RAN HEALTH Personality disorders and mental illnesses with implications in preventing violent extremism, Helsinki 20-21 July 2022

Personality disorders and mental illnesses present amongst radicalised individuals bring additional challenges to prevention of violent extremism (PVE) efforts. On 20-21 June, the RAN Mental Health (HEALTH) Working Group convened 22 participants in Helsinki and discussed with (both clinical or forensic) psychologists, psychiatrists, local authorities and experienced rehabilitation practitioners the underlying dynamics of specific personality disorders and susceptibility to radicalisation leading to violent extremism.

The general aim of the meeting was to create a deeper understanding of the challenges practitioners face when dealing with radicalised individuals with personality disorders, which are: a lack of understanding on the interplay between these specific disorders and radicalisation, how this could lead to violence, and what this means for prevention efforts and treatment options.

The meeting addressed this on the practical level through analysis of real case studies, which resulted in practical recommendations on how to prevent those with specific disorders from being drawn/groomed into violent extremism and to increase our understanding of which violence-supporting factors these disorders may or may not be associated with.

Particular attention was paid to the mechanisms and underlying dynamics of antisocial personality disorder (ASPD) that contribute to the vulnerability for radical opinions and extremist action that has the potential to lead to violence and subsequently to the interventions that address these underlying dynamics. Some of the key outcomes include:

• The underlying dynamics of personality disorders that lead people to violent extremism are associated with specific traits/symptoms of the personality disorder. The diagnosis of personality disorders therefore is not always helpful and sometimes stigmatising. Mental health practitioners in PVE benefit from focusing on the underlying dynamics to better address and treat the specific symptoms of the disorders.
• Challenges regarding the treatment of personality disorders are multiple. In specific cases like ASPD, there are no evidence-based treatments available. Practitioners also have to deal with the frustration of working with uncooperative individuals and the fact that improvement is at times short-lasting. Additionally, with hostile attribution bias being one of the symptoms, practitioners find extreme difficulty in the precondition for treatment, which is building trust.

This paper summarises the main conclusions following the discussion on a range of personality disorders (especially those in Cluster B) with a particular focus on ASPD. Consequently, this paper describes the main (mental) health issues within specific cases, recommendations on how to deal with these, relevant practices and some possible follow-up on this topic.