{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T01:14:06Z","timestamp":1775438046981,"version":"3.50.1"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Young adults in their 20s are at high relative risk for self- and other-directed firearm injury, but little is known about gun access patterns for this group.<\/jats:p><\/jats:sec>Objective<\/jats:title>To describe the longitudinal patterns of firearm access from childhood to young adulthood and to estimate whether violence experienced as a child or as an adult is associated with gun ownership in young adulthood.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>The Great Smoky Mountains Study included participants from 11 contiguous, mostly rural counties in the Southeastern US. The first wave was completed in 1993 and the most recent in 2019. Periodic survey data were gathered in adolescence through participants\u2019 late 20s. In 2023, adjusted Poisson regression with incident rate ratios (IRRs) and 95% CIs were used to estimate associations between violence and gun ownership in young adulthood in 3 age cohorts from the original sample.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Violent experiences in childhood (bullying, sexual and physical abuse, violent events, witnessing trauma, physical violence between parents, and school\/neighborhood dangerousness) or adulthood (physical and sexual assault).<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Initiating gun ownership was defined as no gun access or ownership in childhood followed by gun ownership at age 25 or 30 years. Maintaining gun ownership was defined as reporting gun access or ownership in at least 1 survey in childhood and ownership at age 25 or 30 years.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 1260 participants (679 [54%] male; ages 9, 11, and 13 years), gun access or ownership was more common in childhood (women: 366 [63%]; men: 517 [76%]) than in adulthood (women: 207 [36%]; men: 370 [54%]). The most common longitudinal pattern was consistent access or ownership from childhood to adulthood (373 [35%]) followed by having access or ownership in childhood only (408 [32%]). Most of the violent exposures evaluated were not significantly associated with the outcomes. Being bullied at school was common and was associated with reduced ownership initiation (IRR, 0.76; 95% CI, 0.61-0.94). Witnessing a violent event was significantly associated with increased probability of becoming a gun owner in adulthood (IRR, 1.24; 95% CI, 1.03-1.49).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, gun ownership and access were transitory, even in a geographic area where gun culture is strong. Early adulthood\u2014when the prevalence of gun ownership was relatively low\u2014may represent an opportune time for clinicians and communities to provide education on the risks associated with firearm access, as well as strategies for risk mitigation.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.36907","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T15:03:19Z","timestamp":1697641399000},"page":"e2336907","source":"Crossref","is-referenced-by-count":7,"title":["Violent Experiences and Patterns of Firearm Ownership From Childhood to Young Adulthood"],"prefix":"10.1001","volume":"6","author":[{"given":"Josie","family":"Caves Sivaraman","sequence":"first","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina"},{"name":"Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangyu","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Easter","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Swanson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Copeland","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Vermont, Burlington"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"issue":"2","key":"zoi231072r2","doi-asserted-by":"publisher","first-page":"101","DOI":"10.7326\/M13-1301","article-title":"The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis.","volume":"160","author":"Anglemyer","year":"2014","journal-title":"Ann Intern Med"},{"issue":"10","key":"zoi231072r3","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1001\/archpedi.1993.02160340052013","article-title":"Firearms and adolescent suicide. a community case-control study.","volume":"147","author":"Brent","year":"1993","journal-title":"AJDC"},{"issue":"6","key":"zoi231072r4","doi-asserted-by":"publisher","first-page":"974","DOI":"10.2105\/AJPH.87.6.974","article-title":"The association between the purchase of a handgun and homicide or suicide.","volume":"87","author":"Cummings","year":"1997","journal-title":"Am J Public Health"},{"issue":"1","key":"zoi231072r5","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1136\/ip.9.1.48","article-title":"Association between handgun purchase and mortality from firearm injury.","volume":"9","author":"Grassel","year":"2003","journal-title":"Inj Prev"},{"issue":"6","key":"zoi231072r6","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1001\/jamapsychiatry.2022.0793","article-title":"Suicide deaths among women in California living with handgun owners vs those living with other adults in handgun-free homes, 2004-2016.","volume":"79","author":"Miller","year":"2022","journal-title":"JAMA Psychiatry"},{"issue":"23","key":"zoi231072r7","doi-asserted-by":"publisher","first-page":"2220","DOI":"10.1056\/NEJMsa1916744","article-title":"Handgun ownership and suicide in California.","volume":"382","author":"Studdert","year":"2020","journal-title":"N Engl J