Brian M. Hicks

Understanding student attitudes toward emergency preparedness drills (“drills”) in response to an active shooter is critical to developing best practices and guidance for schools implementing them. We utilized a national sample of middle and high school students and young adults ( N = 1,901) to examine perceptions of school actions when conducting drills including notifications before drills, debriefing, and simulated gunfire. Respondents broadly agreed that drills do not create unnecessary anxiety and should continue to be implemented. Nearly half of respondents reported feeling unprepared in the event of an active shooter, indicating a need to improve drill procedures and training. Debriefing following drills was associated with less drill-related anxiety, feeling more prepared, and taking drills seriously. Notifying before drills and simulating gunshots did not affect responses, especially after controlling for debriefing. Results support more focus on quality debriefing following active shooter drills and that debriefs can have operational and socio-emotional advantages.

Importance: Firearm violence is an important public health problem in the US. Timely identification and intervention for people who have thoughts of shooting others may help reduce the risk of firearm violence. Objective: To examine the psychological and behavioral characteristics associated with thoughts of shooting others. Design, Setting, and Participants: Cross-sectional analyses of the National Firearms, Alcohol, Cannabis, and Suicide (NFACS) survey administered from May 27 to September 2, 2025. The sample included 7034 US adults aged 18 years or older. Survey weights were used to align the sample to national population benchmarks. Main Outcomes and Measures: Lifetime and past-12-month thoughts of shooting others. Correlates included self-reported offensive and defensive gun use, firearm experience and substance-involved firearm handling, firearm- and non-firearm-related victimization, suicidal thoughts and behaviors, psychiatric and substance use problems, antisocial behavior, and personality. Results: Respondents who endorsed lifetime thoughts of shooting others (7.3% lifetime, n = 516; 3.3% past 12 months, n = 231) had higher rates of self-reported offensive (aOR = 3.38; 95% CI, 2.29–5.00) and defensive gun use (aOR = 3.60; 95% CI, 2.67–4.85), firearm and non-firearm victimization, handling or firing a gun under the influence of alcohol or drugs, insecure firearm storage (i.e., unlocked and loaded), and more experience with firearms. Thoughts of firearm suicide were strongly associated with thoughts of shooting others (lifetime aOR = 6.24; 95% CI, 4.57–8.51; past 12 months aOR = 9.25; 95% CI, 5.33–16.06). Thoughts of shooting others were also associated with suicidal thoughts and behaviors broadly and depression, anxiety, and substance use problems. Respondents who reported thoughts of shooting others also reported high levels of antisocial behavior, intimate partner violence, and disinhibited personality traits. Conclusions and Relevance: Characteristics associated with thoughts of shooting others include risk factors across multiple domains, similar to those associated with firearm and non-firearm interpersonal violence and victimization. Future research should examine whether a combination of screening for thoughts of shooting others and assessment of associated risk factors can improve risk formulation and inform prevention strategies for firearm violence.

Background: While guns have significant cultural importance in the United States, guns are also used in crimes and in self-defense and so many Americans will have experiences with guns that involve fear, property loss, or injury. To better inform firearm policy, we estimated the lifetime prevalence of self-reported offensive gun use (OGU), defensive gun use (DGU), and nonfatal firearm victimization (NFV) in the US state of Michigan. Methods: Two independent probability-based cross-sectional surveys were used to ascertain a pooled sample of adults living in the US state of Michigan ( N = 2489; 1264 female, 1225 male) with poststratification weighting to population benchmarks. Each domain of gun use and NFV were assessed using parallel items that ranged from telling someone you have a gun to shooting someone (or being shot by someone). Results: Lifetime prevalence rates were 3.7% (95% CI: 2.9% to 4.8%) for OGU, 8.8% (95% CI: 7.5% to 10.4%) for DGU, and 29.7% (95% CI: 27.5% to 31.9%) for NFV. About 80% of respondents only reported incidents that did not involve firing a gun. There was a high rate of co-occurrence between OGU and DGU (OR = 70.1, 95% CI: 37.6 to 130.7), and between NFV and OGU (OR = 7.4, 95% CI: 4.4 to 12.4) and DGU (OR = 3.9, 95% CI: 2.7 to 5.7). Gun usage and/or NFV was higher among younger ages, men, Black and Hispanic respondents, gun owners, respondents with prior military service or having a job that required carrying a firearm, lower income and education, and living in urban areas and more dangerous neighborhoods. Conclusions: The results suggest that negative firearm-involved encounters may be relatively common in Michigan (and potentially the US) and the need for public policy to minimize firearm-related harms.

