Rozel John S, Mulvey Edward P
Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; email:
Annu Rev Clin Psychol. 2017 May 8;13:445-469. doi: 10.1146/annurev-clinpsy-021815-093459. Epub 2017 Mar 30.
The United States has substantially higher levels of firearm violence than most other developed countries. Firearm violence is a significant and preventable public health crisis. Mental illness is a weak risk factor for violence despite popular misconceptions reflected in the media and policy. That said, mental health professionals play a critical role in assessing their patients for violence risk, counseling about firearm safety, and guiding the creation of rational and evidence-based public policy that can be effective in mitigating violence risk without unnecessarily stigmatizing people with mental illness. This article summarizes existing evidence about the interplay among mental illness, violence, and firearms, with particular attention paid to the role of active symptoms, addiction, victimization, and psychosocial risk factors. The social and legal context of firearm ownership is discussed as a preface to exploring practical, evidence-driven, and behaviorally informed policy recommendations for mitigating firearm violence risk.
美国的枪支暴力水平比大多数其他发达国家要高得多。枪支暴力是一场重大且可预防的公共卫生危机。尽管媒体和政策中存在一些普遍的误解,但精神疾病只是暴力行为的一个微弱风险因素。话虽如此,心理健康专业人员在评估患者的暴力风险、提供枪支安全咨询以及指导制定合理且基于证据的公共政策方面发挥着关键作用,这些政策能够有效降低暴力风险,同时又不会不必要地给患有精神疾病的人贴上污名化标签。本文总结了关于精神疾病、暴力和枪支之间相互作用的现有证据,特别关注了活跃症状、成瘾、受害经历和心理社会风险因素所起的作用。在探讨减轻枪支暴力风险的切实可行、基于证据且考虑行为因素的政策建议之前,先讨论了枪支拥有的社会和法律背景。