Stephen B. Shanfield

Death of Adult Children in Traffic Accidents

The loss of adult children after traffic accidents is relatively common. Bereavement under these circumstances, however, has been little studied. Forty predominantly midlife parents (20 men and 20 women) of predominantly young adult children (27 men and 13 women) who died in traffic accidents were studied 25.6 months after the death. The parents completed the Symptom Checklist 90, the Beck Depression Inventory, and a Bereavement Questionnaire which sought information about the parent, the child, the rest of the family, and the relationship between them. It was found that the parents continued to grieve intensely and had higher than expected levels of psychiatric symptoms as well as increased health complaints. Some parents were more at risk for problems in the bereavement period. Those with unstable families who had ambivalent relationships with their children and whose children were perceived to have had problems at the time of the accident, had more guilt and increased psychiatric symptoms. Parents who had prior bereavement experiences seem to have been protected from higher levels of distress. Additionally, being a mother, losing a daughter, losing children who live at home, losing children born earlier in the birth order, and losing children in single car, single driver accidents seems to portend a more difficult bereavement. This is an important area for further study.

The Psychology of Suicide Terrorism

This paper reviews current understandings of the psychology of suicide terrorism for psychiatrists and other mental health professionals to help them better understand this terrifying phenomenon. After discussing key concepts and definitions, the paper reviews both group and individual models for explaining the development of suicide terrorists, with an emphasis on “collective identity.” Stressing the importance of social psychology, it emphasizes the “normality” and absence of individual psychopathology of the suicide bombers. It will discuss the broad range of terrorisms, but will particularly emphasize terrorism associated with militant Islam. The article emphasizes that comprehending suicide terrorism requires a multidisciplinary approach that includes anthropological, economic, historical, and political factors as well as psychological ones. The paper concludes with a discussion of implications for research, policy, and prevention, reviewing the manner in which social psychiatric knowledge and understandings applied to this phenomenon in an interdisciplinary framework can assist in developing approaches to counter this deadly strategy.

Psychiatry and terrorism

Terrorism has dominated the domestic and international landscape since 9/11. Like other fields, psychiatry was not well prepared. With the 10th anniversary of the 9/11 attack approaching, it is timely to consider what can be done to prepare before the next event. Much has been learned to provide knowledge and resources. The roles of psychiatrists are challenged by what is known of the causes of, consequences of, and responses to terrorism. Reflecting on knowledge from before and since 9/11 introduces concepts, how individuals become terrorists, how to evaluate the psychiatric and behavioral effects of terrorism, and how to expand treatments, behavioral health interventions, public policy initiatives, and other responses for its victims. New research, clinical approaches, and policy perspectives inform strategies to reduce fear and cope with the aftermath. This article identifies the psychiatric training, skills and services, and ethical considerations necessary to prevent or reduce terrorism and its tragic consequences and to enhance resilience.

Building community resilience to counter violent extremism

The Obama administrations new approach to countering violent extremism through engaging community partners challenges us to make a paradigm shift in how we understand the causes of terrorism. This approach is supported by theory, research findings, practice knowledge, and policy successes. However, for the US government to deliver on its promise of building community resilience, it is necessary to better understand the meanings of resilience as applied to US communities under the threat of violent extremism. The resilience approach will need to attend to the issues of multilevel dimensions, sociocultural context, community collaboration, and the need for further research.

Violent Extremism, Community-Based Violence Prevention, and Mental Health Professionals.

Abstract New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.