Torture Journal

This article was published in the journal TORTURE, Volume 5, Number 4, 72-76 p. 1995, and reproduced with the kind authorization of the publisher.

OBJECTIVE: To characterize physical and mental health in trauma exposed refugees by describing a population of patients with regard to background, mental health history and current health problems; and to identify pre- and post-migratory predictors of mental health. METHOD: All patients receiving treatment at the Psychiatric Trauma Clinic for Refugees in Copenhagen from April 2008 to February 2010 completed self-rating inventories on symptoms of PTSD, depression and anxiety as well as level of functioning and quality of life before treatment. Then, associations of pre and post migratory factors with mental health were explored using linear and logistic regression and Pearson's correlation coefficients. RESULTS: Among the patients, the prevalence of depression, somatic disease, pain, psychotic symptoms co-existing with PTSD and very low level of functioning was high. Persecution, being an ex-combatant and living currently in social isolation were significantly associated with PTSD arousal symptoms and self-reported pain. CONCLUSIONS: New treatment modalities should seek to address all of the symptoms and challenges of the patients including psychotic and somatic symptoms and social isolation, and studies of treatment effect should clarify all co-morbidities so that comparable populations can be included in treatment evaluation studies.

This research describes the development and findings of a literature review and analysis meant to inform the international torture and trauma treatment community. The review focuses on interventions that have been used among populations affected by torture, based on a review of journals indexed in commonly used search engines. Work on the review began in September 2008 and continued to be updated until March 2014. In total, 88 studies of interventions for torture victims were identified. Studies ranged from randomized controlled trials utilizing evidence-based treatments to case studies employing non-structured, supportive therapies. Based on the results of the analysis, we have included recommendations for interventions that demonstrate effectiveness in treating survivors of torture and other systematic violence who suffer from PTSD, depression and anxiety. Priorities for mental health research for survivors of torture and other systematic violence are also recommended.

Before their entry into the rehabilitation program at the Rehabilitation and Research Centre for Torture Victims ('RCT') in Copenhagen, the degree of symptoms of a group of resettled traumatized refugees was assessed by means of two rating scales: the Disability Rating Index (DRI) (n=197), measuring pain-related functional disability, and the Hospital Anxiety and Depression Scale (HADS) (n=147). The results obtained were compared with other patient populations, which included (1) a large Swedish mixed pain group and (2) various groups of pain patients previously investigated in the validation study of the DRI scale. The DRI scores of the refugee group were comparable to, or higher than, those of the pain groups, except for patients suffering from multiple sclerosis. The degree of anxiety and depression was found to be considerably greater in the refugee group than in the pain groups. Another recently published Danish study comparing traumatized refugees with psychiatric in-patients in terms of Health of Nation Outcome Scores (HoNOS) documented a higher degree of psychiatric disability for refugees. Based on the hypothesis that the observed differences in this study were underestimated due to the exclusion of refugees with psychotic symptoms and substance abuse, a partial re-analysis of the data was carried out by calculating effect sizes with and without the items measuring these symptoms. Controlling for the exclusion of the critical items resulted in a more pronounced difference between the refugees and psychiatric inpatients. Based on the data compared in this study, traumatized refugees are shown to suffer from multiple problems, including chronic pain, at a high symptom-level. This challenges prior clinical assumptions that single factors like PTSD can explain all symptoms.

BACKGROUND: Following resettlement in Australia, young traumatized refugees often face social challenges, including language and cultural barriers and social adjustment, which can lead to behavioral difficulties. Providing support at this vulnerable stage is therefore vital for reducing future setbacks. OBJECTIVE: The STARTTS Capoeira Angola program was developed to help traumatized adolescents successfully integrate into their school environments. As an Afro-Brazilian martial art that incorporates dance, Capoeira appeared an appropriate intervention for adolescent refugees due to its unique ethos of empowerment and group membership. METHOD: 32 refugeesfrom Middle Eastern and African countries (aged12-17) from the Intensive English Centre (IEC) department of the participant schools were assessed pre- and post- intervention using the Teacher's Strengths and Difficulties Scale (SDQ). Teachers were also asked to observe the students' functioning in a range of different situations at school. RESULTS/CONCLUSIONS: A significant overall decrease in behavioral problems was observed, which was associated with improvements in interpersonal skills, confidence, respect for self and others, self-discipline, and overall sense of responsibility.

