Torture has existed since the earliest times, usually as public punishment prior to death. Today it is predominantly used in secret with the aim of destroying the individual's personality. The effects of torture include severe physical and psychological sequelae which have only recently come under scrutiny. In recent years many Chilean and El Salvadorean migrants have left their countries after being tortured and severely traumatised as a result of organised violence.
The aim of this study was to pilot an investigation into the psychological sequelae of torture. Subjects were 30 Chileans and El Salvadoreans classified into three groups: torture, trauma and non-torture/trauma migrants. It was found to be feasible to access and interview survivors from a clinical research perspective without causing additional psychological morbidity. The subjects were interviewed and administered three scales: the Post-Traumatic Stress Disorder Scale, SCL-90-R, and the Impact of Event Scale. The results from the scales and the descriptive data presented indicate some support for the hypothesis that torture survivors show higher levels of PTSD, psychosomatic impairment and stress response disturbance than the trauma and non-torture/trauma groups. Methodological issues are discussed. The strengths and limitations of this preliminary study are considered in relation to future research.
References
1.
MollicaRFWyshakGLavelleJ.The psychosocial impact of war trauma and torture on South East Asian refugees. American Journal of Psychiatry1987; 144:1567–1571.
2.
WestermeyerJ.DSM-III psychiatric disorders among Hmong refugees in the United States: a point prevalence study. American Journal of Psychiatry1988; 145:197–202.
3.
KrollJHabenichtMMackenzieTYangMChanSVangTNguyenTLyMPhommasouvanhBNguyenHVangYSouvannasothLCabugaoR.Depression and post-traumatic stress disorder in Southeast Asian refugees. American Journal of Psychiatry1989; 146:1592–1597.
4.
McGorryP.The sequelae of torture and the implications for health services in Australia. In: ChiuEMinasIH, eds. Mental health of ethnic communities. Melbourne: Department of Psychiatry, University of Melbourne, St. Vincent's Hospital, and Victorian Transcultural Psychiatry Unit, 1988.
5.
ReidJCStrongT.Torture and trauma. The health care needs of refugee victims in New South Wales. Sydney: Cumberland College of Health Sciences, 1987.
6.
SiloveDTarnRBowlesRReidJ.Psychotherapy for survivors of torture. In: MinasIH, ed. Cultural diversity and mental health. Melbourne: Section of Social and Cultural Psychiatry, Royal Australian and New Zealand College of Psychiatry, and Victorian Transcultural Psychiatry Unit, 1991.
7.
McGorryP.The significance of torture: theoretical and therapeutic aspects. In: MinasIH, ed. Cultural diversity and mental health. Melbourne: Section of Social and Cultural Psychiatry, Royal Australian and New Zealand College of Psychiatry, and Victorian Transcultural Psychiatry Unit, 1991.
8.
KrupinskiJBurrowsG, eds. The price of freedom. Young Indochinese refugees in Australia. Sydney: Pergamon, 1986.
9.
FoucaultM.Discipline and punish: The birth of the prison. Harmondsworth: Penguin, 1977.
10.
McGorryP.Working with survivors of torture and trauma: The Victorian Foundation for Survivors of Torture in perspective. Submitted to Australian and New Zealand Journal of Psychiatry.
11.
Time Magazine, November 1991.
12.
ScarryE.The body in pain: The making and unmaking of the world. New York: Oxford University Press, 1985.
13.
McFarlaneAC.The aetiology of post-traumatic morbidity: Predisposing, precipitating and perpetuating factors. British Journal of Psychiatry; 154:221–228.
14.
BreslauNDavisG.Post-traumatic stress disorder: the stressor criterion. Journal of Nervous and Mental Disease1987; 5:255–275.
15.
HockingF.Psychiatric aspects of extreme environmental stress. Diseases of the Nervous System1970; August:542–545.
16.
