Abstract:Terrorism has dominated the domestic and international landscape since 9/11. Like other fields, psychiatry was not well prepared. With the 10th anniversary of the 9/11 attack approaching, it is timely to consider what can be done to prepare before the next event. Much has been learned to provide knowledge and resources. The roles of psychiatrists are challenged by what is known of the causes of, consequences of, and responses to terrorism. Reflecting on knowledge from before and since 9/11 introduces concepts,… Show more
“…These narratives of adversity, alongside migration experiences, have also been proposed as causing depression and psychosis [14]–[19]. Social explanations and psychiatric opinions abound when known terrorists face conviction [20], yet there are few empirical population studies that investigate these possible explanations for radicalisation and terrorism [21], [22]. One exception is an exploratory study of 52 teenage boys in Gaza that found depressive symptoms were common in supporters of ‘religio-political aggression’, whilst anxiety was heightened amongst Palestinian supporters of radical action [23].…”
BackgroundThis study tests whether depression, psychosocial adversity, and limited social assets offer protection or suggest vulnerability to the process of radicalisation.MethodsA population sample of 608 men and women of Pakistani or Bangladeshi origin, of Muslim heritage, and aged 18–45 were recruited by quota sampling. Radicalisation was measured by 16 questions asking about sympathies for violent protest and terrorism. Cluster analysis of the 16 items generated three groups: most sympathetic (or most vulnerable), most condemning (most resistant), and a large intermediary group that acted as a reference group. Associations were calculated with depression (PHQ9), anxiety (GAD7), poor health, and psychosocial adversity (adverse life events, perceived discrimination, unemployment). We also investigated protective factors such as the number social contacts, social capital (trust, satisfaction, feeling safe), political engagement and religiosity.ResultsThose showing the most sympathy for violent protest and terrorism were more likely to report depression (PHQ9 score of 5 or more; RR = 5.43, 1.35 to 21.84) and to report religion to be important (less often said religion was fairly rather than very important; RR = 0.08, 0.01 to 0.48). Resistance to radicalisation measured by condemnation of violent protest and terrorism was associated with larger number of social contacts (per contact: RR = 1.52, 1.26 to 1.83), less social capital (RR = 0.63, 0.50 to 0.80), unavailability for work due to housekeeping or disability (RR = 8.81, 1.06 to 37.46), and not being born in the UK (RR = 0.22, 0.08 to 0.65).ConclusionsVulnerability to radicalisation is characterised by depression but resistance to radicalisation shows a different profile of health and psychosocial variables. The paradoxical role of social capital warrants further investigation.
“…These narratives of adversity, alongside migration experiences, have also been proposed as causing depression and psychosis [14]–[19]. Social explanations and psychiatric opinions abound when known terrorists face conviction [20], yet there are few empirical population studies that investigate these possible explanations for radicalisation and terrorism [21], [22]. One exception is an exploratory study of 52 teenage boys in Gaza that found depressive symptoms were common in supporters of ‘religio-political aggression’, whilst anxiety was heightened amongst Palestinian supporters of radical action [23].…”
BackgroundThis study tests whether depression, psychosocial adversity, and limited social assets offer protection or suggest vulnerability to the process of radicalisation.MethodsA population sample of 608 men and women of Pakistani or Bangladeshi origin, of Muslim heritage, and aged 18–45 were recruited by quota sampling. Radicalisation was measured by 16 questions asking about sympathies for violent protest and terrorism. Cluster analysis of the 16 items generated three groups: most sympathetic (or most vulnerable), most condemning (most resistant), and a large intermediary group that acted as a reference group. Associations were calculated with depression (PHQ9), anxiety (GAD7), poor health, and psychosocial adversity (adverse life events, perceived discrimination, unemployment). We also investigated protective factors such as the number social contacts, social capital (trust, satisfaction, feeling safe), political engagement and religiosity.ResultsThose showing the most sympathy for violent protest and terrorism were more likely to report depression (PHQ9 score of 5 or more; RR = 5.43, 1.35 to 21.84) and to report religion to be important (less often said religion was fairly rather than very important; RR = 0.08, 0.01 to 0.48). Resistance to radicalisation measured by condemnation of violent protest and terrorism was associated with larger number of social contacts (per contact: RR = 1.52, 1.26 to 1.83), less social capital (RR = 0.63, 0.50 to 0.80), unavailability for work due to housekeeping or disability (RR = 8.81, 1.06 to 37.46), and not being born in the UK (RR = 0.22, 0.08 to 0.65).ConclusionsVulnerability to radicalisation is characterised by depression but resistance to radicalisation shows a different profile of health and psychosocial variables. The paradoxical role of social capital warrants further investigation.