Med"},{"issue":"2","key":"zoi231072r8","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1176\/appi.ps.202000317","article-title":"Preventing suicide through better firearm safety policy in the United States.","volume":"72","author":"Swanson","year":"2021","journal-title":"Psychiatr Serv"},{"issue":"21","key":"zoi231072r9","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1056\/NEJM199911183412106","article-title":"Mortality among recent purchasers of handguns.","volume":"341","author":"Wintemute","year":"1999","journal-title":"N Engl J Med"},{"issue":"3","key":"zoi231072r10","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.jnma.2020.12.005","article-title":"Increasing rate of unintentional firearm deaths in youngest Americans: firearm prevalence and COVID-19 pandemic implication.","volume":"113","author":"Bleyer","year":"2021","journal-title":"J Natl Med Assoc"},{"issue":"5","key":"zoi231072r11","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1097\/00001648-200209000-00006","article-title":"Household firearm ownership and suicide rates in the United States.","volume":"13","author":"Miller","year":"2002","journal-title":"Epidemiology"},{"issue":"1","key":"zoi231072r12","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1093\/jurban\/79.1.26","article-title":"Firearm availability and suicide, homicide, and unintentional firearm deaths among women.","volume":"79","author":"Miller","year":"2002","journal-title":"J Urban Health"},{"issue":"3","key":"zoi231072r13","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1136\/ip.2005.010850","article-title":"The association between changes in household firearm ownership and rates of suicide in the United States, 1981-2002.","volume":"12","author":"Miller","year":"2006","journal-title":"Inj Prev"},{"issue":"10","key":"zoi231072r14","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1056\/NEJMp0805923","article-title":"Guns and suicide in the United States.","volume":"359","author":"Miller","year":"2008","journal-title":"N Engl J Med"},{"issue":"4","key":"zoi231072r15","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1097\/01.ta.0000198214.24056.40","article-title":"Household firearm ownership and rates of suicide across the 50 United States.","volume":"62","author":"Miller","year":"2007","journal-title":"J Trauma"},{"issue":"2","key":"zoi231072r16","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-1171","article-title":"Family firearm ownership and firearm-related mortality among young children: 1976-2016.","volume":"143","author":"Prickett","year":"2019","journal-title":"Pediatrics"},{"issue":"8","key":"zoi231072r17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0236832","article-title":"Early detection of internet trolls: introducing an algorithm based on word pairs\/single words multiple repetition ratio.","volume":"15","author":"Monakhov","year":"2020","journal-title":"PLoS One"},{"issue":"5","key":"zoi231072r18","doi-asserted-by":"publisher","first-page":"38","DOI":"10.7758\/rsf.2017.3.5.02","article-title":"The stock and flow of US firearms: results from the 2015 National Firearms Survey.","volume":"3","author":"Azrael","year":"2017","journal-title":"JSTOR"},{"issue":"4","key":"zoi231072r19","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1111\/crim.1997.35.issue-4","article-title":"The social determinants of gun ownership: Self-protection in an urban environment.","volume":"35","author":"Cao","year":"1997","journal-title":"Criminology"},{"issue":"1","key":"zoi231072r21","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1177\/1536504214567850","article-title":"Carrying guns, contesting gender.","volume":"14","author":"Carlson","year":"2015","journal-title":"Contexts"},{"issue":"5","key":"zoi231072r22","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1007\/s12103-020-09521-9","article-title":"Risk and protective factors associated with youth firearm access, possession or carrying.","volume":"45","author":"Mattson","year":"2020","journal-title":"Am J Crim Justice"},{"issue":"4","key":"zoi231072r23","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1007\/s10865-019-00048-x","article-title":"A scoping review of patterns, motives, and risk and protective factors for adolescent firearm carriage.","volume":"42","author":"Oliphant","year":"2019","journal-title":"J Behav Med"},{"issue":"1","key":"zoi231072r24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40621-021-00367-1","article-title":"Experiences of violence in daily life among adults in California: a population-representative survey.","volume":"9","author":"Wintemute","year":"2022","journal-title":"Inj Epidemiol"},{"issue":"37","key":"zoi231072r25","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1007\/s11606-022-07587-1","article-title":"Prevalence and correlates of firearm access among post-9\/11 US women veterans using reproductive healthcare: a cross-sectional survey.","volume":"37","author":"Monteith","year":"2022","journal-title":"J Gen Intern Med"},{"issue":"4","key":"zoi231072r26","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/j.jcrimjus.2011.03.002","article-title":"The effect of perceived risk and victimization on plans to purchase a gun for self-protection.","volume":"30","author":"Kleck","year":"2011","journal-title":"J Crim Justice"},{"issue":"19-20","key":"zoi231072r27","doi-asserted-by":"publisher","first-page":"NP10886","DOI":"10.1177\/0886260519877945","article-title":"Additive interactions between school bullying victimization and gender on