{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:55:23Z","timestamp":1785437723929,"version":"3.56.0"},"reference-count":32,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"abstract":"<jats:sec id=\"S0007125026105534_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent studies suggest an association between sympathies for violent protest and terrorism, and major depression, anxiety, post-traumatic stress disorder and psychiatric disorders in subgroups of radicalised people and in lone-actor terrorists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026105534_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study is to identify and analyse all documented terrorist attacks in the Global Terrorism Database (GTD), where the motive for terrorism is questioned due to suspected mental health issues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026105534_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study is based on a semi-quantitative, epidemiological analysis of all incidents from 1970 to the first half of 2021, as reported in the GTD. Incidents in which the act of terrorism was questionable because of alleged mental illness were included. Temporal factors, location, target type, attack and weapon type, perpetrator type and number of casualties were collated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026105534_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred and two incidents in the period 1970\u20132020 and five incidents in 2021 were studied. The majority occurred in the period 2011\u20132020. The incidents resulted in a total of 99 fatal and 217 non-fatal injuries. Twenty-nine perpetrators died during the attacks.<\/jats:p>\n                    <jats:p>The majority of the attacks occurred in the USA, followed by France and the West Bank and Gaza Strip. Armed assaults were the most frequently identified attack type (67%).<\/jats:p>\n                    <jats:p>In North America, the incidence was as high as 8.2 and 3.4% of the total number of terrorist attacks in the periods 2001\u20132010 and 2021, respectively. Most of the perpetrators acted as lone actors. Five assailants were detained in a psychiatric facility after the judicial probe, 18 were convicted and 9 had not been sentenced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026105534_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The possible relation between terrorism and mental illness or addiction is a recent phenomenon in the GTD. The prototypical case consists of a lone actor suffering from an assumed mental illness committing an armed assault. Only a minority of perpetrators were unable to stand trial in this series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2026.10553","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T11:18:18Z","timestamp":1772018298000},"page":"1-7","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Investigating the role of mental health in terrorism motives: study of documented attacks from the Global Terrorism Database"],"prefix":"10.1192","author":[{"given":"Katrien","family":"Verveckken","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/008x57b05","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Antwerp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1256-6293","authenticated-orcid":false,"given":"Harald","family":"De Cauwer","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/008x57b05","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Antwerp"},{"name":"General Hospital Saint Dimpna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Khorram-Manesh","sequence":"additional","affiliation":[{"name":"Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Barten","sequence":"additional","affiliation":[{"name":"VieCuri Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick","family":"Tin","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Granholm","sequence":"additional","affiliation":[{"name":"Sundsvall County Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Somville","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/008x57b05","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Antwerp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Cras","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/008x57b05","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Antwerp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Ciottone","sequence":"additional","affiliation":[{"name":"BIDMC, Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"S0007125026105534_ref24","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2019.14"},{"key":"S0007125026105534_ref8","volume-title":"Global Terrorism Database Codebook: Inclusion Criteria and Variables","year":"2019"},{"key":"S0007125026105534_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.2322"},{"key":"S0007125026105534_ref18","first-page":"1","article-title":"Terrorist attacks against COVID-19-related targets during the pandemic year 2020: a review of 165 incidents in the Global Terrorism Database","volume":"38","author":"De Cauwer","year":"2022","journal-title":"Prehosp Disaster Med"},{"key":"S0007125026105534_ref30","first-page":"179","article-title":"Case formulation after Engel \u2013 the 4P model: a philosophical case conference","volume":"21","author":"Bolton","year":"2014","journal-title":"Philos Psychiatry Psychol"},{"key":"S0007125026105534_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2021.07.002"},{"key":"S0007125026105534_ref28","first-page":"554","article-title":"Radicalisering en psychiatrie: pleidooi voor een brede blik [Radicalisation and psychiatry: a plea for a broad perspective]","volume":"61","author":"de Ridder","year":"2019","journal-title":"Tijdschr Psychiatr"},{"key":"S0007125026105534_ref7","unstructured":"7 National Consortium for the Study of Terrorism and Responses to Terrorism (START). Overview of the GTD. University of Maryland, n.d. (https:\/\/www.start.umd.edu\/data-tools\/GTD [cited 24 Jul 2022])."},{"key":"S0007125026105534_ref12","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60060926"},{"key":"S0007125026105534_ref1","doi-asserted-by":"publisher","DOI":"10.1002\/cl2.1268"},{"key":"S0007125026105534_ref9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"S0007125026105534_ref31","doi-asserted-by":"publisher","DOI":"10.5055\/ajdm.2017.0278"},{"key":"S0007125026105534_ref2","unstructured":"2 Schulten, N , Doosje, B , Spaaij, R , Kamphuis, JH. Psychopathologie en terrorisme: stand van zaken, lacunes en prioriteiten voor toekomstig onderzoek [Psychopathology and Terrorism: Current Status, Gaps, and Priorities for Future Research]. Research and Documentation Centre\/Dutch Ministry of Justice and Security, 2019 (==https:\/\/repository.wodc.nl\/bitstream\/handle\/20.500.12832\/2397\/2911_Volledige_Tekst_tcm28-373043.pdf?sequence=2&isAllowed=y)."},{"key":"S0007125026105534_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X22000012"},{"key":"S0007125026105534_ref27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0292941"},{"key":"S0007125026105534_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.avb.2016.03.003"},{"key":"S0007125026105534_ref5","doi-asserted-by":"publisher","DOI":"10.1177\/0004867420944520"},{"key":"S0007125026105534_ref17","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.182.6.475"},{"key":"S0007125026105534_ref20","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X23005794"},{"key":"S0007125026105534_ref21","doi-asserted-by":"publisher","DOI":"10.1027\/0227-5910.27.3.107"},{"key":"S0007125026105534_ref6","doi-asserted-by":"publisher","DOI":"10.1080\/19434472.2022.2142268"},{"key":"S0007125026105534_ref3","doi-asserted-by":"publisher","DOI":"10.1192\/bja.2018.49"},{"key":"S0007125026105534_ref4","doi-asserted-by":"publisher","DOI":"10.1037\/tam0000061"},{"key":"S0007125026105534_ref22","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X21001151"},{"key":"S0007125026105534_ref29","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.33073"},{"key":"S0007125026105534_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.encep.2024.06.006"},{"key":"S0007125026105534_ref11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0090718"},{"key":"S0007125026105534_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721000076"},{"key":"S0007125026105534_ref25","doi-asserted-by":"publisher","DOI":"10.3389\/fsoc.2022.830966"},{"key":"S0007125026105534_ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-021-01264-6"},{"key":"S0007125026105534_ref32","first-page":"356","article-title":"Comparing the top 100 attacks in the Global Terrorism Database: high injury rate versus high fatality rate attacks","volume":"124","author":"De Cauwer","year":"2024","journal-title":"Acta Chir Belg"},{"key":"S0007125026105534_ref15","doi-asserted-by":"publisher","DOI":"10.1037\/lhb0000102"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125026105534","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T11:18:22Z","timestamp":1772018302000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125026105534\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":32,"alternative-id":["S0007125026105534"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2026.10553","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}