“…Controversies surrounding the association between terrorism and mental illness Terrorists can be psychologically normal The majority of terrorists recruited as part of a group operation have no psychopathology (Lankford 2014). They are more likely to be motivated by group and collective psychology and external factors (Stoddard 2011; Horowitz 2015). Personality traits associated with terrorists Paranoid, antisocial and sadomasochistic personality traits are associated with terrorists (Weatherston 2003).…”
Section: Controversies Surrounding Terrorism and Mental Illnessmentioning
confidence: 99%
“…The majority of terrorists recruited as part of a group operation have no psychopathology (Lankford 2014). They are more likely to be motivated by group and collective psychology and external factors (Stoddard 2011; Horowitz 2015).…”
Section: Controversies Surrounding Terrorism and Mental Illnessmentioning
confidence: 99%
“…There would undoubtedly be instances of people with pre-existing mental illness engaging in terrorism, but the numbers are likely to be low, as they are among those who carry out general criminal activity. Stoddard et al (2011) argued that terrorists who belong to a group act according to group and collective psychology and not on the basis of their individual psychopathology. This is illustrated particularly by suicide terrorists recruited as part of a group, who believe that they are engaging in ‘martyrdom operations’ and have been carefully trained to sacrifice their lives.…”
Section: Controversies Surrounding Terrorism and Mental Illnessmentioning
SUMMARYTerrorism is a complex problem that is highly relevant in contemporary society, underscoring the need for greater understanding as well as cross-disciplinary and international research in this area. Controversies surround potential associations between mental illness and terrorism, many due to the limited and conflicting existing research, and mental health professionals’ duties to their patients versus society and the state. In this article, we review the literature, discuss clinical implications and the role of psychiatrists in anti-terrorism efforts. We also propose a simplified framework that may be incorporated into clinical practice to screen for potential terrorist tendencies.LEARNING OBJECTIVES•Understand the landscape and recent advances in the research of terrorism•Appreciate the importance and role of mental health professionals in preventing patients from engaging in terrorist activities•Understand how to assess risk of patients engaging in terrorist activitiesDECLARATION OF INTERESTNone.
“…Victims of a terrorist attack, as well as those who witness or hear about these attacks, are likely to experiment long-term negative effects (30). In order to limit the devastating impact of these events, which are by definition unpredictable and can be highly traumatic, it seems essential to react as quickly and as effectively as possible.…”
Background: Several terrorist attacks have recently taken place in France and Europe. Various studies have shown a high prevalence of Post-Traumatic Stress Disorder (PTSD) and other psychiatric disorders among the victims of these attacks. Nevertheless, research in this field is scarce and no cohort study has been conducted yet to evaluate the impact of a terrorist attack on teenagers directly exposed to this type of events. Therefore, we decided to work on the AVAL (Adolescents Victimes de l’Attentat de Londres) cohort study in order to measure the psycho-traumatic impact of this attack and to describe these adolescents’ health care pathways.Material and method: The 53 students of a French high school who were directly exposed (criterion A1 of PTSD in DSM-5) to the terrorist attack perpetrated in London on March 22, 2017 constitute the target population of this monocentric cross-sectional observational study. We decided not to include the three students who were physically wounded and, therefore, didn’t have the same sensorial exposition. The primary endpoint will be the prevalence of PTSD 12 to 15 months after the attack, measured by the PCL-5 (Post-traumatic stress disorder Check-List for DSM-5) global severity score: the diagnosis of PTSD will be retained when the score is > 32. We will also use an extensive battery of clinical tests to assess the prevalence of anxiety disorders, mood disorders, sleep disorders, addictions, suicide risk, and alterations in social, family, and school functioning 12 to 15 months after the attack. We will also describe these adolescents’ health care pathways since the attack and collect data from the clinical evaluation performed during the initial intervention of the medico-psychological emergency cell within 10 days after the attack.Discussion: The findings of this study are intended to provide epidemiological data about the psycho-traumatic impact of a terrorist attack on the mental health of directly exposed adolescents and to describe these adolescents’ health care pathways, thus contributing to improve the immediate, post-immediate, and delayed response strategies after a major psycho-traumatic event involving adolescents (and in particular after terrorist attacks), as well as the identification and psychiatric care of the young survivors requiring specialized care.Clinical Trial Registration:
, identifier NCT03493243.Ethics and Dissemination: The regional ethics committee (Comité de Protection des Personnes Ouest IV—Nantes) approved the study protocol (Reference 10/18_3). All participants (and their legal guardians, for minors) must sign the informed consent to participate. The protocol was presented at the French congress of psychiatry in Nantes (France) in November 2018. After study completion, the results will be published and detailed in Marion Grenon’s MD thesis in psychiatry.
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