What’s New in Psychology?

Firearm Injury Carries Long-term Physical and Mental Burdens that are Poorly Understood      

Jim Windell

           When I watch action thrillers on television and someone gets shot, the most important thing is that they survive. Once they realize that they are going to live and their injury is not fatal, they recover relatively quickly. This is especially true for a hero or heroine. They always have the amazing ability to get over any near-fatal encounter with a bullet – and life goes on.

           That’s what happens on TV shows and in the movies, but what actually occurs in real life? Can gunshot victims easily shake it off without experiencing psychological problems?

           According to a report recently published in Annals of Internal Medicine, the answer is a decided “No!”

           Knowing this is extremely important given that firearm injury is a public health crisis in the U.S. these days.  While some organizations have called for greater consideration for the long-term consequences of firearm violence, there is little work done to ease the impact of gun violence on survivors. This is true despite previous research suggesting that interpersonal firearm violence survivors report significantly worse physical health and functioning compared with the general population and other types of traumatic injury. There is limited work examining self-reported mental and physical health consequences of firearm violence for survivors and this has an effect on the health care systems’ ability to intervene effectively with gun violence survivors.

           In this latest study, the objective was to describe the mental health symptoms and health-related quality of life of firearm injury survivors six months after injury. To carry out the study, a  convenience sample of 87 adults was recruited from the trauma service of a level one trauma center in a midwestern, mid-sized city. Data were pooled from two studies occurring at the same center between the years of 2014 to 2016 and 2017 to 2021; both studies examined psychological and biological outcomes of traumatic injury. Participants were recruited in the emergency department or during hospitalization.

           Recruited participants were accepted in the study if they were 18 years of age or older, had a Glasgow Coma Scale score of at least 13 on arrival, had an unintentional suicidal self-injury, and could communicate in English. Those people excluded were those who experienced a loss of consciousness greater than 30 minutes, who experienced posttraumatic amnesia for more than 24 hours or who were in police custody. Participants were evaluated at baseline and at 6 months after injury.

           The authors, researchers from the Medical College of Wisconsin, found that despite medical advancements that improve survival from firearm injuries, many survivors experience long-term PTSD and poor physical quality of life. A majority of participants not only experienced chronic PTSD symptoms across time, but had worsened symptoms of depression, anxiety and stress. Many participants also reported poor health-related quality of life at both baseline and six months from injury, but their quality of life did not worsen during this period.

           The authors, led by Sydney C. Timmer-Murillo, Ph.D., a postdoctoral fellow in health and trauma psychology at the Medical College of Wisconsin, concluded that their findings “must be considered within the context of limitations,” which include relatively short follow-up period, lack of data on preinjury mental health comorbidity and the small convenience sample.

           “However, this preliminary study highlights the need to better understand and manage the mental health consequences of firearm injury,” they wrote. “Early screening and comprehensive care may improve outcomes in this at-risk population.”

           To read the original study, find it with this reference:

Timmer-Murillo, S. C., Melin, S. J., Tomas, C. W., Geier, T. J., Brandolino, A., Schramm, A. T., ... & deRoon-Cassini, T. A. (2023). Mental health and health-related quality of life after firearm injury: a preliminary descriptive study. Annals of internal medicine. https://doi.org/10.7326/M23-0309