New Trends in Terrorism-Related Injury Mechanisms: Is There a Difference in Injury Severity?

STUDY OBJECTIVE: The latest wave of terrorism worldwide has seen significant use by terrorists of mundane, "low-technology" weapons, such as utility knives and civilian vehicles. How do the injuries they produce compare with that of more conventional terrorism mechanisms, such as use of firearms and explosives? We compare injury patterns of the most frequent terrorism-related injury mechanisms in an Israeli data set. METHODS: This was a retrospective study of 1,858 patients hospitalized because of terrorism events, which were recorded in the Israeli National Trauma Registry between January 1997 and December 2016. The events were divided into 4 groups based on weapon used: explosions, shootings, stabbings, and vehicular attacks. The groups were compared in terms of injuries sustained, use of hospital resources, and clinical outcomes. RESULTS: Explosion-related and vehicular terrorism resulted in a higher proportion of multiple injuries, whereas stabbings and shootings mostly led to isolated injuries. Victims of vehicular attacks had a high proportion of severe head injuries, whereas stabbing victims had a high volume of vascular injuries. All mechanisms involved significant damage to extremities; however, among stabbing victims injury was mainly to the upper extremities, whereas among vehicular attack victims it was mostly to the lower extremities. The overall injury severity of the compared groups was similar, leading to comparable levels of intensive care use and inhospital mortality. Certain similarities in victims' characteristics were observed between the shootings and stabbings and between explosions and vehicular attacks. CONCLUSION: Despite differences between various terrorist attack mechanisms, the resulting injury severity and inhospital mortality are very similar, with stabbings and vehicular attacks causing injuries as serious as those caused by conventional weapons.

Why is terrorism a man's business?

Terrorism, whether it is group-related or performed as lone actor terrorism, is a predominantly male phenomenon. Generally and throughout history, young males have been the main protagonists of criminal and political violence.This article aims to contribute, from different perspecives, to the question of what makes young men violent. These include neurobiological aspects, such as sex differences in the brain that predispose males to physical aggression and violence; gender role aspects, with regard to aggression and violence being basic components for demonstrating and reconstructing masculinity; demographic aspects of male youth bulges as potential breeding grounds for terrorism; aspects of group dynamics and identity fusion in the process of radicalization; and psychosocial characteristics of lone actor terrorists, which differ from group-related terrorists.It is concluded that in addition to ideological, political, economic, regional, demographic, or psychosocial causes, experiences of threatened masculinity may be an underlying factor and driving force for terrorism.

Terrorism and right-wing extremism: the changing face of terrorism and political violence in the 21st century: the virtual community of hatred.

There are no psychological characteristics or psychopathology that separates terrorists from the general population. Rather it is group dynamics, with a particular emphasis on collective identity that helps explain terrorist psychology. Just as there is a diverse spectrum of terrorisms, so too is there a spectrum of terrorist psychologies. Four waves of terrorism can be distinguished: the Anarchist wave, associated with labor violence in the United States in the late 19th century; the Anti-Colonial wave (nationalist-separatist), with minority groups seeking to be liberated from their colonial masters or from the majority in their country; the New Left wave (social revolutionary); and now the Religious wave. With the communications revolution, a new phenomenon is emerging which may presage a fifth wave: lone wolf terrorists who through the Internet are radicalized and feel they belong to the virtual community of hatred. A typology of lone wolf terrorism is proposed.

Enemy construction after 9/11: aggressor identity effect on the representation of terrorism / Construção do inimigo após o 11 de setembro: os efeitos da identidade do agressor na representação do terrorismo / Construcción del enemigo después del 11 de setiembre: los efectos de la indentidad del agresor en la representación del terrorismo

At the time of the research, there were daily reports in the media regarding terrorist acts. What is it that indeed characterizes an act as being a terrorist one? From a psychosocial perspective, an ambiguous notion of terrorism may legitimate the ingroup/outgroup differentiation that affects intergroup relations. The aim of this research is to understand what people refer to when they talk about terrorism and to study the influence of different variables on the interpretation of some actions such as war or terrorism acts. Results on a sample of 251 University students confirm that the basic criterion for the evaluation of the actions is founded upon the distinction between military or civilian targets (i.e. target effect). However, some subjects use also a criterion based on the aggressor’s ethnic-cultural identity (i.e. actor effect).(AU)

No momento da pesquisa, haviam registros diários na mídia sobre ações terroristas. O que de fato caracteriza um ato como sendo terrorista? A partir de uma perspectiva psicossocial, uma noção ambígua de terrorismo pode legitimar a diferenciação de pertencimento ou não ao grupo, que afeta as relações intergrupais. O objetivo dessa pesquisa é entender ao que as pessoas se referem quando falam sobre terrorismo e estudar a influência das diferentes variáveis na interpretação de algumas ações como guerras ou atos terroristas. Resultados de uma amostra de 251 estudantes universitários confirmam que o critério básico para a avaliação destes atos é encontrado na distinção entre alvos civis ou militares (efeito alvo). No entanto, alguns participantes também usaram um critério baseado na identidade étnicacultural do agressor (efeito ator).(AU)

