Heinz Adrienne J, Cohen Nicole L, Holleran Lori, Alvarez Jennifer A, Bonn-Miller Marcel O
National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025.
Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304.
Mil Med. 2016 Oct;181(10):1207-1211. doi: 10.7205/MILMED-D-15-00552.
Post-traumatic stress disorder (PTSD), a condition that disproportionately affects military veterans, is associated with heightened rates of aggression and suicide. Although experience with firearms is common among this population, virtually nothing is known regarding who is more likely to own a firearm and whether firearm ownership is differentially associated with psychological and behavioral risk factors among veterans with PTSD. Of 465 veterans (79% male) entering PTSD treatment, 28% owned a firearm (median number of firearms among owners = 3, range = 1-40). Firearm owners reported higher income were less likely to be unemployed, and were more likely to be male, Caucasian, married, and living in permanent housing. Ownership was associated with higher combat exposure and driving aggression, yet lower rates of childhood and military sexual trauma, suicidal ideation, and incarceration. Ownership was not associated with previous suicide attempt, arrest history, number of traumas experienced, PTSD symptoms, or depression. Together, among a sample of treatment-seeking military veterans with PTSD, those who owned a firearm appeared to demonstrate greater stability across a number of domains of functioning. Importantly though, routine firearm safety discussions (e.g., accessibility restrictions; violence risk assessments) and bolstering of anger management skills remain critical when working with this high-risk population.
创伤后应激障碍(PTSD)对退伍军人的影响尤为严重,与攻击行为和自杀率的升高有关。虽然该群体中接触枪支的情况很常见,但对于谁更有可能拥有枪支,以及在患有创伤后应激障碍的退伍军人中,枪支拥有情况是否与心理和行为风险因素存在差异关联,几乎一无所知。在465名接受创伤后应激障碍治疗的退伍军人中(79%为男性),28%拥有枪支(枪支拥有者拥有枪支的中位数为3,范围为1至40)。枪支拥有者报告称,他们收入较高,失业可能性较小,更有可能是男性、白人、已婚且居住在永久性住房中。拥有枪支与更高的战斗经历和驾驶攻击行为相关,但童年和军事性创伤、自杀意念及监禁率较低。拥有枪支与既往自杀未遂、逮捕记录、经历的创伤数量、创伤后应激障碍症状或抑郁无关。总体而言,在寻求治疗的患有创伤后应激障碍的退伍军人样本中,拥有枪支的人在多个功能领域似乎表现出更大的稳定性。然而,重要的是,在与这一高风险群体合作时,常规的枪支安全讨论(如获取限制;暴力风险评估)以及加强愤怒管理技能仍然至关重要。