Extremism and common mental illness: cross-sectional community survey of White British and Pakistani men and women living in England

Abstract

BackgroundMental illnesses may explain vulnerability to develop extremist beliefs that can lead to violent protest and terrorism. Yet there is little evidence. AimsTo investigate the relationship between mental illnesses and extremist beliefs. MethodPopulation survey of 618 White British and Pakistani people in England. Extremism was assessed by an established measure of sympathies for violent protest and terrorism (SVPT). Respondents with any positive scores (showing sympathies) were compared with those with all negative scores. We calculated associations between extremist sympathies and ICD-10 diagnoses of depression and dysthymia, and symptoms of anxiety, personality difficulties, autism and post-traumatic stress. Also considered were demographics, life events, social assets, political engagement and criminal convictions. ResultsSVPT were more common in those with major depression with dysthymia (risk ratio 4.07, 95% CI 1.37-12.05, P = 0.01), symptoms of anxiety (risk ratio 1.09, 95% CI 1.03-1.15, P = 0.002) or post-traumatic stress (risk ratio 1.03, 95% CI 1.01-1.05, P = 0.003).At greater risk of SVPT were: young adults (<21 versus ≥21: risk ratio 3.05, 95% CI 1.31-7.06, P = 0.01), White British people (versus Pakistani people: risk ratio 2.24, 95% CI 1.25-4.02, P = 0.007) and those with criminal convictions (risk ratio 2.23, 95% CI 1.01-4.95, P = 0.048). No associations were found with life events, social assets and political engagement. ConclusionDepression, dysthymia and symptoms of anxiety and post-traumatic stress are associated with extremist sympathies.Declaration of interest K.B. is editor-in-chief of British Journal of Psychiatry but played no part in review and decision processes.

Assessing risks of violent extremism in depressive disorders: Developing and validating a new measure of Sympathies for Violent Protest and Terrorism

“…An expression of ‘sympathy’ was considered an attitudinal risk. Previous analyses of the survey 1 data found an association between higher SyfoR scores and common mental disorders, criminal history and trauma (Bhui et al, 2016, 2019). Similar associations were reported in a separate study of individuals with convictions for terror-related offences (Jensen, 2016), adding to the credibility of SyfoR in measuring a vulnerability to being radicalised (Bhui et al, 2019).…”

“…Individual assessments incorporating our measure of SVPT should use additional assessment tools. Additional evidence of cognitive and affective risk factors are important for assessment of vulnerability to engaging in violent extremism, including a heightened sense of injustice; intolerance of alternative beliefs; attempted abolition of perceived threats; paranoia, rage or suspiciousness; self-righteousness (Altemeyer and Altemeyer, 1996; Berlet, 2004; Boyd, 2010; De Regt et al, 2011; Hetherington and Suhay, 2011; Jost et al, 2003; Rogers et al, 2007; Rokeach, 1954; Seipel et al, 2012; Strozier and Boyd, 2010); distress, trauma and social disconnectedness (Bhui et al, 2014, 2016; Centre for the Prevention of Radicalization Leading to Violence (CPRLV), 2018); as well as mental disorders including depression, dysthymia, post-traumatic stress disorder (PTSD) and anxiety (Bhui et al, 2014, 2016, 2019; Borum, 2014; Corner and Gill, 2015; Jensen, 2016; Victoroff, 2005), and should also consider a person’s political and societal context (Knudsen, 2020).…”

“…Data were collected in two surveys in 2011 and 2016 (Bhui et al, 2014, 2019). Both surveys comprised attitudinal and lifestyle questions, along with questions to measure SVPT.…”

“…Second, we tested the convergent validity of short item measure of SVPT to calculate sensitivity, specificity and predictive values, using receiver operating characteristics (ROC) with an outcome of self-reported violence or convictions. Finally, given the interest in prevention in patients presenting with mood disorders, and findings that depressive disorders are associated with SVPT (Bhui et al, 2019), we tested the convergent validity of our SVPT measure to classify those reporting violence, among those with and without depressive disorders.…”

“…The first component was a seven-item subset measuring SVPT; a second component – sympathies for defensive violence; the third – attitudes towards UK foreign policy; and the fourth component – sympathies for fighting against British troops. The four distinct components were replicated in the second survey (Bhui et al, 2019), which included an additional 17th item – the act of fighting against British troops in Syria – that loaded on component 4. The seven-item measure of SVPT consisted of the most extreme attitudes related to violence and terrorism and was found to be consistent between the surveys.…”