En el momento de la investigación, había registros diarios en la prensa sobre acciones terroristas. ¿Lo que de echo caracteriza a un acto como terrorista? A partir de una perspectiva psicosocial, una noción ambigua de terrorismo puede legitimar la diferenciación de pertenecimiento o no al grupo, que afecta a las relaciones intergrupales. El objetivo de esa investigación es entender a lo que las personas se refieren cuando hablan sobre terrorismo y estudiar a la influencia de las diferentes variables en la interpretación de algunas acciones cómo guerras ó actos terroristas. Resultados de una muestra de 251 estudiantes universitarios confirman que lo criterio básico para la evaluación de estos actos es encontrado en la distinción entre dianas civiles o militares (efecto diana). Todavía, algunos participantes también utilizaran un criterio basado en la identidad étnica-cultural del agresor (efecto actor).(AU)

Construção do inimigo após o 11 de setembro: os efeitos da identidade do agressor na representação do terrorismo / Construcción del enemigo después del 11 de setiembre: los efectos de la indentidad del agresor en la representación del terrorismo / Enemy construction after 9/11: aggressor identity effect on the representation of terrorism

At the time of the research, there were daily reports in the media regarding terrorist acts. What is it that indeed characterizes an act as being a terrorist one? From a psychosocial perspective, an ambiguous notion of terrorism may legitimate the ingroup/outgroup differentiation that affects intergroup relations. The aim of this research is to understand what people refer to when they talk about terrorism and to study the influence of different variables on the interpretation of some actions such as war or terrorism acts. Results on a sample of 251 University students confirm that the basic criterion for the evaluation of the actions is founded upon the distinction between military or civilian targets (i.e. target effect). However, some subjects use also a criterion based on the aggressor's ethnic-cultural identity (i.e. actor effect).

No momento da pesquisa, haviam registros diários na mídia sobre ações terroristas. O que de fato caracteriza um ato como sendo terrorista? A partir de uma perspectiva psicossocial, uma noção ambígua de terrorismo pode legitimar a diferenciação de pertencimento ou não ao grupo, que afeta as relações intergrupais. O objetivo dessa pesquisa é entender ao que as pessoas se referem quando falam sobre terrorismo e estudar a influência das diferentes variáveis na interpretação de algumas ações como guerras ou atos terroristas. Resultados de uma amostra de 251 estudantes universitários confirmam que o critério básico para a avaliação destes atos é encontrado na distinção entre alvos civis ou militares (efeito alvo). No entanto, alguns participantes também usaram um critério baseado na identidade étnicacultural do agressor (efeito ator).

n el momento de la investigación, había registros diarios en la prensa sobre acciones terroristas. ¿Lo que de echo caracteriza a un acto como terrorista? A partir de una perspectiva psicosocial, una noción ambigua de terrorismo puede legitimar la diferenciación de pertenecimiento o no al grupo, que afecta a las relaciones intergrupales. El objetivo de esa investigación es entender a lo que las personas se refieren cuando hablan sobre terrorismo y estudiar a la influencia de las diferentes variables en la interpretación de algunas acciones cómo guerras ó actos terroristas. Resultados de una muestra de 251 estudiantes universitarios confirman que lo criterio básico para la evaluación de estos actos es encontrado en la distinción entre dianas civiles o militares (efecto diana). Todavía, algunos participantes también utilizaran un criterio basado en la identidad étnica-cultural del agresor (efecto actor).

Taxomy of the psychosocial consequences caused by the violence of persecution of ET´s network

This paper delimits and analyzes the effects of the harassment perpetrated by ETA’s terrorist network in the Basque Country. The aim was to provide a taxonomy of the consequences of psychological violence and to validate this taxonomy, by means of a content analysis of 37 testimonies of victims of terrorist violence. The taxonomy of consequences of psychological violence is made up by four components: 1. the effects on the context of the persons affected, 2. on their emotional state, 3. on cognition and 4. on behavior. Results show a predominance of contextual consequences and negative cognitions. Intra-observer and inter-observer reliability analysis showed high stability and reproducibility coefficients. This study shows that harassment and psychological violence have major consequences not only for victims but also for family members, threatened collectives and even the society as a whole (AU)

Este estudio delimita y analiza los efectos del acoso aplicado por el entramado terrorista de ETA en el País Vasco. El objetivo consiste en aportar una taxonomía de las consecuencias de la violencia psicológica y validar esta taxonomía, mediante un análisis de contenido de 37 testimonios de víctimas de la violencia terrorista. La taxonomía de consecuencias de la violencia psicológica se encuentra formada por cuatro componentes: 1. los efectos sobre el contexto de las personas afectadas, 2. sobre su estado emocional, 3. sobre la cognición y 4. sobre la conducta. Los resultados muestran una predominancia de las consecuencias contextuales y las cogniciones negativas. El análisis de la fiabilidad intraobservador e interobservador muestra unos adecuados coeficientes de estabilidad y reproducibilidad. Este estudio muestra que el acoso y la violencia psicológica tienen grandes consecuencias no solo para las víctimas sino para los familiares, los colectivos amenazados y para el conjunto de la sociedad (AU)

Strategies of psychological terrorism perpetrated by ETA's network: delimitation and classification.

