Journal of Behavioral Medicine

, Volume 42, Issue 4, pp 646–657 | Cite as

Youth exposure to violence involving a gun: evidence for adverse childhood experience classification

  • Sonali RajanEmail author
  • Charles C. Branas
  • Dawn Myers
  • Nina Agrawal


Adverse childhood experiences (ACEs) have historically included child maltreatment, household dysfunction, and other critical issues known to impact children negatively. Although youth experiences with violence are broadly captured in some ACE measures, youth exposure to violence involving a gun has not been included specifically in the operationalizing, and therefore scientific study, of ACEs. There are numerous implications of this omission, including limiting access to ACE interventions that are currently available and resources for individuals who have been exposed to gun violence. Thus, and given the persistent prevalence of gun violence in the US, we conducted a systematic review of the literature over the past two decades on the assessment of and response to ACEs and gun violence. Eighty-one journal articles across four search engines met our inclusion criteria. Our findings provide evidence that youth gun violence exposure should be classified as an ACE. In addition to increasing access to resources for youth affected by gun violence, these findings may improve the likelihood of funding and research into gun violence, with direct implications for prevention and intervention efforts.


Gun violence Adverse childhood experiences Youth Trauma Firearm injuries Pediatrics 



The authors would like to thank the Institute for Urban and Minority Education at Teachers College, Columbia University for their support of this present work, and in particular for providing funding support via an internal Teachers College grant mechanism for D. Myers, who served as the graduate research assistant on this study.

Compliance with ethical standards

Conflict of interest

Sonali Rajan, Charles C. Branas, Dawn Myers, and Nina Agrawal declare that they have no conflict of interest.

Human and animal rights and Informed consent

This article is a systematic review of existing peer-reviewed research and did involve the collection of data from human subjects nor review of any raw data involving human subjects. As such, and consistent with Teachers College, Columbia University IRB protocol, informed consent was not required (nor sought).


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Authors and Affiliations

  1. 1.Department of Health and Behavior Studies, Teachers CollegeColumbia UniversityNew YorkUSA
  2. 2.Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  3. 3.Department of PediatricsColumbia University Medical CenterNew YorkUSA

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