BackgroundSeveral social trends in the United States (US) suggest an increasing risk for political violence. Little is known about support for and personal willingness to engage in political violence and how those measures vary with lethality of violence, specific circumstances, or specific populations as targets.Design, Setting, ParticipantsCross-sectional nationwide survey conducted May 13 to June 2, 2022; participants were adult members of the Ipsos KnowledgePanel.Main Outcomes and MeasuresWeighted, population-representative proportions endorsing an array of beliefs about American democracy and society and the use of violence, including political violence, and extrapolations to the US adult population.ResultsThe analytic sample included 8,620 respondents; 50.6% (95% Confidence Interval (CI) 49.4%, 51.7%) were female; mean (SD) age was 48.4 (18.0) years. Two-thirds of respondents (67.2%, 95% CI 66.1%, 68.4%) perceived “a serious threat to our democracy,” but more than 40% agreed that “having a strong leader for America is more important than having a democracy” and that “in America, native-born white people are being replaced by immigrants.” Half (50.1%) agreed that “in the next few years, there will be civil war in the United States.” Among 6,768 respondents who considered violence to be at least sometimes justified to achieve 1 or more specific political objectives, 12.2% were willing to commit political violence themselves “to threaten or intimidate a person,” 10.4% “to injure a person,” and 7.1% “to kill a person.” Among all respondents, 18.5% thought it at least somewhat likely that within the next few years, in a situation where they believed political violence was justified, “I will be armed with a gun”; 4.0% thought it at least somewhat likely that “I will shoot someone with a gun.”Conclusions and RelevanceCoupled with prior research, these findings suggest a continuing alienation from and mistrust of American democratic society and its institutions. Substantial minorities of the population endorse violence, including lethal violence, to obtain political objectives. Efforts to prevent that violence, which a large majority of Americans already reject, should proceed rapidly based on the best evidence available. Further research will inform future prevention efforts.

The gun violence restraining order (GVRO) is a new tool for preventing gun violence. Unlike traditional approaches to prohibiting gun purchase and possession, which rely on a high threshold (adjudication by criminal justice or mental health systems) before intervening, the GVRO allows family members and intimate partners who observe a relative's dangerous behavior and believe it may be a precursor to violence to request a GVRO through the civil justice system. Once issued by the court, a GVRO authorizes law enforcement to remove any guns in the respondent's possession and prohibits the respondent from purchasing new guns. In September 2014, California's governor signed AB1014 into law, making California the first U.S. state to enact a GVRO law. This article describes the GVRO and the rationale behind the concept, considers case examples to assess the potential impact of the GVRO as a strategy for preventing gun violence, and reviews the content of the California law.

What diagnostic criterion is noted to be a central feature for each of the diagnoses of intellectual disability, borderline personality disorder, and gender dysphoria? A. Functional impairment. B. Emotional instability. C. Cognitive dysfunction. D. Neurotic traits.

Suicide is complex, with psychiatric, cultural, and socioeconomic roots. Though mental illnesses like depression contribute to risk for suicide, access to lethal means such as firearms is considered a key risk factor for suicide, and half of suicides in the USA are by firearm. When a person at risk of suicide has access to firearms, clinicians have a range of options for intervention. Depending on the patient, the situation, and the access to firearms, counseling on storage practices, temporary transfer of firearms, or further intervention may be appropriate. In the USA, ownership of and access to firearms are common and discussing added risk of access to firearms for those at risk of suicide is not universally practiced. Given the burden of suicide (particularly by firearm) in the USA, the prevalence of firearm access, and the lethality of suicide attempts with firearms, we present the existing evidence on the burden of firearm suicide and what clinicians can do to reduce their patients’ risk. Specifically, we review firearm ownership in the USA, firearm injury epidemiology, risk factors for firearm-related harm, and available interventions to reduce patients’ risk of firearm injury and death.