Psychological torture

From Nature:

The long-term mental anguish caused by psychological torture and humiliating treatment is comparable to that caused by physical torture, a new study indicates. The results, say the study's authors, support the prohibition of psychological torture by international law.

The findings are particularly important given recent debate over how the United States defines torture. The United Nations Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment defines it as "severe suffering, whether physical or mental".

But the US Department of Defense has argued for a definition of torture that does not include many acts of psychological abuse, including humiliating treatment, isolation, or deprivation of sleep, food, or medical care. The implication is that these psychological acts aren't as serious, says Metin Basoglu of King's College University in London, lead author of the new study.

Basoglu and his colleagues studied the effects of psychological abuse in 279 survivors of torture during the war in former Yugoslavia. Nearly all of the participants had been beaten, humiliated and threatened with death. Participants were asked to rank the distress caused by different assaults on a scale of zero to four.

The results, published this week in Archives of General Psychiatry, showed that many forms of psychological abuse ranked as high as physical torture. Fondling of genitals or witnessing a sham execution, for example, scored an average 3.7 out of 4, higher than forced extraction of teeth (3.6) and stretching of the body (3.5), and nearly as high as the most distressing assault: rape, which was rated at 3.9.

Clinicians in torture rehabilitation centres have noted this anecdotally for decades, says David Eisenman, a doctor of internal medicine at the University of California, Los Angeles. "People who have the greatest mental distress are not necessarily the people who are physically injured by the event," says Eisenman. "I've seen many patients where a sham execution was the sole event that destroyed them psychologically."

The United States government has argued, for example, that classifying an interrogation technique as a cause of "severe mental pain or suffering" requires proof that it triggers post-traumatic stress disorder (PTSD), a complex anxiety condition that sometimes arises after a traumatic event. Their argument is based in part on a previous analysis from Basoglu showing that torture survivors have higher rates of PTSD.