The Mental Health Consequences of Torture

Transcription

1 The Mental Health Consequences of Torture Edited by Ellen Gerrity National Institute of Mental Health Bethesda, Maryland Terence M. Keane Boston University School of Medicine Boston, Massachusetts and Farris Tuma National Institute of Mental Health Bethesda, Maryland Kluwer Academic I Plenum Publishers New York, Boston, Dordrecht, London, Moscow

2 Contents PART I. THE IMPACT OF TORTURE Chapter I. Introduction... 3 Ellen Gerrity, Terence M. Keane, and Farris Tuma Mental Health Consequences of Violence and Traumatic Stress... 3 Background... 4 Conceptual and Definitional Concerns... 5 Organization of the Book... 8 References... II Chapter 2. The Survivors' Perspective: Voices from the Center Sister Dianna Ortiz Torture and Related Trauma Victim Versus Survivor The Changed World of the Tortured A Shroud of Guilt Humiliation: How Could I Let That Happen? Contamination: Evil Dancing Within Misdiagnosis Suicide: To Live or Not? Faith: To Believe or Not Resilience of Survivors Transitional Survival Skills Reclaiming Control... : Normalizing Life Through Denial Therapy Effects of Torture on the Family The Culture of Denial Research Recommendations From the Survivors' Perspective References xvii

3 xviii contents xix Chapter 3. Torture aod Mental Health: A Research Overview Chapter 6. Economic Models Melin Basoglu, James M. Jaranson, Richard Mollica, ami Marianne Kastrup Prevalence of Torture Physical Effects of Torture Psychological Effects of Torture A Review of Studies on Torture Evidence for a Torture-Specific Syndrome Social and Economic Consequences of Torture Discussion and Conclusions References Agnes Rupp and Eliot Sorel Conceptual Framework Major Analytic Questions The Role of Economic Burden Measures... I 04 Conclusions... I 04 References... I 05 PART Ill. TORTURE AND THE TRAUMA OF WAR PART II. CONCEPTUAL MODEIB FOR UNDERSTANDING TORTURE Chapter 4. Psychosocial Models Chapter 7. Refugees aod Asylum-Seekers... Ill J David Kinzie and james M. Jaranson John A. Fairbank, Matthew J Friedman, and Melin Basoglu Scope of the Problem Studies of Psychological Problems in Refugee Populations Biological, Social, and Cultural Effects of Torture and Trauma Learning Theory: Classical and Instrumental Conditioning Research Recommendations Cognitive-Behavioral Theories: Information Processing References ' Social-Cognitive Models Social Support Models Developmental Models Chapter 8. Veteraos of Armed Conflicts Learned Helplessness Recommendations for Future Research John A. Fairbank, Matthew J Friedman, and Steven Southwick References Scope of Participation in Armed Conflicts Chapter 5. Neurobiological Models of Posttraumatic Stress Disorder Impact Recommendations for Future Research References Steven Southwick and Matthew J Friedman Chapter 9. Former Prisoners of War: Highlights of Empirical Research Sympathetic Nervous System Alterations in PTSD The Hypothalamic-Pituitary-Adrenal Axis Stress Sensitization Brian Engdahl and John A. Fairbank Fear Conditioning Enhanced Memory for Aversive Events Worldwide POW Research Other Considerations...." Course and Complications References ::~!...;;,;;.. Biological Correlates of Captivity Survivors' Impairments

4 "" The Captor-Captive Relationship and Coping Recent Attention to U.S. POWs References Other Psychological Outcomes Neurobiological Findings Cognitive Outcomes Physical Health Chapter 10. Holocaust Trauma and Sequelae Economic Impact Social Functioning Boaz Kahana and Eva Kahana Risk and Protective Factors Research Recommendations References Impact of Trauma Individual Differences Coping With Life Stresses Subsequent to the Trauma of the Holocaust Protective Factors Facilitating Healing Contextualizing the Holocaust Experience Conclusion References Chapter 11. Survivors of War Trauma, Mass Violence, and Civilian Terror Chapter 13. Homicide and Physical Assault Dean G. Kilpatrick and Mary P. Koss Scope of Exposure Impact Risk Factors References Derrick Silove and J David Kinzie Chapter 14. Children, Adolescents, and Families Exposed to Torture and Related Trauma Introduction Methodology Robert S. Pynoos, J David Kinzie, and Malcolm Gordon Trends in Trauma Assessment Trauma as a Risk Factor Comorbidity and Other Outcomes Introduction Influences on Psychopathology Range and Prevalence of Trauma Exposure in Children and Adolescents Research Recommendations and Conclusions Nature and Course of Psychological, Physical, Social, and Developmental References Consequences Factors That Influence Vulnerability, Adjustment, and Recovery Assessment and Intervention PART IV. TORTURE AND 1HE IMPACT OF SOCIAL VIOLENCE Conclusion References Chapter 12. Rape and Sexual Assault Mary P. Koss and Dean G. Kilpatrick Focus of Section Scope of Exposure Impact Posttraumatic Stress Disorder Chapter 15. Domestic Violence in Families Exposed to Torture and Related Violence and Trauma Malcolm Gordon Does Exposure to Torture Detention; War~Zone, Political, and Ethnic Violence; and Refugee Resettlement Increase the Likelihood or Severity of Domestic Violence?

5 xxii xxili Are the Characteristics of Domestic Violence Different in Families That Have Experienced Severe Trauma? Should Approaches to Treatment and Prevention of Domestic Violence Be Different for Families That Have Experienced Trauma? References PART V. CUNICAL ISSUES FOR SURVIVORS OF TORTURE Chapter 16. Assessment, Diagnosis, and Intervention James M. Jaranson, J David Kinzie, Merle Friedman, Sister Dianna Ortiz, Matthw J Friedman, Steven Southwick, Marianne Kastrup, and Richard Mollica Assessment Diagnoses Intervention Issues Specific Intervention Strategies Community Approaches Research Recommendations References Chapter 17. Measurement Issues Anthony J Marsella Basic Principles of Measurement Measurement Procedures Measurement Instruments Summary of Measurement Issues References Chapter 18. Mental Health Services Research: Implications for Survivors of Torture I Kathryn M. Magruder; Richard Mollica, and Merle Friedman Structure and Organization of the Health Care System Process of Care Intended Outcomes of Care Access to Care Conclusion References Chapter 19. Professional Caregiver and Observer Issues J David Kinzie and Brian Engdahl Therapist Reactions Other Caregiver Responses Ethical Issues in Torture and Trauma Treatment References Chapter 20. Torture and Human Rights Violations: Public Policy and the Law Dean G. Kilpatrick and Margaret E. Ross Definitions The Law and Treatment and Services for Trauma Survivors An Overview of International Human Rights Law Concerning Survivors of Torture Addressing War Crimes and Other Massive Human Rights Violations The Crime Victims' Rights Laws and Their Implementation Reparations, Restitution, and Compensation Restorative Justice Implications and Policy Recommendations References PART VI. DISCUSSION Chapter 2!. Future Directions Ellen Gerrity, Terence M. Keane, Farris Tuma, and Sister Dianna Ortiz Summary of Selected Research Findings Conclusion Index Contributors: Biographical Information