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 ] 88 Pritchard and Amanullah report that reclassification of suicides to include "hidden suicides" (otherwise classified as "other violent death" [ OVD]) resulted in the finding that suicide rates in Islamic countries were as high as those in the United Kingdom and at least eight times higher than otherwise officially reported. 67 Familial network argument. The idea that suicide terrorists could not be suicidal because suicide bombers often act in familial pairs (mother/son, father/daughter, siblings) is problematic in light of growing evidence of genetic factors in suicide. 6 8 According to one study, identical twins share suicidal tendencies in 15 percent of cases. 69 There is additional evidence from adoption studies showing that the biological relatives of people who commit suicide are six times as likely to commit suicide as members of the families that adopted them. 70 Among individual genes that have been associated with suicide are those involved in the brain's response to mood-lifting serotonin and a signaling molecule called brain-derived neurotrophic factor (BDNF) that regulates the brain's response to stress. In a recent study, a group of researchers at MacDill University compared the brains of 46 people who had committed suicide with those of 16 people who died of natural causes. In those who committed suicide, 366 genes, mostly related to learning and memory, had a different set of epigenetic markers—chemical switches that turn genes on and off. These results may be complicated by the fact that many of the people who committed suicide had psychiatric disorders, but the authors found that suicide, rather than the presence of a psychiatric disorder, was the only significant predictor for these specific epigenetic changes. 71 What the evidence shows. Despite widespread acceptance of the claim that suicide terrorists are not suicidal, the evidence for this claim is weak. Nasra Hassan simply asserts that suicide terrorists she interviewed did not exhibit "suicidal symptoms." 32 Rex Hudson makes s imilar claims based on his review of theoretical literature and 12 profiles of terrorists from government archival data. 34 Neither the literature nor the profiles, however, contain any evidence of systematic evaluations of suicidal symptoms. Based on "semi-structured" interviews with 35 terrorists and commanders in Israeli jails, Jerrold Post and colleagues also claim that suicide terrorists are not suicidal. However, they provide little information about the methodology they used to come to this conclusion, relying instead on quotes from terrorist commanders who told them that, unlike suicide, suicide terrorism is istishad (martyrdom or self sacrifice) and that in any case recruiters screen out those who are suicidal. 35 In the controlled Merari study cited earlier, different results were obtained. Merari found that as many as 40 percent of the would-be suicide bombers, but none of the controls (no-suicide terrorists), displayed suicidal tendencies on a standardized battery of tests; and 13 percent had made previous attempts not related to terrorism. These rates are far in excess of the rates in the general population. In addition, Merari found that 64 percent (9/14) of the organizers said they would never volunteer themselves for a suicide mission. One of the organizers put it this way: "No, it's very difficult. Every man has different character and traits. I was destined to organize [suicide attacks] and others were destined to perform martyrdom operations [...] I am willing to fight but not to die in a suicide attack. For me life is very basic." 41 Another explained: "I wouldn't be willing to carry out a martyrdom operation. Everyone has his role. I was an organizer." 41 On the other hand, a would-be bomber made this statement: "I wanted to kill myself. I used to stand in front of Israeli tanks, hoping they would shoot me. I tried it more than once, but it didn't w ork. I didn't know anymore what to do…Then I met people that offered me the chance to carry out an act of istishhad [martyrdom]. I had been thinking for a long time about an opportunity to die, and when these men showed up, I said to myself that this was a good opportunity." 4 1 CONCLUSION and FUTURE DIRECTIONS The literature on suicide terrorism has been dominated by political and social theories. This may be because the political and social aspects of suicide terror are thought to be more important or at least more pertinent to counterterrorism than individual aspects. It may also be because information on what motivates an individual to engage in this behavior is so difficult to obtain. Suicide terrorists, after all, operate in secret, they are protected by clandestine groups, and many do not live to tell their stories. For scholars, there may be an additional concern—that any inquiry into the psychological or psychiatric aspects of suicide terror somehow marginalizes or deligitimizes the real political and social grievances that are thought to lie at the heart of the pheonomenon. Emerging evidence that suicidal ideation and behavior do play a role in a "significant minority" of cases of suicide terrorism should not be dismissed. Just because suicidal ideation operates at some level in some cases does not mean that political and social factors do not also operate at other levels or that these levels are not equally important. What is needed is more systematic, cross-disciplinary research and cross-national collaboration on the subject. The field has benefited from the development of several well

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