The Mental Health Consequences of Torture

Portada
Ellen Gerrity, Terence M. Keane, Farris Tuma
Springer Science & Business Media, 2001 M03 31 - 375 páginas

In 1997 the National Institute of Mental Health assembled a working group of international experts to address the mental health consequences of torture and related violence and trauma; report on the status of scientific knowledge; and include research recommendations with implications for treatment, services, and policy development. This book, dedicated to those who experience the horrors of torture and those who work to end it, is based on that report.

 

Contenido

Introduction
3
Background
4
Conceptual and Definitional Concerns
5
Organization of the Book
8
References
11
The Survivors Perspective Voices from the Center
13
Torture and Related Trauma
14
Victim Versus Survivor
15
Trauma as a Risk Factor
164
Comorbidity and Other Outcomes
167
Influences on Psychopathology
168
Research Recommendations and Conclusions
169
References
171
TORTURE AND THE IMPACT OF SOCIAL VIOLENCE
175
Rape and Sexual Assault
177
Focus of Section
178

A Shroud of Guilt
17
How Could I Let That Happen?
18
Misdiagnosis
19
To Live or Not?
20
To Believe or Not
22
Resilience of Survivors
23
Reclaiming Control
24
Therapy
26
Effects of Torture on the Family
29
The Culture of Denial
30
Research Recommendations From the Survivors Perspective
33
References
34
Torture and Mental Health A Research Overview
35
Prevalence of Torture
36
Physical Effects of Torture
37
Psychological Effects of Torture
38
Evidence for a TortureSpecific Syndrome
45
Discussion and Conclusions
48
References
57
CONCEPTUAL MODELS FOR UNDERSTANDING TORTURE
63
Psychosocial Models
65
Information Processing
66
SocialCognitive Models
67
Social Support Models
68
Learned Helplessness
69
References
70
Neurobiological Models of Posttraumatic Stress Disorder
73
Sympathetic Nervous System Alterations in PTSD
74
The HypothalamicPituitaryAdrenal Axis
76
Stress Sensitization
77
Fear Conditioning
78
Enhanced Memory for Aversive Events
80
Other Considerations
82
References
83
Economic Models
89
Conceptual Framework
90
Major Analytic Questions
91
The Role of Economic Burden Measures
104
References
105
TORTURE AND THE TRAUMA OF WAR
109
Refugees and AsylumSeekers
111
Scope of the Problem
112
Studies of Psychological Problems in Refugee Populations
113
Biological Social and Cultural Effects of Torture and Trauma
115
Research Recommendations
116
References
117
Veterans of Armed Conflicts
121
Impact
122
Recommendations for Future Research
127
References
128
Former Prisoners of War Highlights of Empirical Research
133
Course and Complications
136
Biological Correlates of Captivity Survivors Impairments
137
Recent Attention to US POWs
138
References
140
Holocaust Trauma and Sequelae
143
Impact of Trauma
144
Individual Differences
147
Coping With Life Stresses Subsequent to the Trauma of the Holocaust
149
Protective Factors Facilitating Healing
150
Contextualizing the Holocaust Experience
152
Conclusion
153
References
154
Survivors of War Trauma Mass Violence and Civilian Terror
159
Introduction
160
Methodology
161
Trends in Trauma Assessment
163
Scope of Exposure
179
Impact
180
Other Psychological Outcomes
181
Cognitive Outcomes
182
Economic Impact
184
Risk and Protective Factors
185
Research Recommendations
186
References
187
Homicide and Physical Assault
195
Scope of Exposure
196
Impact
198
Risk Factors
203
References
206
Children Adolescents and Families Exposed to Torture and Related Trauma
211
Range and Prevalence of Trauma Exposure in Children and Adolescents
212
Nature and Course of Psychological Physical Social and Developmental Consequences
214
Factors That Influence Vulnerability Adjustment and Recovery
217
Assessment and Intervention
218
Conclusion
221
Domestic Violence in Families Exposed to Torture and Related Violence and Trauma
227
Does Exposure to Torture Detention WarZone Political and Ethnic Violence and Refugee Resettlement Increase the Likelihood or Severity of Domest...
231
Are the Characteristics of Domestic Violence Different in Families That Have Experienced Severe Trauma?
235
Should Approaches to Treatment and Prevention of Domestic Violence Be Different for Families That Have Experienced Trauma?
239
References
242
CLINICAL ISSUES FOR SURVIVORS OF TORTURE
247
Assessment Diagnosis and Intervention
249
Assessment
251
Diagnoses
253
Intervention Issues
255
Specific Intervention Strategies
259
Community Approaches
265
Research Recommendations
269
References
270
Measurement Issues
277
Basic Principles of Measurement
278
Measurement Procedures
283
Measurement Instruments
285
Summary of Measurement Issues
287
References
288
Mental Health Services Research Implications for Survivors of Torture
291
Structure and Organization of the Health Care System
292
Process of Car
298
Intended Outcomes of Care
301
Access to Care
302
Conclusion
305
Professional Caregiver and Observer Issues
309
Therapist Reactions
310
Other Caregiver Responses
312
Ethical Issues in Torture and Trauma Treatment
313
References
314
Torture and Human Rights Violations Public Policy and the Law
317
The Law and Treatment and Services for Trauma Survivors
318
An Overview of International Human Rights Law Concerning Survivors of Torture
319
Addressing War Crimes and Other Massive Human Rights Violations
320
The Crime Victims Rights Laws and Their Implementation
321
Reparations Resitution and Compensation
326
Restorative Justice
327
Implications and Policy Recommendations
328
References
329
DISCUSSION
333
Future Directions
335
Summary of Selected Research Findings
336
Conclusion
341
Index
343
Biographical Information
369
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