By Thomas R. Simon,  Heather B. Clayton,  Linda L. Dahlberg; Corinne David-Ferdon,  Greta Kilmer,  Colleen Barbero, 

Suicide and homicide are the second and third leading causes of death, respectively, among youths aged 14–17 years (1); nearly one half (46%) of youth suicides and most (93%) youth homicides result from firearm injuries (1). Understanding youth gun carrying and associated outcomes can guide prevention initiatives (2). This study used the updated measure of gun carrying in the 2017 and 2019 administrations of CDC’s Youth Risk Behavior Survey* (YRBS) to describe the national prevalence of gun carrying for reasons other than hunting or sport among high school students aged <18 years and to examine the associations between gun carrying and experiencing violence, suicidal ideation or attempts, or substance use. Gun carrying during the previous 12 months was reported by one in 15 males and one in 50 females. Gun carrying was significantly more likely among youths with violence-related experiences (adjusted prevalence ratio [aPR] range = 1.5–10.1), suicidal ideation or attempts (aPR range = 1.8–3.5), or substance use (aPR range = 4.2–5.6). These results underscore the importance of comprehensive approaches to preventing youth violence and suicide, including strategies that focus on preventing youth substance use and gun carrying (3). CDC’s YRBS uses an independent three-stage cluster sample design to achieve a nationally representative sample of students in grades 9–12 who attend public or private schools in the 50 states and the District of Columbia (4). The overall response rates for 2017 and 2019 were 60% (14,765) and 60.3% (13,677), respectively. After the removal of responses missing age (153; 0.5%), those indicating legal age to purchase a firearm (i.e., age ≥18 years) (3,412; 12%), and those missing sex (138; 0.5%) or gun carrying information (2,927; 10.3%), the final analytic sample included 21,812 students. Information on YRBS weighting, sampling, and psychometric properties has previously been reported (4,5). YRBS was reviewed and approved by CDC and ICF institutional review boards.

Morbidity and Mortality Weekly Report Weekly / Vol. 71 / No. 30 July 29, 2022 

By Megan K. McBride, Kaia Haney, Michelle Strayer, and Jessica Stern

Despite the focus on suicide terrorism over the past 20 years—particularly by media outlets, policy-makers, and academics—scholarship regarding suicidality in domestic terrorism remains sparse. The post-9/11 research related to suicidality in terrorism has largely focused on the suicide terrorism of Islamist extremists. The research that touches on domestic terrorism, however, is both limited and inconclusive. Lankford, for example, has argued that suicidality is one of three key similarities between perpetrators of suicide terrorism and perpetrators of mass shootings. But a 2017 article by Freilich et al., whose research focused on far-right and jihadi attacks in the US, found that suicide attackers were no more likely than non-suicide attackers to have previously attempted suicide. By contrast, suicidality among those who carry out public shootings is well documented. Jillian Peterson and James Densley, leveraging The Violence Prevention Project’s (TVPP’s) Mass Shooter Database, found that 70 percent of the 197 individuals who committed mass shootings over the past 60 years either had a history of suicidality or intended to die carrying out their attack. Retrospective research by the US Secret Service on school shooters from 1974 to 2000 found that at least 78 percent had experienced suicidal thoughts or engaged in suicidal behavior before their attack. And an analysis leveraging the Columbia Mass Murder Database found that nearly half of all mass shooters died by suicide at the scene of their attack. Mass shootings, as Peterson and Densley have noted, may in fact be “crimes of despair.” We leveraged a new dataset—the Domestic Terrorism Offender Level Database (DTOLD)—to explore whether domestic terrorism attacks may also be crimes of despair. The database captures publicly available information (e.g., media reporting, court records) on the life histories of 320 individuals who carried out a non-Islamist terrorist attack in the United States between January 1, 2001, and December 31, 2020. Our data suggest that domestic terrorists in general may be more suicidal than the general population but significantly less suicidal than mass shooters except when domestic terrorists kill four or more people (notably, four is the number of deaths required for a shooting to meet the Federal Bureau of Investigation’s definition of a mass shooting). DTOLD contains three variables relevant to the question of suicidality: history of suicidality (including suicide attempts and suicidal ideation), intention to die while committing a terrorist attack, and death by suicide during or immediately after a terrorist attack. Collecting data on suicidality is difficult, but 19.3 percent (62) of the individuals in DTOLD have been coded positively for at least one of the three indicators of suicidality. This rate is notably higher than the rate calculated by the Substance Abuse and Mental Health Services Administration, which is 4.37 percent for men (89 percent of those in DTOLD are men). This rate is still lower, however, than TVPP’s rate of 70 percent among mass shooters.

Arlington, VA: CNA, 2024. 4p

By : Centers for Disease Control and Prevention

* Suicide was identified using ICD-10 underlying cause-of-death codes U03, X60–X84, and Y87.0. Firearm-involved suicide was identified using ICD-10 underlying cause-of-death codes X72–X74.† Homicide was identified using ICD-10 underlying cause-of-death codes U01–U02, X85–Y09, and Y87.1. Firearm-involved homicide was identified using ICD-10 underlying cause-of-death codes U01.4 and X93–X95.

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In 2022, among persons aged ≥10 years, the percentage of suicide deaths involving a firearm was lowest among persons aged 25–44 years (47.4%) and highest among persons aged ≥65 years (70.6%). The percentage of homicide deaths that involved a firearm was highest among persons aged 10–24 years and then decreased with age, from 92.2% among those aged 10–24 years to 44.5% among those aged ≥65 years.

MMWR Morb Mortal Wkly Rep 2024;73:828. DOI: http://dx.doi.org/10.15585/mmwr.mm7337a3