Seidenbecher S, Steinmetz C, Möller-Leimkühler A-M, Bogerts B
Salus Institut, Salus gGmbH, Seepark 5, 39116, Magdeburg, Deutschland.
Klinik für Psychiatrie und Psychotherapie, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland.
Nervenarzt. 2020 May;91(5):422-432. doi: 10.1007/s00115-020-00894-0.
Terrorism belongs to the extreme forms of violence that have so far received little attention in psychiatric research and are rarely mentioned in textbooks of psychiatry. After terror attacks, however, the question regularly arises whether terrorists suffer from mental disorders.
The aim of this review is to summarize the multidimensional causes of terrorism with special emphasis on psychopathological aspects of the perpetrators. In addition to a brief summary of the historical background and recent developments in terrorism, a literature search was performed using PubMed, SCOPUS, PsychInfo and PsychARTICLES.
From a psychiatric point of view, a differentiation between lone terrorists and group terrorists is essential. Lone terrorists have a much higher prevalence of psychiatric disorders, such as psychotic, paranoid and affective symptoms. The majority of terrorists acting in groups rarely suffer from such mental disorders. For these perpetrators biographic aspects and socialization, group dynamics and ideological personality profiles with narcissistic, histrionic, fanatic and antisocial components are more relevant. The phenomenon of terrorism predominantly being a male domain is discussed.
The manifold manifestations of terrorism are caused by complex patterns of interacting biographic, sociological, ideological and psychopathological components that differ between lone acting and group terrorists. The real causes for acts of terrorism are not various ideologies permitting violence but consist more of a pre-existing violence-oriented mentality of the perpetrators looking for such ideologies to justify their acts. The possibilities of psychiatry in prevention and early recognition are limited. Some recently developed scales for risk assessment of extreme violence are mentioned.
恐怖主义属于极端暴力形式，迄今为止在精神病学研究中很少受到关注，在精神病学教科书中也很少被提及。然而，在恐怖袭击之后，恐怖分子是否患有精神障碍的问题经常出现。
本综述的目的是总结恐怖主义的多维度成因，特别强调实施者的精神病理学方面。除了简要概述恐怖主义的历史背景和近期发展外，还使用PubMed、SCOPUS、PsychInfo和PsychARTICLES进行了文献检索。
从精神病学角度来看，区分单独行动的恐怖分子和团伙恐怖分子至关重要。单独行动的恐怖分子患精神疾病的比例要高得多，如精神病性、偏执和情感症状。大多数团伙行动的恐怖分子很少患有此类精神障碍。对于这些实施者来说，个人经历和社会化、群体动态以及具有自恋、表演型、狂热和反社会成分的意识形态人格特征更为相关。文中讨论了恐怖主义主要是男性领域的现象。
恐怖主义的多种表现形式是由个人经历、社会学、意识形态和精神病理学成分相互作用的复杂模式造成的，单独行动的恐怖分子和团伙恐怖分子之间存在差异。恐怖主义行为的真正原因不是允许暴力的各种意识形态，而更多地是实施者预先存在的以暴力为导向的心态，他们在寻找此类意识形态来为自己的行为辩护。精神病学在预防和早期识别方面的可能性有限。文中提到了一些最近开发的极端暴力风险评估量表。