METHODS: The authors conducted a systematic review of scholarly journals and manuscripts. The search was limited to articles published in English that focused on group treatment with torture survivors. FINDINGS: The authors identified 36 articles and chapters for review describing a variety of group interventions for survivors of torture, including: • Supportive Group Therapy • Empowerment Workshops • Group Treatment for Sleep Disorders • Den Bosch model • Wraparound approach • Stage-oriented model The literature examined varied in approach and format: present-day and past-focused groups; structured, time-limited groups; and flexible, ongoing support groups. The studies took place in diverse locations, including Denmark, Germany, Guinea, Namibia, the Netherlands, Palestine, Serbia, the U.S., the UK, and Zimbabwe, and, in conflict, post-conflict and/or humanitarian settings. The interventions were facilitated by licensed mental health professionals, paraprofessionals, and bilingual/bicultural staff - or a combination of the latter two. INTERPRETATIONS: Group treatment is an approach which can be administered to larger groups of survivors to address a range of treatment issues. The authors examined key clinical practice issues for group treatment including group composition and content, facilitation and measurement strategies. While the literature does provide a compelling conceptual rationale for using group treatment, the empirical literature is in fact very limited at this time, and needs to be strengthened in order to build confidence in outcomes across contexts and survivor communities. CONCLUSIONS: This paper points to a growing interest in the topic of group treatment for survivors of torture and severe violence, providing a comprehensive picture of group-based interventions and highlighting the need for additional research and knowledge-building.

BACKGROUND: Torture survivors face multiple problems, including psychological difficulties, whether they are refugees or remain in the country where they were tortured. Provision of rehabilitation varies not only with the needs of survivors and resources available, but also with service models, service provider preferences and the local and country context. Despite increasing efforts in research on effectiveness of psychological interventions with torture survivors, results are inconclusive. METHODS: We undertook a Cochrane systematic review of psychological, social and welfare provision, with meta-analysis to best estimate efficacy. The process raised conceptual, methodological and ethical issues of relevance to the wider field. FINDINGS: We searched very widely, but rejected hundreds of papers which recommended treatment without providing evidence. We found nine randomised controlled trials, from developed and under-resourced settings. All conceptualised survivors' problems in psychiatric terms, using outcomes of post-traumatic stress symptoms, distress, and quality of life, by self-report, with or without translation or unstandardised interpretation, and with little mention of cultural or language issues. None used social or welfare interventions. Four related studies used narrative exposure therapy (NET) in a brief form, and without ensuring a safe setting as recommended. Five used mixed methods, including exposure, cognitive behavioural therapy, and eye movement desensitisation. Combined, the studies showed no immediate improvement in PTSD, distress, or quality of life; at six months follow-up, a minority showed some improvement in PTSD and distress, although participants remained severely affected. CONCLUSIONS: While applauding researchers' commitment in running these trials, we raise ethical issues about exposure in particular, and about the effects of shortcomings in methodology, particularly around assessment using unfamiliar cultural frameworks and language, and the lack of concern about dropout which may indicate harm. The issues addressed aid interpretation of existing research, and guide clinical practice as well as future studies evaluating its effectiveness.

The article presents the recently launched Principles on Effective Interviewing for Investigations and Information Gathering.

UNLABELLED: Basic Body Awareness Therapy (BBAT) is a form of physiotherapy that is often used for psychiatric patients in Scandinavian countries. To our knowledge there has not been any studies investigating BBAT as a treatment for traumatised refugees until now. OBJECTIVE: To explore the compliance, acceptability and treatment satisfaction using group BBAT in traumatised refugees. To study changes in psychiatric and somatic symptoms as well as quality of life, level of functioning and quality of movement during treatment with BBAT. METHOD: All Arabic speaking patients that previously had received treatment at the Competence Centre for Transcultural Psychiatry in Copenhagen from April 2008 to June 2009 were invited to participate (N=29). Nine persons were included in a male (N=4) and female (N=5) group. All participants were traumatised refugees. The BBAT treatment consisted of 14 sessions over a period of 14 weeks. Before and after treatment the participants were interviewed using a semi-structured interview guide. The interviews were transcribed and analysed with a thematic approach. The participants also filled out self-administrated questionnaires and two physiotherapists tested the participants' movement harmony using the Body Awareness Rating Scale-Movement Harmony (BARS-MH) test. At the end of the study, the participants filled out anonymous questionnaires about treatment satisfaction. RESULTS: The results showed that the participants had a high compliance, acceptability and treatment satisfaction with BBAT. The majority of participants showed improvements in symptoms from baseline to post-intervention on the self-administrated questionnaires and in the BARS-MH test. CONCLUSIONS: Further research is needed to expand the scientific knowledge regarding the use of BBAT in traumatised refugees. If future research can confirm our positive findings it will have a considerable impact on future treatment designs and for the individual patient.

