A Proposed Universal Medical and Public Health Definition of
                        Terrorism

Arnold, Jeffrey L.; Örtenwall, Per; Birnbaum, Marvin L.; Sundnes, Knut Ole; Aggrawal, Anil; Arantharaman, V.; Musleh, Abdul Wahab Al; Asai, Yasufumi; Burkle, Frederick M.; Chung, Jae Myung; Vega, Felipe Cruz; Debacker, Michel; Corte, Francesco Della; Delooz, Herman; Dickinson, Garth; Hodgetts, Timothy; Holliman, C. James; MacFarlane, Campbell; Rodoplu, Ulkumen; Stok, Edita; Tsai, Ming-Chao

doi:10.1017/s1049023x00000753

Cited by 34 publications

(20 citation statements)

References 4 publications

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“…We limited our search to studies defined closely by time and place and excluded studies of torture, political repression, the effects of expatriation on political refugees, incidents of non-politically motivated violence such as criminal Terrorism substance use meta-analysis 895 shootings and studies of potential threats, such as bioterrorist attacks, rather than actual incidents. We defined substance use and misuse to include alcohol, cigarette, narcotics and prescription drugs, and terrorism as 'The intentional use of violence-real or threatened-against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death' [25].…”

Section: Methodsmentioning

confidence: 99%

Substance use and misuse in the aftermath of terrorism. A Bayesian meta‐analysis

DiMaggio

Galea

2009

Addiction

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AimTo conduct a comprehensive analysis of the conflicting evidence on substance use and misuse following mass traumas such as terrorist incidents. Methods We reviewed and synthesized evidence from 31 population-based studies using Bayesian meta-analysis and meta-regression. Results The majority of the studied were conducted in the aftermath of the terrorist attacks of 11 September 2001. Controlling for exposure, type of incident and time since the event occurred, 7.3% [95% credible interval (CrI) 1.1-32.5%] of a population can be expected to report increased alcohol consumption in the first 2 years following a terrorist event. There is, however, a 20% probability that the prevalence will be as high as 14%. The unadjusted prevalence of increased cigarette smoking following a terrorist event is 6.8% (95% Cr I 2.6-16.5%). Unadjusted reports of mixed drug use (including narcotics and prescription medications) was 16.3% (95% Cr I 1.3-72.5%). Conclusions These results underscore the potentially pervasive behavioral health effects of mass terrorism, and suggest that public health interventions may usefully consider substance use as an area of focus after such events.

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Section: Methodsmentioning

confidence: 99%

Substance use and misuse in the aftermath of terrorism. A Bayesian meta‐analysis

DiMaggio

Galea

2009

Addiction

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“…Terrorism is defined as ''the intentional use of violence against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death'' [5]. The results of several revisions of the consequences of disasters have shown that terrorism may be associated with a greater risk of psychopathology than other disasters [6].…”

Section: Introductionmentioning

confidence: 99%

Major depressive disorder following terrorist attacks: A systematic review of prevalence, course and correlates

et al. 2011

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BackgroundTerrorist attacks are traumatic events that may result in a wide range of psychological disorders for people exposed. This review aimed to systematically assess the current evidence on major depressive disorder (MDD) after terrorist attacks.MethodsA systematic review was performed. Studies included assessed the impact of human-made, intentional, terrorist attacks in direct victims and/or persons in general population and evaluated MDD based on diagnostic criteria.ResultsA total of 567 reports were identified, 11 of which were eligible for this review: 6 carried out with direct victims, 4 with persons in general population, and 1 with victims and general population. The reviewed literature suggests that the risk of MDD ranges between 20 and 30% in direct victims and between 4 and 10% in the general population in the first few months after terrorist attacks. Characteristics that tend to increase risk of MDD after a terrorist attack are female gender, having experienced more stressful situations before or after the attack, peritraumatic reactions during the attack, loss of psychosocial resources, and low social support. The course of MDD after terrorist attacks is less clear due to the scarcity of longitudinal studies.ConclusionsMethodological limitations in the literature of this field are considered and potentially important areas for future research such as the assessment of the course of MDD, the study of correlates of MDD or the comorbidity between MDD and other mental health problems are discussed.

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“…We recognise that definitions of terrorism are variable and contentious [12][13][14]. This study used the US State Department's definition for Ôinternational terrorism', which includes attacks that are probably better classified in other ways.…”

Section: Limitations With This Analysis and Data Setmentioning

confidence: 99%

The epidemiology of international terrorism involving fatal outcomes in developed countries (1994–2003)

Wilson

Thomson

2005

Eur J Epidemiol

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We aimed to describe the public health burden and epidemiology of international terrorism (i.e. involving foreign nationals) with fatal outcomes in developed countries. Data was abstracted from a United States Department of State database for 21 'established market economy' countries and 18 'former socialist economies of Europe' for 1994-2003. To put the findings in a wider context, comparisons were made with WHO data on all homicides for each country. A total of 32 international terrorist attacks causing fatalities were identified over the 10-year period. These resulted in 3299 deaths, giving a crude annual mortality rate of 0.3 per million population. The mortality burden attributable to international terrorism in these countries was 208 times less than that attributable to other homicide. Even for the country with the highest mortality burden from international terrorism (the United States), this ratio was 60. There was no statistically significant trend in the number of attacks over time, but the attack severity (in terms of deaths per attack) was higher in the latter part of the 10-year period. A number of limitations with this data set were identified. If a more rigorous definition of 'international terrorism' was used, then this would substantially reduce the total number of such attacks defined in this way. In conclusion, there is a need for better quality data and improved classification systems for describing international terrorism. Nevertheless, the available data indicates that the mortality burden from international terrorism in developed countries is small compared to that from other homicide.

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A Proposed Universal Medical and Public Health Definition of Terrorism

Cited by 34 publications

References 4 publications

Substance use and misuse in the aftermath of terrorism. A Bayesian meta‐analysis

Substance use and misuse in the aftermath of terrorism. A Bayesian meta‐analysis

Major depressive disorder following terrorist attacks: A systematic review of prevalence, course and correlates

The epidemiology of international terrorism involving fatal outcomes in developed countries (1994–2003)

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