TERRORISM AND MENTAL HEALTH
LET. COL. DR. EHAB ELBAZ
PSYCHIATRY HOSPITAL
MAADI MILITARY MEDICAL COMPLEX
DEFINITION OF TERRORISM
• Various legal systems and government agencies use different definitions of terrorism in their national legislation.
• The international community has been slow to
formulate a universally agreed, legally binding definition of this crime.
• These difficulties arise from the fact that the term "terrorism" is politically and emotionally charged
DEFINITION OF TERRORISM
• Terrorism is commonly defined as violent acts (or the threat of violent acts) intended to create fear (terror), perpetrated for a religious, political, or ideological goal, and which deliberately target or disregard the safety of non-combatants (e.g., neutral military personnel or civilians).
قانون الكيانات االرهابية )2015)
:اإلرهابيالكيان
الجمعيات أو المنظمات أو الجماعات أو العصابات أو الخاليا أو غيرها من التجمعات أيا كان شكلها القانوني أو
الواقعي، متى مارست أو كان الغرر منهرا الرةعوأ ب يري وسريلي أا را أو رار الرإالأ ءلرى ءير اإ ااءرراأ وءلقراإ
الرعررب بيررنهو، أو ضعررريه يرراضهو أو ريرراضهو أو قرروقهو أو أمررنهو للخضررر أو ءلةررا المرررر بالإي رري أو بررالمواأ
الضإيعيررري أو بار رررار أو با ضصرررا ت أو المواةرررالت الإريررري أو الجويررري أو الإةريررري أو برررااموا أو بالمإررراني أو
برراامالا العامرري أو الخاةرري أو ا تاللهررا أو ا سررتيالإ عليهررا أو منررل أو عرقلرري الاررلضات العامرري أو الجهررات أو
الهي ات القمائيي أو مصالح الةكومي، أو الو رةات المةليري أو أور العإراأأ أو الماتار يات أو متسارات ومعاهرة
العلو، أو غيرها من المراءق العامي، أو الإعثات الةبلوماسيي والقنصليي، أو المنظمات والهي ات اإلقليميي والةوليري
ءى مصر من القيام بعملها أو ممارستها لكا أو بعه أوجه نااطها أو مقاومتها، أو ضعضيا المواةالت العامي أو
الخاةي أو منل أو عرقلي سيرها أو ضعريمها للخضر ب يي وسيلي كانت، أو كان الغر منهرا الرةعوأ ب يري وسريلي
ءلى اإل ال بالنظام العام أو ضعرريه سرالمي المجتمرل أو مصرالةه أو أمتره للخضرر أو ضعضيرا أ كرام الةسرتور او
القوانين أو منل ء ةى متساات الةولي أو ء ةى الالضات العامي من ممارسري أعمالهرا، أو ا عترةاإ علرى الةريري
الاخصيي للمواطن أو غيرها من الةريات والةقو العامري التري ك لهرا الةسرتور والقرانون، أو اإلبررار بالو رةأ
.الوطنيي أو الاالم ا جتماعي أو اامن القومي
ONE MAN`S TERRORIST IS
ANOTHER`S FREEDOM FIGHTER
EARLY HISTORY OF TERRORISM
• ZEALOTS (1st century )
• ASSASSINS (11th century )
• FRENCH REVOLUTION (1789)
“Kill one to terrorize ten thousand.”
4th century B.C
Sun Tzu
MENTAL HEALTH OF THE GENERAL POPULATION FOLLOWING TERRORIST ATTACKS
• Within the first month after the 11 September 2001 attacks, symptoms of stress were evident in individuals geographically far distant from the original incident, and nationally depressive symptoms in the USA rose for 4 weeks only to fall back to previous levels thereafter (Knudsen et al, 2005).
• Rates of substantial stress are extremely high in the first few days after the incident but are already in decline in the first 2 weeks and by 6–8 weeks have fallen by two-thirds. Thus for the majority of individuals significant stress symptoms are temporary and are unlikely to have lasting mental health implications ( Vázquez et al, 2006).
MENTAL HEALTH OF THE GENERAL POPULATION FOLLOWING TERRORIST ATTACKS
• Rates of PTSD in the general population attributable to single attacks may be as high as 11–13% in the first 6 weeks but decline sharply with time, with most studies indicating rates below 3% 2 months after the incident.
• Those reporting more symptoms will include members of minority groups (Schuster et al, 2001; Galea et al, 2002; Rubin et al, 2005), people with previous experience of adversity (Galea et al, 2002, 2003) and people who have developed psychiatric disorders in response to past stresses (DeLisi et al, 2003)
CHILDREN
• Close to 1 year after the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, about 5% of elementary schoolchildren reported clinically significant levels of symptoms of PTSD (Gurwitch et al, 2002).
• In New York City itself, 6 months later Hoven et al (2005) reported that 28.6% of children had at least one probable anxiety/depressive disorder, the most common being agoraphobia (14.8%), separation anxiety (12.3%) and PTSD (10.6%).
MENTAL HEALTH OF DIRECT VICTIMS
• PTSD appears to be the most common disorder attributable to the attack, followed by depression (North et al, 1999; Miguel-Tobal et al, 2005), although other sequelae include traumatic grief, panic, phobias, generalised anxiety disorder and substance misuse
• There is remarkable uniformity that within 2 years of the incident 30–40% of the people closest to the site of the attack are likely to develop a clinically diagnosable disorder.
CHILDREN
• Elbedour et al (1999) found that 50% 0of the daughters and 23.1% of the sons of those killed in the Hebron massacre were suffering from probable PTSD.
• Children were more likely to experience post-traumatic symptoms following the Oklahoma City bombing if they had been bereaved (Pfefferbaum et al, 1999).
BELTWAY SNIPERS )2002October 24 -02 (Washington DC region,
Copyright 2005-2014
Michael A. Bozarth, Ph.D.
10
Killed
3
physically injured
100’s psychologically ‘injured’
100,000’s terrorized
Photo from Gwww.azette.net
Photo from www.FBI.gov
TOKYO SUBWAY ATTACK )1995March 20 cult, kyo-Shinri Aumgas attack by Sarin(
Copyright 2005-2014
Michael A. Bozarth, Ph.D.
12
Killed
5,700
physically injured
9,000+ psychologically ‘injured’
10,000’s terrorized
Photo from www.ait.org.tw
Photo from www.tofugu.com
ATTACK ON AMERICA )2001September 11 (World Trade Center & Pentagon,
Copyright 2005-2014
Michael A. Bozarth, Ph.D.
3,025
Killed
1,000’s
physically injured
10,000+ psychologically ‘injured’
A nation terrorized
CONCLUSION
• Terrorism is a weapon
• Mental health professionals have to study terrorism , like surgeons studying firearm injuries
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