weapon carrying among US high school students: Youth Risk Behavior Survey 2009 to 2015.","volume":"36","author":"Pontes","year":"2021","journal-title":"J Interpers Violence"},{"issue":"3","key":"zoi231072r28","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.jadohealth.2017.03.022","article-title":"Access to a loaded gun without adult permission and school-based bullying.","volume":"61","author":"Simckes","year":"2017","journal-title":"J Adolesc Health"},{"issue":"8","key":"zoi231072r29","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1177\/0306624X15573547","article-title":"On the association between repeat bully victimizations and carrying a firearm: evidence in a national sample.","volume":"60","author":"Turner","year":"2016","journal-title":"Int J Offender Ther Comp Criminol"},{"issue":"8","key":"zoi231072r30","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1001\/jamapediatrics.2014.213","article-title":"Bullying and weapon carrying: a meta-analysis.","volume":"168","author":"van Geel","year":"2014","journal-title":"JAMA Pediatr"},{"issue":"2","key":"zoi231072r31","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-042291","article-title":"Childhood gun access, adult suicidality, and crime.","volume":"148","author":"Copeland","year":"2021","journal-title":"Pediatrics"},{"issue":"1","key":"zoi231072r32","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.jaac.2013.09.017","article-title":"Longitudinal patterns of anxiety from childhood to adulthood: the Great Smoky Mountains Study.","volume":"53","author":"Copeland","year":"2014","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"12","key":"zoi231072r33","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1001\/archpsyc.1996.01830120067012","article-title":"The Great Smoky Mountains Study of youth. goals, design, methods, and the prevalence of DSM-III-R disorders.","volume":"53","author":"Costello","year":"1996","journal-title":"Arch Gen Psychiatry"},{"issue":"2","key":"zoi231072r34","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-042291","article-title":"Childhood gun access, adult suicidality, and crime.","volume":"148","author":"Copeland","year":"2021","journal-title":"Pediatrics"},{"issue":"1","key":"zoi231072r35","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1097\/00004583-200001000-00015","article-title":"The Child and Adolescent Psychiatric Assessment (CAPA).","volume":"39","author":"Angold","year":"2000","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"6","key":"zoi231072r36","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1017\/S0033291798007569","article-title":"Life events and post-traumatic stress: the development of a new measure for children and adolescents.","volume":"28","author":"Costello","year":"1998","journal-title":"Psychol Med"},{"issue":"5","key":"zoi231072r37","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1037\/0003-066X.55.5.469","article-title":"Emerging adulthood. a theory of development from the late teens through the twenties.","volume":"55","author":"Arnett","year":"2000","journal-title":"Am Psychol"},{"issue":"6","key":"zoi231072r38","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014407","article-title":"Developing implementation strategies for firearm safety promotion in paediatric primary care for suicide prevention in two large US health systems: a study protocol for a mixed-methods implementation study.","volume":"7","author":"Wolk","year":"2017","journal-title":"BMJ Open"},{"issue":"5","key":"zoi231072r39","doi-asserted-by":"publisher","first-page":"725","DOI":"10.7326\/M20-6314","article-title":"Firearm safety discussions between clinicians and US adults living in households with firearms: results from a 2019 national survey.","volume":"174","author":"Conner","year":"2021","journal-title":"Ann Intern Med"},{"issue":"4","key":"zoi231072r40","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4016","article-title":"Adverse childhood experiences and adult well-being in a low-income, urban cohort.","volume":"137","author":"Giovanelli","year":"2016","journal-title":"Pediatrics"},{"issue":"2","key":"zoi231072r41","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1111\/crim.2015.53.issue-2","article-title":"The law of crime concentration and the criminology of place.","volume":"53","author":"Weisburd","year":"2015","journal-title":"Criminology"},{"issue":"2","key":"zoi231072r42","doi-asserted-by":"publisher","first-page":"219","DOI":"10.7326\/M21-3423","article-title":"Firearm purchasing during the COVID-19 pandemic: results from the 2021 National Firearms Survey.","volume":"175","author":"Miller","year":"2022","journal-title":"Ann Intern Med"},{"key":"zoi231072r20","doi-asserted-by":"crossref","DOI":"10.7249\/TL354","volume-title":"State-Level Estimates of Household Firearm Ownership","author":"Schell","year":"2020"},{"key":"zoi231072r1","unstructured":"US Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS). Published 2005. Accessed November 1, 2022. https:\/\/www.cdc.gov\/injury\/wisqars\/index.html"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2810829\/caves_sivaraman_2023_oi_231072_1697031994.43644.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T15:03:24Z","timestamp":1697641404000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2810829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,18]]},"references-count":42,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.36907","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,18]]}}}