The psychological impact of torture and other types of systemic abuse

© 2011 Dr. Maritza ThompsonConcerns continue to be raised worldwide about the psychological impact of torture and other types of systemic abuse. Few controlled studies have investigated psychological distress resulting from torture and other systemic abuse or from the asylum seeking processes itself. No study has taken into account the impact of systemic abuse on the subjective ‘self view’. By contrast, this thesis compares the degree of psychological distress, and ‘self views’ between three groups: survivors of torture, survivors of other types of systemic abuse, and a control group who experienced neither. It was expected that torture survivors would present with higher levels of psychiatric symptoms and greater negative self views compared to the other two groups. Similarly, it was predicted that survivors of other types of systemic abuse would present with higher levels of psychiatric symptoms and greater negative ‘self views’ compared to the control group. A further question concerns residential status, that is, whether asylum seekers in detention have higher levels of distress and changes in ‘self-view’ compared to asylum seekers living in the community and those with permanent residency who never experienced the asylum seeking process. It was expected that asylum seekers in detention would present more negatively compared to asylum seekers in the community. It was also expected that asylum seekers in the community would present with greater psychiatric symptoms and negative ‘self views’ than permanent residents. These hypotheses were tested in a sample of 259 people using a comprehensive methodology that included a semi-structured interview incorporating the structured interview for PTSD, the Global Assessment of Functioning and the ICD-10 for personality change. The interviews included three self report psychiatric scales: the SCL- 90-R, The Impact of Event Scale, and The Repertory Grid (measuring ‘self views’). Although torture survivors presented with increased psychiatric symptoms, there was no significant difference between torture survivors and survivors of other types of systemic abuse as measured by the IES and PTSD. Survivors of other systemic abuse presented with greater psychiatric symptoms than the control group on PTSD and IES measures, but not for the SCL-90-R. Torture survivors’ ‘self views’ were more negative than the other two groups but not for present and future views of self. There was no difference between torture survivors and survivors of other systemic abuse on the GAF. There were significant differences between these groups on personality change. The hypothesis that asylum seekers in detention will present with greater psychological distress and more negative ‘self views’ was not clearly confirmed. In fact, asylum seekers living in the community presented with greater psychological distress than both other categories as measured by the SCL-90. Both asylum seeker categories presented with greater PTSD symptoms than permanent residents; however, there was no significant difference between the two asylum seeker categories. There was no difference between the three residential categories on the GAF. There were significant differences between these categories on personality change and ‘self view’. The results are discussed in relation to: other studies, complexity of symptom presentation, ‘self views’ and resilience of survivors. The consequences of systemic abuse and asylum seeking are complex and worthy of further research