Innovations In Clinical Neuroscience

SEP-OCT 2014

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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Innovations in CLINICAL NEUROSCIENCE [ V O L U M E 1 1 , N U M B E R 9 – 1 0 , S E P T E M B E R – O C T O B E R 2 0 1 4 ] 86 out" the mentally unstable—as if that closes the case. 34,35 Others, however, have provided anecdotal evidence that suggests t hat such screens may not be successful, if they are conducted at all. Reporting on her interviews with the families of female suicide bombers in Chechnya, the West Bank, and Gaza, Lisa Ling notes that many had lost a husband or close relative in the war and most were "vulnerable broken women who saw no way out." 36 Similarly, Brian Glyn Williams, in his study of suicide attacks in Afghanistan, notes that Afghan police told him that large numbers of suicide bombers the police arrested after failed suicide bombing attempts were "mentally unsound, deranged" or cognitively impaired. 37 Others have supported these claims. 3 8 According to Yusef Yadgani, a pathologist at Kabul Medical University, three of every five suicide bombers he studied in his lab had a physical ailment or disability. Adding those who suffer from mental illness, the number of sick and disabled bombers climbs to more than 80 percent in his estimate. 39 To date, relatively few formal studies of psychopathology in suicide terrorists have been published, and the results are mixed. University of Toronto professors Robert Brym and Bader Araj conducted 42 sets of in-depth semi-structured interviews with the immediate family members and friends of a random sample of suicide bombers who died in suicide missions in the West Bank and Gaza. Using a battery of questions and documentary evidence, they found that although 21 percent of the bombers had expressed a desire for martyrdom, 76 percent did not manifest any outward sign of depression or personal crisis in the year preceding the attack. While 24 percent did show outward signs of depression, this rate, they claim, was not unusually high given population statistics for depression in the West Bank and Gaza. 41 This evidence, however, has limitations. As Ariel Merari observes, information from family and friends may be "skewed by the wish to p resent them in a positive light." 4 1 I n addition, as the authors themselves observe, "loved ones can be oblivious to the internal turmoil" of the person engaging in these acts. 41 Somewhat different results were obtained by Anne Speckhard of Georgetown University and her colleague Khapta Akhmedova in their study of 26 female Chechen suicide bombers. Based on interviews with family members and close associates, they found that nearly all had lost close family members in air raids, bombings, or landmines carried out by Russian forces and in battle. Many had personally witnessed death or beatings of family members at close hand. According to their family members and friends, none had significant personality disorders or psychiatric symptoms before the trauma, but all changed afterwards. In particular, all had dissociative symptoms characteristic of posttraumatic stress disorder (PTSD). In addition, in the period before they engaged in suicide terrorism, three fourths (73%) showed signs of depression, 92 percent became socially isolated, 23 percent became aggressive, and 31 percent began talking repetitively about "revenge." 42 The latter results are supported in a controlled study of "would-be" suicide terrorists by the Israeli psychologist Ariel Merari. Merari interviewed 15 would-be suicide terrorists (intercepted moments before their attacks), 12 nonsuicide terrorist matched controls, and 14 terrorist organizers. None of the subjects had a diagnosis of psychosis or a history of hospitalization for mental disorders. Eight (53%) of the would-be suicide terrorists displayed symptoms of depression—melancholy, sadness, hopelessness, low energy, tearfulness, emotional constriction, and distracted attention. In addition, three of the would-be suicide terrorists, but no controls, had evidence of PTSD. In contrast, only three of the organizers (8%) h ad depressive tendencies and none of the controls or organizers had evidence of PTSD. Merari also found a much higher incidence of dependent avoidant personality in the would-be suicide bombers (69%) compared to controls (20%) and organizers (8%). As another difference, he found that while three of the controls (25%) and one organizer (7%) exhibited psychopathic tendencies, none of the suicide bombers showed these traits. 2 7 These results are supported by case studies of deceased suicide bombers conducted by University of Alabama criminal justice professor Adam Lankford. 43 ARE THEY SUICIDAL? Arguments against suicidality as a contributing factor. The prevailing view among scholars is that suicide terrorists are not suicidal. Again, how good is the evidence? Ellen Townsend of University of Nottingham argues that suicide terrorists are not suicidal based on the following propositions: 1) suicide is associated with psychopathology, and suicide terrorists do not exhibit overt psychopathology; 2) recruiters screen out the mentally ill; 3) suicide using violent methods is an impulsive act while suicide terrorism is meticulously planned; 4) suicide terrorism has murderous intent, and murderous intent is rare in suicide; 5) many suicide terrorists are religious, but religion protects against suicide. 44 Another assumption that is sometimes made is that suicide terrorists could not be suicidal since suicide terrorists often act in familial networks of relative pairs (siblings, parent-child, or cousin pairs) and such acts are more likely to be a result of socialization and family bonds. How well do these arguments hold up? Psychopathology argument. The proposition that suicide terrorists

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