Refugee survivors of torture: Trauma and treatment.

It is increasingly likely that psychologists may be faced with clients who have been tortured, although the significance of this background can be easily unrecognized or mishandled. With the growing incidence of refugees to the United States escaping from organized violence and human rights violations in many parts of the world, the need for psychological assistance in the recovery from torture is well documented. By integrating principles from trauma theory and multicultural theory with a conceptual analysis of power and liberation theory, the author offers an understanding of both the nature of the damage inflicted by politically based torture and strategies to help overcome that damage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term preoperative treatment in a case of pheochromocytoma

The authors show the case of a young drug addict patient with chronic hepatitis affected by pheochromocytoma, owing to his conditions, which was prepared preoperatively with a short term phenoxybenzamine i.v. We had no complications in the perioperative period. Our opinion is that it is possible, when necessary, to administer a short term therapy but this preparation isn't be considered a standard therapeutic program.     

Therapists' reactions to treatment of survivors of political torture.

Working with survivors of political torture and war trauma can trigger strong emotional responses in the therapist. As more survivors seek treatment, it is essential to identify and develop robust support systems for therapists who help their clients confront nearly unspeakable experiences. The emotional reactions of 6 psychotherapists who worked with traumatized survivors in a refugee treatment center were explored. The psychotherapists' reactions were compared with those of therapists who worked in different treatment settings with other presenting problems. The results of the study show that the strong level of responsibility therapists feel for their traumatized clients may hide an emotional strain and may lead to burnout. Suggestions are offered for supporting therapists in this difficult but important work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical and psychiatric aspects of torture: a Canadian study

In the last two decades widespread use of torture by totalitarian governments has been reported in over 60 countries. This situation concerns physicians who are sometimes called upon to see the victims. This paper reports the psychiatric findings in a group of 41 Latin American refugees who arrived in Canada from 1977 to 1979 and alleged to have been subjected to political persecution and torture under the military rulers of their own countries. Most of them, young educated men, were apprehended violently and imprisoned under conditions below the minimum international standards. Systematic physical and psychological torture was the rule, including blindfolding, beatings, electrical shocks, sexual abuse and threats of execution or sham executions. These experiences were followed by a cluster of psychiatric symptoms and physical evidence of trauma compatible with the history given. This pattern constitutes the torture syndrome included under category 308 and 309 of the DSM-III and ICD-9. The alleged professional conduct of 19 doctors who saw 21 of these patients is discussed. A list of codes of medical ethics, intended to guide and protect doctors confronted with this difficult problem, is included.     

Dreams and other sketches from a torture survivor's notes.

Presents the personal experiences of a torture survivor who sought treatment. The author, a priest, was imprisoned and tortured under the martial law regime of former President Marcos of the Philippines. Three months after his release he came to the US. It took him almost 10 yrs to decide to look for help, and when he did, he went to a center for survivors of torture. His therapy process lasted approximately 2 yrs. The author recounts some observations and certain incidents of the therapy process that may be helpful to health professionals working with survivors of torture. His comments and suggestions rest on 2 principles. (1) The therapist–client relationship is generally based on power and this feels extremely unequal when the client has suffered the trauma of torture, which results in unusual vulnerability. (2) Empowerment must be central in the therapy process if it is to succeed. The author stresses the importance of highlighting the active role of the survivor in the healing process and the rebuilding of a life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bone scintigraphy in screening of torture survivors

BACKGROUND: In most developed countries, survivors of physical torture inflicted for political, religious, or ethnic reasons face ever more stringent review when seeking asylum. In Austria, asylum seekers are required by immigration authorities to undergo medical examination as part of the review. Bone scintigraphy can detect bone lesions that are not detectable clinically or radiologically. We assessed the value of bone scintigraphy as corroboration of alleged injuries. METHODS: Human-rights organisations referred 25 asylum seekers to us from countries where torture is practised. We included patients who claimed to have been beaten by the security forces in their home country because of political or religious conviction or ethnic origin. Injuries had been inflicted 4 months to 5 years earlier. The patients (three women, 22 men) from 12 countries were categorised retrospectively into two groups: group A (n=12), tortured with blows from hard objects, and group B (n=13), tortured with blows from fists and kicks. We also used a control group of 25 individuals with the same age and sex distribution from the same countries who had no history of torture. FINDINGS: In group A, bone scans showed abnormalities in the area of alleged injury in all patients, whereas radiography was positive in only five patients. In group B, bone scans in the alleged areas of damage were positive in seven patients, but radiography yielded no positive outcomes. Among the controls there was one abnormal scan due to a known coxarthrosis. INTERPRETATION: Our preliminary results suggest that bone scintigraphy is a sensitive, non-invasive tool to document trauma some years after the actual injury.     

