A major review of over 400 research articles studying the association between acts of terrorism and mental health has reached the significant conclusion that 'terrorism isn't terrorising' - at least not in a way that causes increases in post-traumatic stress disorder (PTSD) greater than would be expected from any other distressing event.
The findings, released today [Wednesday 17 October] in The Lancet Psychiatry from researchers at the University of Bath (UK), run counter to much commentary on the topic, which usually suggests that an increase in terrorist attacks will have a negative impact on peoples' psychological wellbeing. Such an association, say the researchers, is overstated due to a modern day tendency to imagine the worst, particularly on matters relating to mental health.
By conducting an extensive review and analysis of the research published both pre and post 9/11, the team involved note that attempts to understand the links between terrorism and mental health are actually quite recent. In fact, there was almost no such focus until shortly before 9/11 following which there was a spike in articles focused on the assumed connection. The study highlights that this was encouraged by the recognition of post-traumatic stress disorder (PTSD) and its redefinition by the American Psychological Association in 1994 in a cultural climate also more attuned to emotional hurt. Most of the articles analysed for this study were published post 9/11.
However, in spite of increasing attention to the subject, the researchers found no clear association between terror events and cases of PTSD in the literature. Their findings suggest that many studies were drawn to expanding what was meant by the term, allowing categories such as 'pre-PTSD' or 'PTSD-symptom' to be audited instead.
This, they argue, confuses and conflates what is meant by PTSD and has the negative effect of ignoring other significant impacts tied to terror events - not least social, economic and physical ones. They also suggest that expanding what constitutes PTSD may lead to the minority who genuinely suffer from its effects being less able to access the support they really need. Instead, they suggest policy-makers would do better to note how people usually cope by making use of their own networks and initiative, and to encourage responses to terrorist events that highlight social bonds and people's resilience, rather than their psychological vulnerability.
Lead author, Professor Bill Durodie from the Department of Politics, Languages & International Studies at the University of Bath explained: "After 9/11 there was an enormous push to uncover evidence of PTSD in people who said that they had been affected by those events either directly or indirectly through the media.
"Despite this, the reassuring conclusion of our work is that terrorism does not terrorise - at least not any more than being traumatised by any other challenging event. In that regard, our findings fly in the face of various announcements from politicians, officials, the media and even other academics that terrorist incidents impact our mental health and wellbeing adversely.
"This is not to say that people who experience traumatic events do not need psychological support, but we believe that it is unhelpful to categorise more people than is true with PTSD. We are also saying that there were many other effects of 9/11 that were overlooked - primarily respiratory disorders, as well as economic and social ones, such as people losing their jobs. "There is clear evidence of people's resilience in the face of such events and so, for us, it is important for politicians, the media and commentators to take these findings on board and re-focus attention more on this in the face of such terrible events."
Dr David Wainwright, Senior Lecturer in the University's Department for Health, added: "Notably, our work also drew into question the presumption that people, particularly the young, can be traumatised merely through watching such events unfold on TV. Some researchers did rush to such conclusions but usually retracted them a few years later. Unfortunately though, it is their earlier, impressionistic assumptions that continue to be cited in many instances, despite most noting that there is no conclusive evidence on this.
"Of course, young people should be protected from events and have these explained to them. They may need to have their television viewing limited too. But this has more to do with the challenges of asserting parental authority today - a social factor - than media or medical effects that are deemed to be inevitable. The inordinate focus on children in the work we reviewed may also express an unstated desire to control adult responses through the auspices of protection."
Professor Durodie acknowledges the support of the Gerda Henkel Stiftung in Germany for their provision of funds under their Special Programme for Security, Society and the State that has assisted this work.
To access the latest paper see: https://www.thelancet.com/journals/lanpsy/onlineFirst
The Lancet Psychiatry