Firearm-related encounters have the potential for high risk of injury, but few studies have estimated the prevalence and co-occurrence among offensive gun use (OGU), defensive gun use (DGU), and nonfatal firearm victimization (NFV) in a national sample. We did so with data from the National Firearms, Alcohol, Cannabis, and Suicide survey (N = 7034) of US adults that assessed broad definitions of gun use and victimization (e.g., gun displays to shootings). Lifetime prevalence was 5.2% (95% CI 4.5% to 6.0%) for OGU, 12.6% (95% CI 11.5% to 13.7%) for DGU, and 31.5% (95% CI 30.0% to 33.0%) for NFV. Using survey weights to extrapolate to the US adult population, we estimate nearly 13.9 million adults have used a gun offensively, 33.3 million have used a gun defensively, and 83.3 million have experienced NFV in their lifetime. Most respondents (~80%) only reported gun use and victimization that did not involve firing a gun. There was a high rate of co-occurrence between OGU and DGU (OR = 33.8, 95% CI 23.7 to 48.0), and between NFV and OGU (OR = 5.3, 95% CI 3.9 to 7.2) and DGU (OR = 4.5, 95% CI 3.7 to 5.6). Rates of OGU, DGU, and/or NFV were higher among respondents who were males, lower income, lived in more dangerous neighborhoods, current gun owners, and had a job that required carrying a firearm. Occupational firearm carriage was associated with especially high rates of OGU (20.5%, 95% CI 15.8% to 26.1%), DGU (49.6%, 95% CI 43.9% to 55.2%), and NFV (50.9%, 95% CI 45.2% to 56.5%). A large minority of Americans have had a firearm-related victimization experience, and a smaller but substantial proportion have used a gun for defense. OGU, DGU, and NFV frequently co-occur but event-level information is needed to delineate the mechanisms of overlap.

Background: The prevalence and societal impacts of defensive gun use (DGU; the use of a firearm to protect oneself, others, or property) are contested, but few studies have characterized the behavioral and psychological characteristics of people who report DGU. Therefore, we examined the demographic, firearm-related behaviors, mental health and substance use problems, antisocial behavior, and personality correlates of self-reported DGU. Methods: This study used data from the National Firearms, Alcohol, Cannabis, and Suicide (NFACS) survey, a probability-based sample of 7034 adults living in the US, that was fielded from May 27 to September 2, 2025. Lifetime DGU was stratified by a history of offensive gun use (OGU) and firearm ownership (current, former, never owner). Results: DGU was associated with higher rates of military service, having a job that required carrying a firearm, thoughts of shooting others and thoughts of firearm suicide, handling and firing a gun under the influence of alcohol or cannabis, and antisocial behavior relative to those who did not report DGU. Firearm ownership history–but not OGU–differentiated meaningful DGU subgroups. Current firearm owners who reported DGU had similar psychosocial functioning to those who did not report DGU, while former and never firearm owners reporting DGU had higher levels of mental health and substance use problems, antisocial behavior, and disinhibited personality traits. Conclusion: Self-reported DGU encompasses different people in terms of psychosocial functioning, and history of firearm ownership (current, former, never) may be indicative of different contexts for DGU. More information about incidents of DGU, firearm access, and developmental trajectories is needed to better understand influences that contribute to DGU.

While guns have significant cultural importance in the United States, guns are also used in crimes and in self-defense and so many Americans will have experiences with guns that involve fear, property loss, or injury. We estimated the lifetime prevalence of offensive gun use (OGU), defensive gun use (DGU), and nonfatal firearm victimization (NFV), their co-occurrence, and their demographic correlates in a representative sample of adults living in the US state of Michigan. The sample was ascertained using probability-based recruitment with poststratification weights applied to match the major demographic benchmarks for the target population (N = 2489; 1265 female, 1224 male). Each domain of gun use and NFV were assessed using parallel items that ranged from telling someone you have a gun to shooting someone (or being shot by someone). Lifetime prevalence rates were 3.9% (95% CI 3.1%-4.9%) for OGU, 8.9% (95% CI 7.6%-10.4%) for DGU, and 29.7% (95% CI 27.6%-31.8%) for NFV. For each domain, about 80% of respondents only reported incidents that did not involve firing a gun. There was a high rate of co-occurrence between OGU and DGU (OR = 65.9, 95% CI 35.5-122.5), and between NFV and OGU (OR = 6.8, 95% CI 4.1-11.4) and DGU (OR = 3.8, 95% CI 2.7-5.3). Gun usage and/or NFV was associated with male sex, Black race, lower income and education, gun ownership, and military service or having a job that required carrying a firearm. When defined broadly, a large proportion of Michigan residents reported negative experiences with firearms, though a subset of cases involved use of a firearm for defense. The results suggest that firearm-involved encounters may be more common than thought and the need for public policy to minimize firearm-related harms.

