University of Michigan Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI 48109, United States; Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48105, United States; Michigan Youth Violence Prevention Center, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
University of Michigan Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI 48109, United States; Michigan Youth Violence Prevention Center, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States; University of Michigan Addiction Research Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Rd., Ann Arbor, MI 48109, United States.
Prev Med. 2017 Sep;102:112-119. doi: 10.1016/j.ypmed.2017.07.011. Epub 2017 Jul 17.
Firearm homicide is the leading cause of violence-related youth mortality. To inform prevention efforts, we analyzed event-level data to identify unique precursors to firearm conflicts. Youth (ages:14-24) seeking Emergency Department (ED) treatment for assault or for other reasons and reporting past 6-month drug use were enrolled in a 2-year longitudinal study. Time-line follow-back substance use/aggression modules were administered at baseline and each 6-month follow-up. Violent non-partner conflicts were combined across time-points. Regression analyzed: a)antecedents of firearm-related conflicts (i.e., threats/use) as compared to non-firearm conflicts; and b)substance use on conflict (vs. non-conflict) days for those engaged in firearm conflict. During the 24-months, we found that 421-youth reported involvement in violent non-partner conflict (n=829-conflicts;197-firearm/632-non-firearm). Among firearm conflicts, 24.9% involved aggression and 92.9% involved victimization. Retaliation was the most common motivation for firearm-aggression (51.0%), while "shot for no reason" (29.5%) and conflicts motivated by arguments over "personal belongings" (24.0%) were most common for firearm-victimization. Male sex (AOR=5.14), Black race (AOR=2.75), a ED visit for assault (AOR=3.46), marijuana use before the conflict (AOR=2.02), and conflicts motivated by retaliation (AOR=4.57) or personal belongings (AOR=2.28) increased the odds that a conflict involved firearms. Alcohol (AOR=2.80), marijuana (AOR=1.63), and prescription drugs (AOR=4.06) had a higher association with conflict (vs. non-conflict) days among youth reporting firearm conflict. Overall, we found that firearm conflicts are differentially associated with substance use and violence motivations. Addressing substance use, interrupting the cycle of retaliatory violence, and developing conflict resolution strategies that address escalation over infringement on personal belongings may aid in decreasing and preventing adolescent firearm violence.
枪支凶杀是与暴力相关的青年死亡的主要原因。为了提供预防工作的信息，我们分析了事件层面的数据，以确定枪支冲突的独特前兆。年龄在 14-24 岁之间的青少年在急诊室（ED）接受攻击或其他原因的治疗，并报告过去 6 个月的药物使用情况，他们被纳入一项为期 2 年的纵向研究。在基线和每 6 个月的随访时进行时间线回溯物质使用/攻击模块。将跨时间点的暴力非伴侣冲突进行组合。回归分析：a）与非枪支冲突相比，枪支相关冲突（即威胁/使用）的前兆；b）在参与枪支冲突的情况下，在冲突（与非冲突）日的物质使用情况。在 24 个月期间，我们发现 421 名青少年报告参与了暴力非伴侣冲突（n=829 次冲突；197 次枪支/632 次非枪支）。在枪支冲突中，24.9%涉及攻击，92.9%涉及受害。报复是枪支攻击的最常见动机（51.0%），而“无缘无故被枪击”（29.5%）和因“个人物品”（24.0%）发生争执而导致的枪支受害则是最常见的动机。男性（优势比[OR]=5.14）、黑人（OR=2.75）、因攻击到急诊室就诊（OR=3.46）、冲突前使用大麻（OR=2.02）、因报复（OR=4.57）或个人物品（OR=2.28）导致冲突的可能性增加了冲突涉及枪支的几率。酒精（OR=2.80）、大麻（OR=1.63）和处方药物（OR=4.06）与报告枪支冲突的青少年的冲突（与非冲突）日之间的关联更高。总体而言，我们发现枪支冲突与物质使用和暴力动机有不同的关联。解决物质使用问题，中断报复性暴力循环，并制定解决侵犯个人物品升级问题的冲突解决策略，可能有助于减少和预防青少年枪支暴力。
