Terrorism and mental illness: a pragmatic approach for the clinician

Ho, Cyrus S.H.; Quek, Tian Ci; Ho, Roger; Choo, Carol C

doi:10.1192/bja.2018.49

Cited by 9 publications

(5 citation statements)

References 46 publications

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“…Given the tremendous impacts on mental illness that terrorist acts have on the general population, developing ways to detect someone's risk of displaying terrorist behaviours is essential. Some papers have already compiled lists including social and clinical risk factors, and acts specific to terrorism that can be used as screening tools [94]. The UK's counterterrorism strategy, CONTEST, which was established in 2003 is one such team that is looking into this.…”

Section: Discussionmentioning

confidence: 99%

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Anxiety, Depression and Posttraumatic Stress Disorder after Terrorist Attacks: A General Review of the Literature

Rigutto

Sapara

Agyapong

2021

Behavioral Sciences

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Terrorism, though not well-defined, is a violent act that has been shown to have longstanding effects on the mental health of those who witness it. The aim of this general literature review is to explore the effect that terrorism has on posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and anxiety disorders, as well as the bio-psycho-social determinants that mediate its impact. This paper describes the prevalence, risk factors, protective factors, common presentations and interventions identified for PTSD, depression and anxiety disorders occurring following terrorist attacks. We conducted a literature search in MEDLINE using a number of keywords detailed below. After applying inclusion and exclusion criteria, we kept 80 articles, which we summarized in tabular form. A majority of articles found detailed the impact of terrorism on PTSD, and took place in a Western, mainly American setting. The main factors that impacted the presentation of mental illness include gender, ethnicity, social supports, socioeconomic status, level of preparedness, level of exposure, pre-existing trauma and mental illness, and subsequent life stressors. The main intervention detailed in this article as showing evidence post-terrorism is trauma-focused cognitive-behavioural therapy. This study highlights the importance of this topic, and in particular, its implications for public health policy and practice.

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Section: Discussionmentioning

confidence: 99%

“…The Terrorism Radicalization Assessment Protocol (TRAP-18) has been identified as a tool that may be helpful for clinicians. Further research looking into risk and protective factors for becoming a terrorist may be useful [94].…”

Section: Discussionmentioning

confidence: 99%

Anxiety, Depression and Posttraumatic Stress Disorder after Terrorist Attacks: A General Review of the Literature

Rigutto

Sapara

Agyapong

2021

Behavioral Sciences

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“…As noted earlier, findings in the literature examining the link between terrorism and mental disorder are inconsistent (Ho et al, 2019).…”

Section: Why It Is Important To Do the Reviewmentioning

confidence: 98%

“…As noted earlier, findings in the literature examining the link between terrorism and mental disorder are inconsistent (Ho et al, 2019). Where such inconsistencies are a feature of an evidence base, the cherry‐picking of results to suit a specific position can impede a nuanced understanding.…”

Section: Introductionmentioning

confidence: 95%

PROTOCOL: Mental disorder, psychological problems and terrorist behaviour: A systematic review

Sarma

Carthy

Cox

2022

Campbell Systematic Reviews

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This is the protocol for a Campbell systematic review. The objectives are as follows:the first objective of the review (Objective 1-Prevalence) is to present a synthesis of the reported prevalence rates of mental health difficulties in terrorist samples.Where sufficient data is available, the synthesis will be sensitive to the heterogeneity of the terrorism phenomenon by exploring the rates of mental health difficulties for different forms of terrorism and for different terrorist roles (e.g., bombing, logistics, finance, etc.). The second objective (Objective 2-Temporality) will synthesise the extent to which mental health difficulties pre-date involvement in terrorism within prevalence studies. Finally, the third objective (Objective 3-Risk) aims to further establish temporality by examining the extent to which the presence of mental disorder is associated with terrorist involvement by comparing terrorist and non-terrorist samples.

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“…Nevertheless, the perpetrator of the tram shooting also suffered from a personality disorder and intellectual disability, as became clear after a psychological evaluation conducted during the trial. This is something that is seen in more terrorist attacks worldwide, especially in attacks by lone wolfs (Ho et al, 2019). In other words, the line between patient with a mental illness and a terrorist can be a fine one.…”

Section: Introductionmentioning

confidence: 98%

The impact of a terrorist attack: Survivors’ health, functioning and need for support following the 2019 Utrecht tram shooting 6 and 18 months post-attack

Bosmans

Plevier²,

Schutz³

et al. 2022

Front. Psychol.

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BackgroundExtremely violent events such as terrorist attacks and mass shootings form a severe risk for the health and wellbeing of affected individuals. In this study based on a public health monitor, we focus on the health impact (including PTSD symptoms, physical problems and day-to-day functioning) of the Utrecht tram shooting, which took place in the morning of March 18th 2019. A lone gunman opened fire on passengers within a moving tram. Four people died, and six people were injured in this attack. The attack resulted in nationwide commotion and drew much media attention. Aim of this study was to increase insight into the health effects for the survivors (those directly impacted by a terrorist attack and the bereaved), and whether they received the needed care and support.MethodsSemi-structured interviews with accompanying questionnaires were conducted at six and 18 months post-attack. Overall, 21 survivors (victims/witnesses and loved ones of deceased victims) participated in the first series of interviews, 15 in the second series. Qualitative data were analyzed using reflexive thematic analysis, quantitative data was only described because of the low sample size.ResultsAt both six and 18 months after the attack many survivors had been able to resume daily life, and most rated their overall health as (very) good or excellent. At the same time, a substantial portion suffered from health problems such as posttraumatic stress symptoms and other complaints, and needed professional care. Furthermore, those in need did not always find their own way to appropriate care through the existing health system: half of the survivors still needed support in finding the right care 18 months later.ConclusionAlthough the design and implementation of this public health monitor were accompanied by multiple challenges, it was possible to track a portion of the survivors and gain insight in the considerable health burden of the attack. Also, it is clear in this study that the health impact of terrorism affects survivors in the long run and requires attention from health authorities and professionals, as survivors were not able to find the right care by themselves.

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Terrorism and mental illness: a pragmatic approach for the clinician

Cited by 9 publications

References 46 publications

Anxiety, Depression and Posttraumatic Stress Disorder after Terrorist Attacks: A General Review of the Literature

Anxiety, Depression and Posttraumatic Stress Disorder after Terrorist Attacks: A General Review of the Literature

PROTOCOL: Mental disorder, psychological problems and terrorist behaviour: A systematic review

The impact of a terrorist attack: Survivors’ health, functioning and need for support following the 2019 Utrecht tram shooting 6 and 18 months post-attack

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