Understanding student attitudes toward emergency preparedness drills (“drills”) in response to an active shooter is critical to developing best practices and guidance for schools implementing them. We utilized a national sample of middle and high school students and young adults (N = 1,901) to examine perceptions of school actions when conducting drills including notifications before drills, debriefing, and simulated gunfire. Respondents broadly agreed that drills do not create unnecessary anxiety and should continue to be implemented. Nearly half of respondents reported feeling unprepared in the event of an active shooter, indicating a need to improve drill procedures and training. Debriefing following drills was associated with less drill-related anxiety, feeling more prepared, and taking drills seriously. Notifying before drills and simulating gunshots did not affect responses, especially after controlling for debriefing. Results support more focus on quality debriefing following active shooter drills and that debriefs can have operational and socio-emotional advantages.

We provide an historical perspective on the development, empirical support, and evolution of the behavioral disinhibition model of addiction that has been a central aim of the Minnesota Twin Family Study (MTFS). Conceived by David Lykken, the MTFS initiated a 35-year collaboration between Matt McGue and Bill Iacono, who together built the Minnesota Center for Twin and Family Research (MCTFR). The behavioral disinhibition model posited that a heritable psychobiological liability expressed as the failure to conform to normative behavior and deficits in self-regulation underlies the co-occurrence, family transmission, and early onset of substance use problems and externalizing psychopathology. MCTFR longitudinal investigations spanning childhood through adulthood and twin, adoption, family, and genome-wide association studies support the genetic basis of behavioral disinhibition and its associations with numerous impulse control problems. Heritability of externalizing peaks in late adolescence, while there is consistent evidence for shared environmental influences on child antisocial behavior and early adolescent problem behaviors. Environmental adversity amplifies genetic vulnerability, driving an adolescent onset of substance use problems while behavioral disinhibition is key to their persistence. We also present an updated behavioral disinhibition model that spans childhood through young adulthood and report novel cotwin control analyses of 1382 twin pairs finding bidirectional associations wherein heavy substance use has robust casual non-familial effects that contribute to greater antisocial behavior and a more disinhibited personality structure in adulthood and vice versa. Genetic and shared environmental influences on behavioral disinhibition and the non-familial effects of heavy substance use create a system of person-environment transactions that maintain stable developmental trajectories and changes in adjustment across young adulthood.

Background: Cannabinoid hyperemesis syndrome (CHS), a disorder characterized by severe nausea, vomiting, and abdominal pain among heavy cannabis users. We previously showed that CHS symptoms are associated with several behavioral and psychological characteristics linked to psychosocial impairment. We examined links between CHS symptoms and suicidal thoughts, behaviors, and proximal suicide risk factors. Methods: We used data from the National Firearms, Alcohol, Cannabis, and Suicide survey, a nationally representative survey of 7034 US adults. Items assessed symptoms of CHS and suicidal thoughts and behaviors, proximal suicide risk factors, and non-suicidal self-injury. Comparisons focused on: those with daily cannabis use and CHS symptoms (n = 191), those with daily cannabis use without CHS symptoms (n = 882), those with past year cannabis use but not daily use (n = 1288), and those without past year cannabis use (n = 4673).Results: Those with CHS symptoms reported the highest lifetime and past 12 months prevalence of suicidal thoughts and behaviors with nearly all being significantly higher than those with daily cannabis use without CHS symptoms. Those with CHS symptoms also reported higher mean-levels of proximal risk factors for suicide (i.e., perceived burdensomeness, thwarted belongingness, defeat, entrapment) than all the other groups. Conclusions: Those with CHS symptoms reported especially high rates of suicidal thoughts, behaviors, and attempts even when compared to others with daily cannabis use. People with CHS symptoms appear to be at high risk of suicide, possibly related to distress from their gastrointestinal symptoms and psychiatric, substance use, and medical comorbidities.