪支相关发病率的政策举措聚焦于心理健康与疾病。然而,很少有研究同时考察家庭中的心理健康和行为预测因素,或者它们与新购枪支之间的纵向关联。
对美国3个大都市地区4251名五年级学生家长进行基于人群的纵向调查;时间跨度为2004年至2011年。采用多变量逻辑模型评估拥有或购置枪支与家长精神疾病及物质使用之间的关联。
接受访谈的家长中93%为女性。总体而言,19.6%的家庭报告家中有枪支。在对混杂因素进行调整后,抑郁症病史(调整后的优势比[aOR]为1.36;95%置信区间[CI]为1.04 - 1.77)、暴饮(aOR为1.75;95% CI为1.14 - 2.68)以及非法药物使用(aOR为1.75;95% CI为1.12 - 2.76)与家中拥有枪支的可能性较高相关。平均3.1年后,基线时家中没有枪支的家长中有6.1%在随访时购置了一支并将其留存家中(年均可能性 = 2.1%)。家中新购枪支与自我伤害或其他暴力的风险因素无关。
与无风险因素的家庭相比,有自我伤害或其他暴力风险因素的家庭家中拥有枪支的可能性略高,且新购枪支的可能性相似。针对其中许多风险因素的治疗干预可能会降低枪支相关发病率。