A controlled study on the predictors of torture-related chronic post-traumatic stress disorder among political torture survivors

Paker, M. (1992). A controlled study on the predictors of torture-related chronic post-traumatic stress disorder among political torture survivors. Unpublished MA thesis. Istanbul, Turkey: Bogazici University.

Abstract

The aims of this study are a) to conduct a comparative survey of the psychological disturbances (particularly post-traumatic stress disorder – PTSD) of torture survivors and non-tortured controls, b) to investigate some additional psychological effects of torture, c) to identify some of the factors which predict torture-related PTSD. While much has been written about the psychological effects of torture, there are few controlled studies of its psychological impact. The results of these studies are suggestive of an independent effect of torture per se, but their methodological problems preclude definitive conclusions on this issue. Thus there is no study which takes into account the potential effects of all intervening variables. In this study, it was hypothesized that PTSD would be more commonly encountered in torture survivors than controls, torture survivors would be more depressive and anxious than controls. Additionally a series of factors expected to predict PTSD were stated.
The subject sample consisted of 55 tortured political ex-detainees/prisoners and 55 non-tortured political controls matched for age, sex, educational level. Socio-demographic characteristics of the two groups were very similar. The tortured group was more politically involved, and was detained and imprisoned longer than were controls. The sample was a particularly severely tortured group. The time of the torture trauma on the average was relatively old, thus any psychological problems related to torture were chronic. The two groups differed only on the diagnosis of PTSD among all DSM-III-R diagnoses. Although the tortured group scored higher on most of the depression and anxiety scales, all scores were within the normal range. A higher degree of perceived severity of torture, lower social/emotional support, more impact of other traumatic events, more intense torture, and higher political involvement were found to be predictors of PTSD.

The results show that 1) torture has some psychological effects independent from the other forms of political repression and organized violence, 2) the relatively low incidence of severe psychological problems among severely tortured survivors requires that the term of ‘torture victim’ should be abandoned, 3) the impact of other traumatic experiences, cross-cultural differences, value differences, subjective meaning of the trauma, individual differences, and personality characteristics should be taken into account in order to develop a more holistic approach for understanding / explaining / treating (post-torture) traumatic stress, 4) social/emotional support is the most important factor in preventing traumatic stress.