This paper defines and analyzes the harassment perpetrated by ETA's terrorist network in the Basque Country, providing a taxonomy of its strategies of psychological violence. The usefulness of this taxonomy has been tested and contrasted by means of a content analysis of 19 testimonies of persons who were the victims of violence by the terrorist network. The taxonomy of strategies of psychological violence is made up of four dimensions that emphasize the actions on the context of the persons affected, and on their emotional state, cognitions, and behaviour. Results show the predominance of emotional and cognitive strategies. Intra-observer and inter-observer reliability analysis in coding showed a Cohen's Kappa coefficient of .92 and .87, respectively. The psychological violence analyzed in this study reflects a form of psychological terrorism that harasses and persecutes a specific sector of the population.

Methodological challenges in assessing general population reactions in the immediate aftermath of a terrorist attack.

Assessing mental health needs following a disaster is important, particularly within high-risk groups such as first responders or individuals who found themselves directly caught up in the incident. Particularly following events involving widespread destruction, ingenuity and hard work are required to successfully study these issues. When considering responses among the general population following less devastating events such as a conventional terrorist attack, or following an event involving a chemical, biological, radiological or nuclear agent, other variables may become more relevant for determining the population's overall psychosocial well-being. Trust, perceived risk, sense of safety, willingness to take prophylaxis and unnecessary attendance at medical facilities will all be important in determining the overall psychological, medical, economic and political impact of such attacks. Assessing these variables can help government agencies and non-governmental organizations to adjust their communication and outreach efforts. As there is often a need to provide these data quickly, telephone surveys using short time-windows for data collection or which use quota samples are often required. It is unclear whether slower, more conventional and more expensive survey methods with better response rates would produce results different enough to these quicker and cheaper methods to have a major impact on any resulting policy decisions. This empirical question would benefit from further study.

International terrorism and mental health: recent research and future directions.

International terrorism has become a major global concern. Several studies conducted in North America and Europe in the aftermath of terrorist attacks reveal that international terrorism represents a significant short-term and long-term threat to mental health. In the present article, the authors clarify the concept and categories of terrorism and then present central findings from studies conducted in the United States and Europe, which mainly focus on negative impacts on mental health, such as emotional stress and PTSD. Furthermore, the authors outline experiments that focus on social interaction processes thought to be triggered by international terrorism and which are assumed to be related indirectly to mental health processes. Next, they highlight the potential positive outcomes on the resilience side, in line with the current theory on posttraumatic growth in adversity. Finally, theoretical and practical implications as well as limitations and future directions are discussed.

Mission failure: emergency medical services response to chemical, biological, radiological, nuclear, and explosive events.

INTRODUCTION: Only 4% of the United States Homeland Security funding for public safety terrorism preparedness is allotted to emergency medical services (EMS), despite the primary threat from a mass-terrorism chemical weapons attack (MTCWA) being personal injury. This study examines the preparedness of the EMS to respond to, treat, and transport victims of such attacks. HYPOTHESIS: It was hypothesized that US EMS agencies lack the necessary equipment to mitigate large-scale morbidity and mortality from a MTCWA. METHODS: Seventy after-action reports from full-scale, chemical weapons exercises conducted in large cities across the US were examined by the Office of Domestic Preparedness, Chemical Weapons Improved Response Program to ascertain if EMS responders had personal protective equipment sufficient to operate at the scene of a MTCWA. RESULTS: Of the 50 after action reports that mentioned EMS personal protective equipment, only six (12%) EMS agencies equipped their staff with personal protective equipment. CONCLUSIONS: Results indicate that EMS responders are not prepared to safely respond to MTCWAs, which may result in a significant loss of life of victims and responders.

Ionizing radiation in secret services' conspirative actions.

INTRODUCTION: The death of Litvinenko has been reported by the media. It has raised the question whether this case had been unique. The fall of the wall has allowed a glimpse in the planning and comporting of a secret service. MATERIAL AND METHOD: Documents of the secret service of the former German democratic republic (GDR), books of defectors, and media reports about secret service actions with radiating substances have been analyzed. RESULTS: Since decades, secret services have been using radioactive nuclides and radiation for their tasks. Several killings with radiation have been reported. A complicated logistic had been developed. CONCLUSION: Only singular cases of the employment of radiating substances have become known. It is probable that the majority rests unknown. Government support seems necessary in secret services' conspirative actions with radiating substance.