PURPOSE: To describe change in mental health after treatment with antidepressants and trauma-focused cognitive behavioral therapy. METHODS: Patients receiving treatment at the Psychiatric Trauma Clinic for Refugees in Copenhagen completed self-ratings of level of functioning, quality of life, and symptoms of PTSD, depression and anxiety before and after treatment. Changes in mental state and predictors of change were evaluated in a sample that all received well-described and comparable treatment. RESULTS: 85 patients with PTSD or depression were included in the analysis. Significant improvement and effect size were observed on all rating scales (p-value <0.01 and Cohen's d 45-0.68). Correlation analysis showed no association between severity of symptoms at baseline and the observed change. CONCLUSION: Despite methodological limitations, the finding of a significant improvement on all rating scales is important considering that previous follow-up studies of comparable patient populations have not found significant change in the patients'condition after treatment.

Introducción: Se analizan las entrevistas de dos proyectos de investigación-acción participativa para comprender los impactos de la tortura y las expresiones de resiliencia en ex presos políticos venezolanos, con énfasis en los aspectos relacionales tanto de los impactos de la tortura como de las estrategias de resiliencia. Métodos: Se analizaron y codificaron treinta entrevistas de un primer proyecto mediante análisis temático reflexivo, y ocho entrevistas de un segundo proyecto para refinar las categorías. Resultados: Además de los resultados que replican hallazgos reportados en otros estudios sobre el sufrimiento individual, estas entrevistas, desarrolladas en colaboración con ex presos políticos y sus familias, revelan una dimensión menos documentada relacionada con la importancia de las relaciones. El aislamiento, presenciar la tortura de otros y sufrir lo que imaginan que sufren sus familiares se consideraron las consecuencias más angustiantes. También profundizamos en los hallazgos, reportados en otros contextos, sobre la importancia de la resiliencia en sus testimonios. La resiliencia, interpretada a la luz de lo que la opresión intenta lograr, se categoriza como las estrategias para recuperar la agencia y las estrategias para mantener las relaciones. Discusión: Se analiza la relevancia de centrarse en la importancia de las relaciones y la resiliencia al trabajar con sobrevivientes de tortura como una forma de reconocer sus perspectivas y fortalecer su resistencia. También se analiza el uso de la investigación-acción participativa como un enfoque ético que busca empoderar a los sobrevivientes durante el desarrollo del proceso.

Асноўныя палажэнні У гэтай выбарцы эміграваных былых беларускіх палітычных зняволеных рэспандэнты апісвалі катаванні і жорсткае абыходжанне як рэгулярны досвед, які пачынаўся падчас затрымання і працягваўся праз дасудовае ўтрыманне пад вартай, адбыванне пакарання і перыяд пасля вызвалення. Псіхалагічны ціск і зневажальныя практыкі займалі цэнтральнае месца ў аповедах рэспандэнтаў. Інфармацыйная ізаляцыя, разлучэнне з блізкімі, прыніжэнне, адмова ў медыцынскай дапамозе, штрафная ізаляцыя і прымусовая залежнасць ад адміністрацыі ўстановы паведамляліся як частка асяроддзя зняволення, а не толькі як асобныя інцыдэнты. Дакументаванне, рэабілітацыя і медыка-прававая ацэнка павінны ўключаць як фізічныя, так і псіхалагічныя формы катаванняў і жорсткага абыходжання, а таксама падчас ацэнкі стану былых палітычных зняволеных у выгнанні ўлічваць пасляпенітэнцыярную небяспеку і звязаныя з міграцыяй стрэсары.

This review explores Tortured as a Child: Torture, Forced Migration and the Right to Rehabilitation (Johansson Metso, 2026), an interdisciplinary anthology from the Swedish Red Cross Competence Center for the Rehabilitation of Torture and War Trauma. The book addresses the limited recognition of children as victims of torture and the resulting gaps in identification, documentation, and access to rehabilitation. It makes a timely and urgent contribution to a field where both clinical practice and legal frameworks remain underdeveloped, highlighting the consequences of continued invisibility for affected children. The volume brings together seven chapters from experts in law, psychology, paediatrics, and neuropsychology. It highlights key challenges such as difficulties in distinguishing trauma from developmental conditions, ethical and methodological issues in interviewing children, and the lack of legal precedent on child torture cases. The anthology also presents emerging approaches to treatment and assessment, including intensive short-term therapy models and structured clinical tools, though the evidence base remains limited. Overall, the book argues that children subjected to torture remain largely invisible within both legal and healthcare systems. It constitutes an important contribution to bridging disciplinary gaps and strengthening interdisciplinary collaboration, with the aim of improving recognition, protection, and access to rehabilitation services.

