Thursday, July 10, 2014
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Prevention and reducing gun access to curb gun violence, urge psychologists

The American Psychological Association released a report that found programs to reduce aggressive behavior and policies to restrict access of firearms to certain groups can curb gun violence.

Prevention and reducing gun access to curb gun violence, urge psychologists

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The prevention of violence should occur along a continuum that begins in early childhood with programs to help parents raise emotionally healthy children and end with efforts to identify and intervene with troubled individuals who are threatening violence, according to a report on gun violence released today by the American Psychological Association.

The committee who developed these recommendations come from many backgrounds: security experts, police psychologists, researchers involved in improving the welfare of communities, and child psychologists.  It is a long complex document, but gun violence is a long standing multifaceted problems.  

In the United States, death by guns is now over 31,000 each year with suicides accounting for nearly two-thirds of those deaths and most of the remainder homicides. Less than a 1,000 deaths are police or self-protection shootings. Other countries, most notably Australia, have been able to bring down their overall death rates of homicide and suicide by nearly two-thirds by setting some limits to gun access.  American cities are the most violent in the world with homicide rates in major U.S. cities almost four times as frequent as places we think of as dangerous such as Bogota Columbia, or Belfast, Ireland.  

One of the major findings of this review is that the two most simplistic explanations that “people kill people” or “guns kill people” are essentially both wrong. It is people with guns who kill people, and thus we have to evaluate both the development of aggressive behavior and access to firearms if we are ever to control this problem.

While horrible school shootings such as Newtown come to mind this week, we need to remember that those incidents are rare. While 20 children and six adults died that day in Newtown, many more children were killed all over America that month in single shootings in cities, suburban and rural areas. Daily shootings in the streets of Philadelphia and Wilmington will claim more young lives this year than that awful day in Newtown.

A tendency for violence can begin early in life, and there needs to be a focus on family and community environments that provide healthy development. This includes helping families with children who demonstrate aggressive behavior. Very aggressive children who engage in serious acts of violence during later childhood and adolescence, also frequently grow up in places that encourage violence throughout development. 

The family environment has been found to be influential in the development of aggressive behavior.  Youths who are aggressive from an early age are often raised in families that are under a high degree of stress. Aggressive child behavior is often dealt with by harsh parenting practices that amplify aggression. Examples of family risk factors include low parent–child communication and warmth, harsh or inconsistent discipline, poor parental supervision, the modeling of pro-violent attitudes, and criminal justice involvement by the parents.

Reducing aggressive behavior can start in the first three years of life. For very aggressive children, teaching parents how to manage those problems effectively without escalating the violence is essential.  Mental health professionals who work with families, and programs to help with parenting skills such as Strengthening Families, Triple P parenting, or the Incredible Years programs all help families to teach and discipline effectively without violence and lower the tendency towards aggressive acts. Children with significant aggression need referrals early in life, these are not problems that kids “grow out of,”and these are difficulties that require specific teaching of skills to the parents.

For those children who grow up troubled and have a hard time regulating their emotions (and those adults who have the same problems), the key to therapy is an ongoing consultation with a mental health professional can help the child focus on identifying what is getting them upset and determining a better solution.   Kids need to learn that lashing out aggressively is never acceptable.  You can assert yourself without hurting yourself or others.  Some children learn that by observing adults around them, and others need to be explicitly taught those skills.

Research has shown that early intervention with at-risk families can improve parenting skills and disrupt the pathway from early-onset aggression to violence. Aggressive teens can be taught to manage their feelings better and work more constructively. We have the ability to teach people to manage their emotions better and show better self control, it is access to that treatment that is often limited.

With regards to guns, there needs to be a return to sensible gun safety. In a home with guns, children under 18 should never have access without adult supervision. They should be unloaded and locked.  Kids should be taught to call 911 first when they feel threatened, not to reach for a gun. Although keeping firearms at home is not a direct cause of youth gun violence, the rates of suicides, homicides, and unintentional firearm fatalities are higher for 5 to 14-year-olds who live in states or regions in which rates of gun ownership are more prevalent, almost always due to insecure guns.   From the published reports, it is clear that Adam Lanza was a troubled young man who had difficulty fitting in with peers, and indeed with anyone.  He was fine when he was at the gun range shooting with his mother. The problem started when his mother gave him unlimited access to firearms without supervision.

While we can help people manage their aggression more effectively, we also need to make sure that those who are upset, unstable or aggressive don’t have easy access to firearms.  Since gun ownership is so widespread here, we need to assume that there are guns in all homes.  When your children visit other homes, ask if there are guns and if they are locked.  The Center to Prevent Youth Violence offers tips to make it easier to ask about guns. Tell your children what to do if they find a gun, and if you wish to teach your children to shoot, do it at a range with proper instruction and safety precautions. 

Tynan was one of the authors of the APA report.


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W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
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Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D. St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, M.D., Ph.D Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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