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Extremism and common mental illness: a cross-sectional community survey of White British and Pakistani men and women living in England

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Kamaldeep Bhui, Michaela Otis, Maria Joao Silva, Kristoffer Halvorsrud, Mark Freestone, Edgar Jones

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalBritish Journal of Psychiatry
Early online date15 Mar 2019
Publication statusPublished - 15 Mar 2019


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Background: Mental illnesses may explain vulnerability to develop extremist beliefs that can lead to violent protest and terrorism. Yet there is little empirical evidence.
Aims: To investigate the relationship between common mental illnesses and violent extremist beliefs.
Method: A population survey of 618 White British and Pakistani men and women living in three localities in England. Extremism was assessed on 7 items of an established measure of sympathies for violent protest and terrorism (SVPT). Respondents with any positive scores (showing sympathies) were compared with those who had all negative scores (meaning condemnation). We calculated associations (Risk Ratios and 95% confidence intervals) between extremist sympathies and ICD-10 diagnoses of depression and dysthymia, and symptoms of anxiety, personality difficulties, autism and post-traumatic symptoms (assessed with established and valid measures). We also considered the complex influences of demographics, life events, social assets, political engagement, and criminal convictions.
Results: SVPT were more common in those with major depression with dysthymia (RR=4.07, 95% CI: 1.37-12.05, p=0.01), symptoms of anxiety (RR=1.09, 95%CI: 1.03-1.15, p=0.002) or post-traumatic stress (RR=1.03, 95%CI: 1.01-1.05, p=0.003). Some groups were at greater risk of SVPT: young adults (under 21 compared with 21 or older: RR=3.05, 95%CI: 1.31-7.06, p=0.01), White British people (compared with Pakistani people: RR=2.24, 1.25-4.02, p=0.007), and those with a criminal conviction (RR=2.23, 95%CI: 1.01-4.95, p=0.048). Life events, social assets and political engagement were unrelated to SVPT on this improved 7-item measure.
Conclusion: Depression and dysthymia, and symptoms of anxiety and post-traumatic stress are associated with extremist sympathies (SVPT).

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