Short-term group treatment for adult children of alcoholics.

Highly significant test score changes of adult children of alcoholics supported the effectiveness of individual therapy in short-term groups. 24 Ss were tested on measures of loneliness (UCLA Loneliness Scale); anxiety, hostility, and depression (Multiple Affect Adjective Check List—Revised [MAACL—R]); and interpersonal dependency (Interpersonal Dependency Inventory [IDI]). MAACL—R Anxiety and Depression scores declined. MAACL—R Hostility scores rose at the end of the treatment and then declined sharply 8 wks later. Increases toward test norms occurred on the IDI Lack of Social Confidence scale. Scores on the IDI Emotional Reliance on Another Person scale, the IDI Assertion of Autonomy scale, and the UCLA Loneliness Scale fell within scale norms and showed little change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term structured treatment for avoidant personality disorder.

Forty-two men and 34 women (mean age 27.5 years) who met DSM-III criteria for avoidant personality disorder were randomly assigned to 1 of 3 treatment conditions or to a waiting-list control group. Treatment Ss who participated in a 10-week group treatment program displayed significantly greater improvement on a variety of self-report and behavioral measures than did untreated control subjects. The inclusion of skills-training procedures did not contribute to the effects of graduated exposure procedures alone. The gains made during treatment were maintained over the follow-up period, but few further improvements were made. Clinical significance was evaluated by both the subjective evaluation method and the social comparison method. These procedures indicated that although significant improvements had been made, these avoidant Ss were not functioning at the level of normative comparison samples at treatment termination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating survivors of war trauma and torture.

Recognizes Karen L. Hanscom, who received the International Humanitarian Award, for "her commitment to human rights, to the healing of torture victims, and to educating the world community about torture." A citation and biography are provided, as well as the award address she delivered at APA's 2001 Annual Convention, entitled, "Treating Survivors of War Trauma and Torture." (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Self-definition as a survivor of childhood sexual abuse among Navy recruits.

This study explored how specific childhood sexual experiences (CSEs) might be related to self-identification as a victim of sexual abuse and to gender differences in self-defined victimization. Hierarchical logistic regression was used to estimate the relationship of demographic and CSE characteristics with self-definitions. The characteristics most strongly associated were threats--force, incest, and younger age at the time of the experience. Men were less likely than were women to acknowledge abuse and to report CSE characteristics indicative of abuse. Women were more likely to identify themselves as victims the more CSEs they reported involving sexual penetration. Finally, in an analysis of familial abuse, men were more likely to define themselves as victims if the perpetrator was also male. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconstructing safety: Adjustments to the therapeutic frame in the treatment of survivors of political torture.

What are the special needs in the treatment of survivors of political torture? This article examines the issues of safety and power within the therapeutic relationship and calls for adjustments to conventional techniques, such as the therapeutic frame, to accommodate the needs of survivors. Understanding the context of the survivor's experience of loss of safety and control during the torture experience and promoting the empowerment of the survivor guide the development of the necessary treatment modifications. With these adjustments, the therapeutic process is likely to avoid the revictimization of the survivor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural adaptation of a group treatment for Haitian American adolescents.

As the psychology field moves towards establishing more evidence-based treatment (EBT), the applicability of EBT for different racial and immigrant groups (i.e., African American, Asian Americans and Pacific Islander, and Native American/Native Alaskan) is paramount. The current paper highlights the process of culturally adapting an EBT group cognitive behavioral therapy (CBT) intervention for use with Haitian American adolescents diagnosed with depression. Overall the main objective of this project was to culturally adapt the Adolescent Coping with Depression Course (ACDC) to ensure that it includes cultural factors that are likely to engage and retain Haitian adolescents in mental health treatment. The paper summarizes the cultural training of the focus group leaders, the focus group sessions with a group of Haitian middle-school students, and the feedback received from the participants regarding the intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)