Journal of Behavioral Medicine

, Volume 42, Issue 4, pp 724–740 | Cite as

What are the long-term consequences of youth exposure to firearm injury, and how do we prevent them? A scoping review

  • Megan RanneyEmail author
  • Rebecca Karb
  • Peter Ehrlich
  • Kira Bromwich
  • Rebecca Cunningham
  • Rinad S. Beidas
  • for the FACTS Consortium


The long-term consequences of exposure to firearm injury—including suicide, assault, and mass shootings—on children’s mental and physical health is unknown. Using PRISMA-ScR guidelines, we conducted a scoping review of four databases (PubMed, Scopus, PsychINFO, and CJ abstract) between January 1, 1985 and April 2, 2018 for articles describing long-term outcomes of child or adolescent firearm injury exposure (n = 3582). Among included studies (n = 31), most used retrospective cohorts or cross-sectional studies to describe the correlation between firearm injury and post-traumatic stress. A disproportionate number of studies examined the effect of mass shootings, although few of these studies were conducted in the United States and none described the impact of social media. Despite methodologic limitations, youth firearm injury exposure is clearly linked to high rates of post-traumatic stress symptoms and high rates of future injury. Evidence is lacking on best practices for prevention of mental health and behavioral sequelae among youth exposed to firearm injury. Future research should use rigorous methods to identify prevalence, correlates, and intervention strategies for these at-risk youth.


Firearm Suicide Mass shooting Accidental injury Community violence Post-traumatic stress 



The authors wish to acknowledge Lynn Massey for assistance with the literature search, organizing data abstraction, and manuscript preparation. We would also like to acknowledge Gurpreet Kaur Rana, Informationist at the Taubman Health Sciences Library, University of Michigan, for creating the search strategies for the scoping review; and Zahra Asghar for her assistance with initial literature reviews.


This review was funded by NIH/NICHD 1R24HD087149-01A1. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies.

Compliance with ethical standards

Conflict of interest

Megan Ranney, Rebecca Karb, Peter Ehrlich, Kira Bromwich, Rebecca Cunningham, Rinad S. Beidas, for the FACTS Consortium declares that they have no conflict of interest.

Human and animal rights and Informed Consent

This article does not contain any studies with human participants or animals performed by any of the authors.


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Authors and Affiliations

  1. 1.Department of Emergency Medicine, Alpert Medical SchoolBrown UniversityProvidenceUSA
  2. 2.Department of Health Services, Policy, and Practice, School of Public HealthBrown UniversityProvidenceUSA
  3. 3.American Foundation for Firearm Injury Reduction in MedicineWilliamstownUSA
  4. 4.Department of Surgery, Section of Pediatric SurgeryUniversity of Michigan School of MedicineAnn ArborUSA
  5. 5.Department of Emergency MedicineUniversity of Michigan School of MedicineAnn ArborUSA
  6. 6.School of Public HealthUniversity of MichiganAnn ArborUSA
  7. 7.Department of Psychiatry, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  8. 8.Department of Medical Ethics and Health Policy, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  9. 9.Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaUSA

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