The epidemiology of torture: A case series of 58 survivors of torture

Sanders, James E.; Wagner-Schuman, Melissa; Marbella, Anne

doi:10.1016/j.forsciint.2009.03.026

Cited by 13 publications

(15 citation statements)

References 12 publications

(15 reference statements)

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“…Research on who are most susceptible to post‐traumatic distress after torture points to a lack of social support, the number of times detained for political reasons, strong religiousness, and female gender . In agreement with the present findings, female refugees appear to be at a greater risk of sexual abuse , which is a known risk factor for dental anxiety, especially when the abuse involved oral penetration .…”

Section: Discussionsupporting

confidence: 86%

Dental anxiety in relation to torture experiences and symptoms of post‐traumatic stress disorder

Høyvik

Lie

Willumsen

2018

European J Oral Sciences

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Torture victims often show symptoms of dental anxiety when receiving dental care, but little systematic research is available. The purpose of this study was to explore torture experiences, symptoms of post‐traumatic stress disorder (PTSD), and dental anxiety in refugees in Norway and to test the hypothesis that refugees with torture experiences are more prone to dental anxiety than refugees with no such experiences. A total of 173 refugees were interviewed shortly after an oral examination. The Modified Dental Anxiety Scale (MDAS) and the Harvard Trauma Questionnaire‐PTSS16 were administered verbally through attending interpreters. Among torture victims (47%, n = 81), the prevalence of torture experiences involving mouth or teeth was 35% and 23%, respectively. Harvard Trauma Questionnaire mean sum scores were statistically significantly higher in torture victims (34.3 vs. 24.8). Torture survivors report a larger number of symptoms of PTSD, and dental anxiety shows a higher prevalence in refugees reporting PTSD symptoms than in refugees who do not report such symptoms. When analysed using logistic regression models, the data showed the odds of high levels of dental anxiety being 6.1 times higher in refugees with torture experiences compared with other refugees and 9.3 times higher in torture victims with PTSD symptoms. Oral health professionals should be aware of these associations when providing dental care to refugees. The hypothesis that tortured refugees are more prone to dental anxiety is supported.

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Section: Discussionsupporting

confidence: 86%

Dental anxiety in relation to torture experiences and symptoms of post‐traumatic stress disorder

Høyvik

Lie

Willumsen

2018

European J Oral Sciences

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“…Self‐reporting has been demonstrated to have a sensitivity of 82% and a specificity of 92% 32,33 . Family is included in this screening instrument, as physical torture is frequently directed toward family members to inflict psychological terror and coerce subjects 34,35 . While the modified DTSS has not been tested in an ED population, there are no other validated screening instruments available that would allow effective administration in an ED setting.…”

Section: Methodsmentioning

confidence: 99%

Survivors of Torture: Prevalence in an Urban Emergency Department

Hexom

Fernando

Manini

et al. 2012

Academic Emergency Medicine

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Objectives: Torture has been documented in 132 countries, and approximately 400,000 survivors of torture reside in the United States. It is unknown if torture survivors seek medical care in emergency departments (EDs). The authors set out to estimate the prevalence of survivors of torture presenting to an urban ED.Methods: A cross-sectional survey of ED patients was performed by convenience sampling from October 2008 to September 2009 in a large urban teaching hospital in New York City. ED patients not of a vulnerable population were consented and entered into the study. Participants were asked two screening questions to ascertain if they were self-reported survivors of torture. For exploratory purposes only, these individuals were further queried about their experiences. The detailed responses of these self-reported survivors of torture were compared to the United Nations Convention Against Torture (UNCAT) definition by a blinded, independent panel.Results: Of 470 study participants, 54 individuals (11.5%, 95% confidence interval [CI] = 8.6% to 14.4%) self-reported torture. Nine (16.7%) had ongoing physical disabilities, 30 (55.6%) had recurrent intrusive and distressing memories, 42 (77.8%) never had a physician inquire about torture, and only eight (14.8%) had requested political asylum. Of these self-reported survivors of torture, 29 (53.7%) met the UNCAT definition, for an adjudicated prevalence of 6.2% (95% CI = 4.3% to 8.7%).Conclusions: Self-reported survivors of torture presented to this urban ED, and a significant proportion of them met the UNCAT definition of a torture survivor. Continuing torture-related medical and psychological sequelae were identified, yet there was a low rate of asylum-seeking. Only a minority were previously identified by a physician. These data suggest an unrecognized public health concern and an opportunity for emergency physicians to intervene and refer survivors of torture to existing community resources.

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“…This is in accordance with findings of many previous studies, which generally describe an incidence of 95-100%. [6][7][8][10][11][12][13] Some authors report a lower incidence of blunt force trauma against females. For instance, Masmas et al 3 reported an incidence of 78%, whereas Edston and Olsson 12 found an incidence almost identical to the one found in tortured males.…”

Section: Discussionmentioning

confidence: 99%

“…These findings are similar to those of other studies. 6,13 In 2007, Edston and Olsson 12 found a prevalence of rape of 70% among female torture victims. Morof et al reported a prevalence of sexual violence and rape of 63% and 49%, respectively, among 117 Congolese and Somalian women in a study from 2014.…”

Section: S C I E N T I F I C a R T I C L Ementioning

confidence: 99%

Geographical distribution of torture: An epidemiological study of torture reported by asylum applicants examined at the Department of Forensic Medicine, University of Copenhagen

Busch

Hansen

Hougen

2018

torture

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Using reports from 154 examinations of alleged torture victims among asylum applicants to Denmark conducted by the Department of Forensic Medicine, University of Copenhagen, between 2001 and 2013, we have categorized the victims into four geographical regions, as well as according to the conflict that caused them to flee. The torture incidents described by the victims were divided into 12 different categories defined by the Istanbul Protocol. These data were cross-referenced in order to identify any differences in the prevalence of the 12 forms of torture. The study showed that crush injuries were only reported by refugees from Asia, including Afghanistan and Pakistan, and that incidents of electrical torture were reported twice as frequently by torture victims from Middle Eastern and North African countries, though it was lower among Iraqis, Iranians and ethnic Kurds. Sexual torture was reported by 78% of females and 25% of males.

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The epidemiology of torture: A case series of 58 survivors of torture

Cited by 13 publications

References 12 publications

Dental anxiety in relation to torture experiences and symptoms of post‐traumatic stress disorder

Dental anxiety in relation to torture experiences and symptoms of post‐traumatic stress disorder

Survivors of Torture: Prevalence in an Urban Emergency Department

Geographical distribution of torture: An epidemiological study of torture reported by asylum applicants examined at the Department of Forensic Medicine, University of Copenhagen

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