"Danger Is Everywhere": Experiences of Continuous Traumatic Stress Following Gunshot Survivorship

Background and Purpose: Community-based gun violence disproportionately impacts young Black and Latino boys and men and is a catalyst for ethnic and racial health disparities in the United States. The fear of community-based gun violence substantially distorts the way that millions of people live their lives. This is especially true as the majority of community-based gun violence injuries result in survivorship producing detrimental mental and physical repercussions for survivors and family members. Post-Traumatic Stress Disorder, a concept used to understand the traumatic aftermath and symptomatology, doesn’t take into account the forward-facing nature of gun violence and lacks historical context accounting for the disproportionate nature of community-based gun violence (e.g., race and socioeconomic status). Continuous Traumatic Stress (CTS) focuses on the ongoing anticipation of future threats and traumas rather than those from the past. CTS has mainly been utilized within the international literature in war-torn countries and highlights how persistent poverty, racial and gender-based violence, as well as violence committed by institutional actors (e.g., law enforcement) continuously traumatize vulnerable populations. Understanding community-based gun violence through CTS may provide a new perspective on its psychological and social impact.

Methods: A structured purposive sampling method was used to conduct 21 separate qualitative interviews between November 2022 and March 2024 with survivors of gun violence and their chosen family members from Brooklyn, NY. The interviews were transcribed verbatim and then analyzed by a team of three researchers. In combination with CTS researchers utilized a grounded theory and thematic analysis approach to allow ideas and concepts to emerge from the data. Member checking was an integral analytical method to enhance the credibility of study findings. It involved the feedback from advisory board members composed of staff at a Brooklyn-based hospital-based violence intervention program and community residents who have extensive experience working with or living in communities impacted by gun violence.

Results: Qualitative analysis from separate interviews with gunshot survivors and their chosen family members yielded three key thematic findings: 1) Absence of protection: Highlights a failure of just and effective systems to promote safety. 2) Present and Anticipated Trauma: Describes the fixation on current and expected traumatic threats. 3) Necessary Adaptive Symptoms: Suggests that individual responses and behaviors evolve as coping mechanisms to manage ongoing threats.

Conclusion and Implications: Little scholarship has utilized CTS to explore the varying adaptations and frameworks that gunshot survivors and their family members use to maximize safety despite little institutional protection. Findings address this research gap by utilizing CTS to illuminate how gunshot survivors and family members experience absence of system protection, adopt hypervigilance and psychosocial strategies to enhance protection and may experience post traumatic growth following their injury. Future research should consider utilizing CTS in cases of community-based gun violence and collaborate with international scholars who are working within communities with high rates of gun violence. These findings add new insights into the gun violence literature and bolster existing trauma literature by utilizing the conceptualization of CTS from the perspectives of both community-based gunshot survivors and their family members.