GUNS: The Narrative Uber Alles: Gun-Related Injuries and Juvenile Mental Health.

In a recent medical journal report the authors find that a firearm injury to an adult is associated with a child in the family receiving a psychiatric diagnosis. They imply that distress related to the injury leads to the emergence of psychiatric difficulties and subsequently a psychiatric diagnosis. On its face, this seems plausible.

The authors note some limitations, including relying exclusively on commercial health insurance to obtain data regarding injuries and psychiatric diagnoses. While they utilize a large sample it is perhaps only about 13 percent of the US population. As they note, it excludes families covered by Medicaid, which may be different in important ways from those whose health insurance tends to be through an employer. Additionally, they point out that an alternative explanation for an association between injuries and children’s receiving a psychiatric diagnosis is that the injury prompted a set of interactions with the medical community, thus increasing the likelihood that psychiatric difficulties would be identified and diagnosed in these children. This seems plausible as well.

However, the conclusion that an adult’s injury leads to a child’s diagnosis is undercut by the graph they present showing diagnoses both before and after the injury. While the graph indicates that indeed children’s psychiatric diagnoses increased following the injury, they were on an upward curve before the injury. This might suggest that situational factors led to both the diagnosis and the injury.

Much more at the link, but these days it pays to be extra-skeptical of anything published in medical journals — particularly when it involves firearms.