What is terrorism and can psychology do anything to prevent it?

Terrorism has a long history, which continues to unfold, and takes many forms. Notwithstanding these facts, there is no generally accepted definition of terrorism. I set forth the definitional issues that underlie the current debate about terrorism. By comparing terrorism with various forms of violence, I argue that it is plausible to construe terrorism as crime and, in support of this, I demonstrate why terrorism cannot be morally justified. Next, I cluster various immediate and long-term approaches intended to prevent terrorism, highlighting psychologically based strategies, such as behavioral profiling, teaching tolerance and citizenship, modifying media images of terrorism, and building peace. In order to understand and respond more effectively to 21st-century terrorism, I advocate adoption of a multidisciplinary, contextually sensitive approach.

Uniform emergency codes: will they improve safety?

There are pros and cons to uniform code systems, according to emergency medicine experts. Uniformity can be a benefit when ED nurses and other staff work at several facilities. It's critical that your staff understand not only what the codes stand for, but what they must do when codes are called. If your state institutes a new system, be sure to hold regular drills to familiarize your ED staff.

Hospital preparedness for possible nonconventional casualties: an Israeli experience.

Since 9/11, hospitals and health authorities have been preparing medical response in case of various mass terror attacks. The experience of Tel Aviv Sourasky Medical Center in treating suicide-bombing mass casualties served, in the time leading up to the war in Iraq, as a platform for launching a preparedness program for possible attacks with biological and chemical agents of mass destruction. Adapting Quarantelli's criteria on disaster mitigation to the "microinfrastructure" of the hospital, and including human behavior experts, we attempted to foster an interactive emergency management process that would deal with contingencies stemming from the potential hazards of chemical and biological (CB) weapons. The main objective of our work was to encourage an organization-wide communication network that could effectively address the contingent hazards unique to this unprecedented situation. A stratified assessment of needs, identification of unique dangers to first responders, and assignment of team-training sessions paved the way for program development. Empowerment through leadership and resilience training was introduced to emergency team leaders of all disciplines. Focal subject matters included proactive planning, problem-solving, informal horizontal and vertical communication, and coping through stress-management techniques. The outcome of this process was manifested in an "operation and people" orientation supporting a more effective and compatible emergency management. The aim of article is to describe this process and to point toward the need for a broad-spectrum view in such circumstances. Unlike military units, the civilian hospital staff at risk, expected to deal with CB casualties, requires adequate personal consideration to enable effective functioning. Issues remain to be addressed in the future. We believe that collaboration and sharing of knowledge, information, and expertise beyond the medical realm is imperative in assisting hospitals to expedite appropriate preparedness programs.

Mass violence and early mental health intervention: a proposed application of best practice guidelines to chemical, biological, and radiological attacks.

Based on past episodes, there will be psychological sequelae to chemical, biological, and radiological attacks. Some of the psychological morbidity should be able to be ameliorated through planning and appropriate early intervention. Key components of early intervention are illustrated following a hypothetical scenario of a bomb and anthrax threat near the Pentagon. Many of these components, such as monitoring clear, consistent messages about health risks, are provided by physicians or politicians, not mental health providers, but have a serious impact on the mental health of the population. We hope that this scenario and the principles of response will prove useful to planners of emergency preparedness and responders in the case of an actual attack.

A proposed universal medical and public health definition of terrorism.

The lack of a universally applicable definition of terrorism has confounded the understanding of terrorism since the term was first coined in 18th Century France. Although a myriad of definitions of terrorism have been advanced over the years, virtually all of these definitions have been crisis-centered, frequently reflecting the political perspectives of those who seek to define it. In this article, we deconstruct these previously used definitions of terrorism in order to reconstruct a definition of terrorism that is consequence-centered, medically relevant, and universally harmonized. A universal medical and public health definition of terrorism will facilitate clinical and scientific research, education, and communication about terrorism-related events or disasters. We propose the following universal medical and public definition of terrorism: The intentional use of violence--real or threatened--against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death.

An exploratory comparison of disasters, riots and terrorist acts.

One question that emerged following the 11 September attacks was how to categorise and classify the event within existing disaster and conflict-event research frameworks. A decade ago, Quarantelli (1993) compared findings on the similarities and differences between consensus- and conflict-type events by illustrating a conceptual distinction between the two. In this paper, this discussion is expanded to include terrorist attacks by offering comparisons from research findings following 11 September. We provide analyses of individual, organisational, and community-level behaviour in crisis situations and suggest how 11 September is both similar to, and differs from, consensus- and conflict-type events as they were previously considered. Applications for emergency management are also suggested.