Introduction: Article 18(1) of the Federal Democratic Republic of Ethiopia (FDRE) Constitution prohibits cruel, inhuman or degrading treatment without naming torture. Routine human rights monitoring has treated the omission as a textual matter that interpretation under Articles 13(2) and 9(4) repairs. The article argues that the interpretive solution understates the legal consequences of the omission, which extend across constitutional non-derogation, criminalisation, and transitional justice. Methods: The study applies doctrinal legal analysis combining constitutional and criminal-law interpretation, treaty interpretation under the Vienna Convention, examination of the work of the Committee against Torture and the jurisprudence of the International Court of Justice and other tribunals, contemporary documentation from international and African civil society networks, and comparative analysis of standalone anti-torture statutes in Uganda, South Africa, and Nigeria. Results: The omission produces three orders of consequence. At the constitutional level, Article 93(4)(c) protects only what Article 18 textually names, leaving emergency protection of torture dependent on interpretive performance in a system with limited judicial review. At the criminal-law level, Article 424 is not an autonomous offence of torture, Articles 270 to 272 capture torture only conditionally as a war crime, and crimes against humanity remain uncriminalised as a discrete international offence. At the prospective level, the 2024 Transitional Justice Policy mentions torture but does not perform the legal work that naming requires, leaving the draft Proclamation at risk of inheriting the deficit. Discussion: Drawing on three African comparators, the article specifies seven legislative elements that corrective legislation must contain to align Ethiopian law with the Convention against Torture and to support practice in investigation, charging, evidentiary exclusion under Article 15, victim recognition, and accountability.

Introduction: Palestinian detainees held during the October 2023 war have widely reported torture, but quantitative studies jointly assessing depression, anxiety, and post-traumatic stress disorder (PTSD) remain rare. We aimed to characterise the prevalence, severity, and comorbidity of these conditions and to examine demographic and detention-related predictors. Methods: In this cross-sectional study, we recruited 383 Palestinian adults detained by Israeli authorities during the October 2023 war, subsequently released, and reporting torture. Participants were recruited through rehabilitation centres, human rights organisations, and community networks in Gaza, and completed Arabic-language PHQ-9, GAD-7, and PCL-5 measures in structured, trauma-informed interviews between late 2025 and early 2026. Multiple linear regression assessed predictors of symptom severity, and regression-based path analysis examined the pathway from cumulative torture exposure to depression through PTSD. Results: 76.75% scored in the moderate-to-severe range on the PHQ-9, 65.50% on the GAD-7, and 68.50% met the PCL-5 threshold for probable PTSD. The three conditions were strongly intercorrelated (r = 0.59–0.66, p < .0001), with 49.35% meeting thresholds for all three. Education was the only demographic variable significantly associated with depression, anxiety, and PTSD severity, though models explained under 3% of variance; age, gender, detention duration, and cumulative torture exposure were not significant predictors. PTSD severity was strongly associated with depression, whereas cumulative torture exposure was not significantly associated with either outcome. Internal consistency was good (Cronbach's α = 0.80–0.91). Discussion: Palestinian detention survivors showed an extremely high and highly comorbid burden of depression, anxiety, and PTSD. The near-ceiling torture exposure in this sample may help explain the limited predictive power of individual demographic and exposure variables. These findings support integrated, trauma-informed mental health care and continued human rights documentation for this population. torture, detention, PTSD, depression, comorbidity

Lutz Oette, The Transformation of the Prohibition of Torture in International Law (Oxford University Press 2024), 368 pp. Sara López Martín

Debate about interrogational torture still returns to the ticking-bomb scenario, despite the weight of evidence that it neither works nor withstands moral scrutiny. The post-9/11 record, from Abu Ghraib to the CIA black sites, already marked a decisive shift toward psychological forms of coercion. The technologies now emerging make a different kind of coercion possible. This paper argues that defence-funded brain-computer interfaces, of which Synchron's Stentrode is the clearest current example, combined with large language models and fusion databases, could support what I call nano-totalitarianism: the convergence of pervasive personal data, neurodata, adaptive AI, and technologically mediated coercion in ways that could penetrate or continuously condition the inner sphere of the person. Operationalised, this is a self-sustaining regime in which a detainee is held in continuous psychological distress through fabricated scenarios, interference with memory, and synthetic social contact. Such a system would turn neuroplasticity into an instrument, laying down durable neural pathways of fear, while automated monitoring assesses compliance in real time. Its lineage runs from MKULTRA's psychochemical experiments to the extraction logic of surveillance capitalism, and its endpoint is a panopticon inside the skull. The essay proceeds anticipatorily, distinguishing throughout between demonstrated current capability, plausible convergence of existing components, and speculative future possibility.

