Arch Gen Psychiatry: Torture vs Other Cruel, Inhuman, and Degrading Treatment

What
can you say?  



Arch Gen Psychiatry is one of those non-open-access journals that
publishes one free-access article in each issue.  Usually the
free article is not particularly interesting; they do not seem to make
use of the open-access articles routinely to make material of general
public interest available to all.  This is an exception.



At first, I was almost offended that this article was published.
 Why bother to even pose the question?  The question,
in this case, being whether there is any scientific basis for
distinguishing between torture and other bad things.

href="http://archpsyc.ama-assn.org/cgi/content/full/64/3/277">Torture
vs Other Cruel, Inhuman, and Degrading Treatment

Is the Distinction Real or Apparent?

Metin Basoglu, MD, PhD; Maria Livanou, PhD; Cvetana Crnobaric, MD

Arch Gen Psychiatry. 2007;64:277-285.

Context  After the reports of human
rights
abuses by the US military in Guantanamo Bay, Iraq, and Afghanistan,
questions have been raised as to whether certain detention and
interrogation procedures amount to torture.



Objective  To examine the distinction
between various forms of ill treatment and torture during captivity in
terms of their relative psychological impact.



Design and Setting  A cross-sectional survey was
conducted with a population-based sample of survivors of torture from
Sarajevo in Bosnia and Herzegovina, Banja Luka in Republica Srpska,
Rijeka in Croatia, and Belgrade in Serbia.



Participants  A total of 279 survivors of
torture accessed through linkage sampling in the community (Banja Luka,
Sarajevo, and Rijeka) and among the members of 2 associations for war
veterans and prisoners of war (Belgrade).



Main Outcome Measures  Scores on the
Semi-structured Interview for Survivors of War, Exposure to Torture
Scale, Structured Clinical Interview for DSM-IV, and
Clinician-Administered PTSD (posttraumatic stress disorder) Scale for
DSM-IV.



Results  Psychological manipulations,
humiliating treatment, exposure to aversive environmental conditions,
and forced stress positions showed considerable overlap with physical
torture stressors in terms of associated distress and
uncontrollability. In regression analyses, physical torture did not
significantly relate to posttraumatic stress disorder (odds ratio,
1.41, 95% confidence interval, 0.89-2.25) or depression (odds ratio,
1.41, 95% confidence interval, 0.71-2.78). The traumatic stress impact
of torture (physical or nonphysical torture and ill treatment) seemed
to be determined by perceived uncontrollability and distress associated
with the stressors.



Conclusions  Ill treatment during
captivity, such as psychological manipulations, humiliating treatment,
and forced stress positions, does not seem to be substantially
different from physical torture in terms of the severity of mental
suffering they cause, the underlying mechanism of traumatic stress, and
their long-term psychological outcome. Thus, these procedures do amount
to torture, thereby lending support to their prohibition by
international law.

I recall when a certain President was derided for hair-splitting,
arguing about what the definition of "is" is.  I also remember
being derisive of another President (and Alberto Gonzales -- remember
him?)  trying to split hairs about what "torture" is.
 



Both seemed kind of ridiculous, but one is funny whereas the other is
deadly serious.  I don't know why I thought of that.
 Comic relief, maybe?



It seems doubtful that anyone who is serious about being in one of the
helping professions would wonder if there is a meaningful distinction
between torture and "Other Cruel, Inhuman, and Degrading Treatment."
 On the other hand, sometimes it makes sense to try to
evaluate, with some degree of objectivity, whether that which seems
obvious, is in fact correct.  I think that is what this
article is about.  



They find what one would expect:

COMMENT



The
present study results suggest that psychological stressors cannot
be easily distinguished from physical torture in terms of their
relative psychological impact. Although physical torture methods were
rated as somewhat more distressing than some stressors that did not
involve severe physical pain, certain other stressors, such as sham
executions, threats of rape, sexual advances, threats against self or
family, witnessing the torture of others, humiliating treatment,
isolation, deprivation of urination/defecation, blindfolding, sleep
deprivation, and certain forced stress positions, seemed to be as
distressing as most physical torture stressors. These findings suggest
that physical pain per se is not the most important determinant of
traumatic stress in survivors of torture.

This article seems to be a refutation of what was reported earlier in href="http://www.foxnews.com/story/0,2933,160688,00.html">Fox
News:

Last
week, human rights investigators for the United Nations urged the
U.S. to allow them inside to inspect the facility. They cited
"persistent and credible" reports of "serious allegations of torture,
cruel, inhuman and degrading treatment of detainees" as well as
arbitrary detentions and violations of rights.



In
response, Vice President Dick Cheney told CNN on Thursday that the
detainees are well treated, well fed and "living in the tropics."

I can't help but wonder: if any American officials are ever convicted
of war crimes, and end up at Guantanamo, will they still refer to it as
"living in the tropics?"