One of the most malignant illnesses in psychiatry is opioid addiction. This disorder has resulted in a current epidemic of addiction, overdose, and death that continues in large part because of the lack of robust treatments and the surprising lack of utilization of the treatments that are available.

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.

A large proportion of the persons who join terrorist groups as well as lone-acting terrorists have a history of violent behavior or mental disorder that predated their becoming terrorists. This suggests that brain alterations found to occur in violent perpetrators may also be present in a significant percentage of terrorists. After a short delineation of phylogenetically old neuronal networks that are important for the generation of aggressive behavior in inconspicuous brains, this review summarizes structural and functional brain-imaging studies in violent offenders published over the last 10 years. Depending on the subtype of violence (impulsive or instrumental), deviations in structure or function were mainly found in the prefrontal, orbitofrontal, and insular cortex, as well as in temporolimbic structures (e.g., the amygdala, hippocampus, and parahippocampus). These brain areas are essentially responsible for the control of the archaic neuronal generators of aggression located in the hypothalamus and limbic system. This regional distribution of brain alterations also shows a remarkable overlap with those brain regions that are crucial for such prosocial traits as empathy and compassion. Feelings of superiority, dominance, and satisfaction gained by performing violent and terroristic attacks suggest that a hedonistic component via an activation of brain reward systems plays an additional role. In our current debate about the causes of terrorism, aspects of brain dysfunction should receive more attention.

Terrorist behavior represents a subtype of human aggression probably determined by a combination of biological, psychological, and social factors, as well as by peculiar environmental influences and group dynamics. As regards terrorists’ psychological characteristics, the available studies (mostly carried out with no sound scientific design) have failed to identify the common or typical pathological personality traits of modern terrorists. The popular opinion that terrorists must be insane or psychopathic is still widespread; however, no evidence exists that terrorist behavior may be caused either by prior or current psychiatric disorders or psychopathy. Not surprisingly, some theories have proposed social factors and non-pathological psychological traits as predisposing elements for terrorist acts, but they generally lack of empirical validation. Moreover, most of these theories do not explain why, even if so many people are exposed to the same social factors or show the same psychological traits, only a tiny minority of them join a terrorist group. Therefore, it is mandatory that systematic and scientific investigations be carried out in order to understand the possible bases for terrorist aggression, including the early detection of possibly associated psychopathology, and to design an appropriate counterterrorism prevention policy.

After reviewing the available literature about the main hypotheses on suicide terrorism and the psychological characteristics of terrorists that have been proposed throughout the years, the present authors have put forward some personal considerations on what the distinctive traits of today’s suicide bombers might be. In spite of the heterogeneity and paucity of “real” data, it is evident that there is no peculiar familial, educational, or socioeconomic factors that may account for religious radicalization leading to suicide terrorism. On the contrary, some common psychological features can be highlighted: such as isolation, feelings of emptiness, cold rationality, a lack of empathy, and a lust for martyrdom and death. To die to kill: this is the core feature, a sort of organizer that can twist higher cognitive and emotional processes, resulting in the supreme and highly rewarding suicidal and killing behaviors.

Psychiatric evaluations of violent political crime were mostly performed on a case-by-case basis in a forensic environment, which made them unduly dependent on categories of presumed dangerousness and legal responsibility, rather than on a clinical definition of their mental status. In referring to such “clinical” definitions, the disorder we have in mind is not limited to the major, agitated psychotic manias or mixed states. The presence of a dominant temperament, or protracted hypomania, is enough by itself to explain an individual’s engagement in a wide range of activities, not necessarily sociopathic or violent. We put forward the hypothesis that formal and transpolitical radical choices, either in favor of an illegal lifestyle or of activities involving a high level of risk, may be linked with certain mental states, especially when considering small clandestine groups showing a high level of internal ideological consensus, and a no-return attitude toward a commitment to radical choices. Available data about the psycho(patho)logical profile of terrorists are still hard to come by. The only available studies are those on identified living terrorists (judging by the trials of those who personally admitted to having been terrorists), and statistical data imply a number of documented cases belonging to the same terrorist organization. In Italy, the period often called the “years of lead [bullets]” displays an interesting viewpoint for the study of terrorist psychology, for two main reasons: first of all, it is a historically defined period (1968–1988), and second, the number of ascertained participants in terrorist activities was quite large.

“Fighting terrorism is like eating soup with a fork” (Shimon Peres). Peres’s quote symbolically captures the key problem of countering terrorism. 9/11 proved to be a hallmark in the global perception of modern terrorism. The following questions form the framework of the present essay: What is the essence of modern terrorism? How did it develop during the past two decades? Who are the key players within the terror framework? What are the root causes for global terrorism? How are we to deal appropriately with the global phenomenon of terrorism? Are there any solutions (short-, medium-, long-term) to terrorism? If yes, where do we have to look for them? The underlying essay provides a strategic overview of antiterrorism policy that is based on the author’s years-long experience as a high-level expert and advisor within the security policy framework. For this reason, citations are expressly not included. The key target audience comprises laypersons interested in the phenomenon of global terrorism and its social interplay.

Between 1940 and 1944, an estimated 48,588 patients resident in French psychiatric hospitals died of starvation. Standard prisons, while facing similar problems, did not experience the same number of deaths by starvation, partly due to their ability to develop a black market for food and rations. Patients in psychiatric hospitals, on the other hand, were completely at the mercy of their doctors and the personnel in charge. At Hôpital du Vinatier, a psychiatric facility in Lyon, the mortality rate increased sharply from 1940 to 1944. In 1942, the worst year, 42% of patients died of hunger and exposure. In the end, more than 2,000 patients died at Vinatier. Was this due to a supposed lack of rations, or was it something more sinister? In Germany at the same time, tens of thousands of psychiatric patients died of purposeful starvation in psychiatric hospitals as part of the Nazi program of psychiatric euthanasia. Was the same thing occurring in Lyon?