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Abstract
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The prevalence of mass violence incidents (MVIs), such as mass shootings, in the US necessitates documentation of the public health burden in order to direct resources appropriately to help communities recover and heal. The research by Moreland et al1 extends the extant research documenting the mental health consequences of MVIs by examining rates of posttraumatic stress disorder (PTSD) in 6 different communities affected by an MVI, using address-based sampling of randomly selected households in each community. They were able to demonstrate the ripple effects of MVI on PTSD beyond those directly exposed to the MVI to those indirectly exposed through having the MVI in their community. Their research found higher rates of past-year and lifetime PTSD in these communities compared with existing national estimates. They also explored how demographic, exposure, and risk factors unrelated to the MVI affected risk for PTSD. These results are of interest to health professionals and policy and legal professionals interested in documenting the wider impacts of MVIs on people indirectly exposed, in order to advance policies that may reduce MVIs.
This study1 is novel in that it moves beyond studying a single MVI to documenting the association of MVIs with PTSD across 6 different communities. However, the outcome of PTSD and the demographic, exposure, and risk factors assessed are the same ones that the majority of studies on MVIs have examined2,3; thus, this study does not expand our understanding of the range of potential impacts of MVIs on communities. Given the potential public health burden of PTSD, it is understandable why researchers assess PTSD in the aftermath of an MVI, but we also need to expand our empirical attention to other mental and behavioral health consequences. Following PTSD, the next most common mental health outcomes studied following MVIs are anxiety, depression, or general distress. We need more empirical attention to the potential associations of MVIs with substance use disorders, anger and aggression, sleep problems, functional impairment, educational and vocational outcomes, and somatic complaints, to name a few.
Likewise, the authors1 examined low social support, exposure to the MVI, and prior exposure to other potentially traumatic events as risk factors, which are among the most well studied. Therefore, our knowledge of what to screen for in the aftermath of an MVI and who is potentially at greater risk for long-term mental health consequences has not changed on the basis of these results. We need to know what other potentially modifiable factors affect mental health beyond social support. Belief in one's ability to cope, optimism about the future, and a pattern of coping flexibly with the challenges engendered by a potentially traumatic event are associated with greater likelihood of resilience4; therefore, understanding how MVIs may affect these characteristics can be helpful.
We also need more research that will directly support communities, survivors, and the work of public health and emergency management professionals in the aftermath of MVIs. Although it is good to document the potential public health burden of higher rates of PTSD in communities affected by MVI, we need more research
Language: en |