Introduction: Political imprisonment is associated with long-term psychological harm, but evidence from Eastern and Central Europe, particularly Belarus, remains limited. After the 2020 post-election crackdown, many former Belarusian political prisoners live in emigration, yet their experiences of torture and ill-treatment have not been systematically documented. Methods: We conducted a cross-sectional survey of 77 former Belarusian political prisoners who had been criminally prosecuted on political grounds, detained or imprisoned, and subsequently emigrated. The online questionnaire covered detention history, physical and psychological violence and ill-treatment, suicidality in custody, subjective stressors, and perceived purposes of violence. Six semi-structured interviews were used to contextualise and illustrate the quantitative findings. Results: The assessments took place a median of 11 months after emigration. Violence at arrest was reported by 85.7% of respondents. During imprisonment, with a median duration of 30 months, physical torture or ill-treatment was reported by 88.3% and psychological torture or ill-treatment by 98.6%; 54.8% endorsed ten or more psychological categories. Punitive isolation was reported by 52.1%, suicidal thoughts in custody by 30.1%, self-harm by 12.3%, and suicide attempts by four respondents. Loneliness and separation from relatives were rated as the most severe stressor. Humiliation of the person (81.9%) and submission or suppression of the person (80.6%) were the most common perceived purposes of violence. Discussion: Respondents described a systematic pattern of physical, psychological, and degrading abuse from arrest through imprisonment and into post-release migration. Psychological and degrading forms of ill-treatment were central and converged with the political framing of detention. Findings support revised Istanbul Protocol–based assessment, documentation, and rehabilitation, with imprisonment, release under continuing risk, and forced migration treated as a single exposure trajectory.

Introduction: The interviews from two participatory action research projects are analysed to understand the impacts of torture and the expressions of resilience found in former political prisoners of Venezuela, with an emphasis on the relational aspects of both the impacts of torture and the strategies used for resilience. Methods: Thirty interviews from a first project were analysed and coded using reflexive thematic analysis, and eight interviews from a second project were analysed to refine the categories. Results: In addition to replicating findings reported elsewhere on individual suffering, these interviews, developed in collaboration with former political prisoners and their families, reveal a less-reported strand concerning the importance of relationships. Being isolated, witnessing the torture of others and suffering from what they imagine their family members to be suffering were considered the most distressing consequences. We also expand on the findings reported in other contexts regarding the importance of resilience in their testimonies. Resilience, interpreted in light of what oppression seeks to achieve, is categorised into strategies to regain agency and strategies to sustain relationships. Discussion: The relevance of focusing on the importance of relationships and of resilience when working with survivors of torture as a way to acknowledge their perspectives and empower their resistance is discussed. The use of participatory action research as an ethical approach that seeks to empower survivors throughout the process is also discussed.

Introduction: Although State Parties to the United Nations Convention against Torture (UNCAT) are called on to criminalise torture in domestic law by the Committee against Torture, national legislation varies considerably in both the adoption and design of torture offences. This article examines how states have domesticated UNCAT’s prohibition of torture, focusing in particular on whether domestic criminalisation limits criminal liability to state-linked perpetrators or extends it to a broader range of nonstate actors. Method: Drawing on original global data on domestic torture legislation, the article maps patterns in the criminalisation of torture across UNCAT State Parties. It complements this analysis with qualitative case studies of Uganda and Kenya, using theories of the domestic implementation of international human rights obligations to explore how international commitments, domestic political dynamics, institutional and legal frameworks, and historical experiences of violence shaped different legislative approaches. Results: The findings reveal substantial variation in how States criminalise torture. Drawing on the new dataset, the article shows that nearly two-thirds of State Parties have criminalised torture as an autonomous crime, and around a quarter of these extend criminal liability to all nonstate actors. The case studies suggest that while international commitments encouraged legislative reform in both countries, different combinations of strategic adaptation, institutional and legal fit, and historical patterns of violence contributed to divergent legislative designs. Uganda adopted a broad definition encompassing private actors as torture perpetrators, whereas Kenya largely retained UNCAT’s state-centred approach. Conclusions: The findings indicate that international human rights obligations are not incorporated uniformly into domestic law but are interpreted and adapted through domestic political, institutional, and historical contexts. By shifting attention from whether states criminalise torture to how they design torture legislation, the article contributes to scholarship on the domestication of international human rights law and offers new hypotheses about the sources of variation in national anti-torture legislation in terms of the definition and scope of torture perpetrators.