WeisaethL.Torture of a Norwegian ship's crew. The torture, stress reactions and psychiatric after-effects. Acta Psychiatrica Scandinavica1989; Suppl 355:63–72.
17.
Janoff-BulmanR.The aftermath of victimization: rebuilding shattered assumptions. In: FigleyCR, ed. Trauma and its wake. The study and treatment of post-traumatic stress disorder. New York: Brunner/Mazel, 1985.
18.
LiraECastilloMI.Psicologia De La Amenaza Politica y Del Miedo. Santiago, Chile: ILAS, 1991.
19.
AllodiF.Assessment and treatment of torture victims: a critical review. Journal of Nervous and Mental Disease1991; 179:4–11.
20.
AlegriaG.They won't take me alive. London: Women's Press, 1987.
21.
ScooleyH.Conflict in Central America. London: Longman, 1987.
22.
El Salvador Committee for Human Rights, Guatemala Committee for Human Rights and War on Want Campaigns. Out of the ashes — The lives and hopes of refugees from El Salvador and Guatemala. Nottingham: Russell Press, El Salvador and Guatemala Committee for Human Rights and WOW Campaigns, 1985.
FriedmanMJSchneidermanCKWestANCorsonJA.Measurement of combat exposure, post-traumatic stress disorder, and life stress among Vietnam combat veterans. American Journal of Psychiatry1986; 143:537–539.
27.
SolomonZWeisenbergMSchwarzwaldJMikulincerM.Posttraumatic stress disorder among front line soldiers with combat stress reaction: the 1982 Israeli experience. American Journal of Psychiatry1987; 144:448–454.
28.
McGorryPDChanenAMcCarthyEvan RielRMcKenzieDSinghBS.Posttraumatic stress disorder following recent-onset psychosis: an unrecognized postpsychotic syndrome. Journal of Nervous and Mental Disease1991; 179:253–258.
29.
RoglerLH.The meaning of culturally sensitive research in mental health. American Journal of Psychiatry1989; 146:296–303.
30.
CienfuegosAJMonelliC.The testimony of political repression as a therapeutic instrument. American Journal of Orthopsychiatry1983; 53:43–51.
ScurfieldRM.Post-trauma stress assessment and treatment: overview and formulations. In: FigleyCR, ed. Trauma and its wake. The study and treatment of post-traumatic stress disorder. New York: Brunner/Mazel, 1985.
33.
LiftonRJ.Understanding the traumatised self. In: WilsonJPHarelZKahahaB, eds. Human adaptation to extreme stress from the Holocaust to Vietnam. New York: Plenum, 1988.
34.
WilsonJPHarelZKahanaB, eds. Human adaptation to stress from the Holocaust to Vietnam. New York: Plenum, 1988.
35.
FigleyCR.Trauma and its wake. The study and treatment of post-traumatic stress disorder. New York: Brunner/Mazel, 1985.
36.
KnightB.Help for those subjected to torture. Medical Foundation for the Care of Victims of Torture. Lancet1986; 11:108–109.
37.
Doctors, ethics, and torture.Proceedings of an International Meeting, Copenhagen, August 1986. Danish Medical Bulletin1987; 34:185–202.
38.
JakobsenK.Confidence and security are presuppositions for helping torture victims. Danish Nurses’ Journal “Sygeplejersken”1985, Vol. 27. [Danish-English translation available from RCT, Copenhagen].
39.
StoverE.The open secret: Torture and the medical profession in Chile. Washington: American Association for the Advancement of Science, 1987.
40.
KahanaEKahanaBHarelZRosnerT.Coping with extreme trauma. In: WilsonJPHarelZKahanaB, eds. Human adaptation to extreme stress, from the Holocaust to Vietnam. New York: Plenum, 1988.
41.
OrtmannJGenefkeIKJakobsenRNLundeI.Rehabilitation of torture victims: an interdisciplinary treatment model. American Journal of Social Psychiatry1987; 7:161–167.
