The risk of weapons abuse cannot be brought down to a syndrome (or a nosographically definable disease) and its prevention must include various domains.
Clinically relevant aspects in this setting – though they are not nosologically sensitive – concern the domains of mental functioning, e.g.: the impact of flexible, wavering or internally persecutory rules and moral ideals in the regulation of behavior; the capacity for abstract reasoning and symbolic thinking at the service of interpersonal relations (the so-called capacity for mentalization) that enables people to identify with and understand their own and others' minds (their intentions, affects and desires, their thinking patterns, and so on), the impairment of which - and there are scales to measure such a deficiency – can make individuals more or less incapable of imagining for themselves what consequences their actions may have for other people and for themselves (also in terms of pain, joy and, in the more severe cases, of life or death); the capacity to integrate and differentiate mentally between fantasy and reality, between past, present and future, between desires and the time; the capacity to govern one's own impulses; etc.
Models are therefore needed that seek to study how an individual’s functioning is organized, in order to detect whether any decompensation of his/her psychic organization might involve the abuse of firearms.
Among the diagnostic tools currently available to clinicians, there are some - such as the Psychodynamic Diagnostic Manual (PDM Task Force, 2006) - that recommend a dimensional assessment such as those mentioned above. Clinically relevant empirical tools are also currently being developed, such as the QMF-27 (Questionnaire on Mental Functioning), to facilitate the diagnoses obtained by means of PDM.
Future developments in the field of prevention may focus on our understanding of the links between these variables and the risk of abuse.