Peritajes transculturales de supervivientes de tortura basados en el Protocolo de Estambul
DOI:
https://doi.org/10.7146/torture.v34i2.149964Keywords:
TorturaAbstract
Se ofrece una visión general de las consideraciones clave para llevar a cabo un peritaje transcultural de un superviviente de tortura. La primera parte introduce algunos conceptos esenciales de antropología, medicina, psicología transcultural y psiquiatría. La segunda parte repasa los elementos más relevantes relativos al informe forense de un superviviente. Se presta especial atención a las consideraciones culturales referidas a los aspectos éticos del Protocolo de Estambul. También aborda los aspectos relacionados con el encuentro con la superviviente y la entrevista, los aspectos médicos, incluido el examen físico con especial atención al dolor y el sufrimiento, y la evaluación psicológica y psicométrica. También aborda brevemente aspectos relacionados con el análisis de coherencia y credibilidad. En la última sección, el texto ofrece una visión general de las consideraciones culturales siguiendo el esquema del Protocolo de Estambul.
References
Abd-Elsayed, A. (2019). Pain. A review guide (A. Abd-Elsayed (ed.)).
Springer International Publishing. https://doi.org/10.1007/978-
-319-99124-5
Alexander, A., Blake, S., & Bernstein, M. A. (2007). The staying
power of pain. A comparison of torture survivors from Bosnia
and Colombia and their rates of anxiety, depression and PTSD.
Torture : Quarterly Journal on Rehabilitation of Torture Victims
and Prevention of Torture, 17, 1–10. https://doi.org/2007-
2005-0018 [pii]
Bachem, R., Mazza, A., Eberle, D. J., & Maercker, A. (2024). A new
approach to cultural scripts of trauma sequelae assessment: The
sample case of Switzerland. PLoS ONE, 19(4 April), 1–17.
https://doi.org/10.1371/journal.pone.0301645
Baird, E., Williams, A. C. de C., Hearn, L., & Amris, K. (2017).
Interventions for treating persistent pain in survivors of
torture. Cochrane Database of Systematic Reviews. https://doi.
org/10.1002/14651858.CD012051.pub2
Berthold, S. M., Mollica, R. F., Silove, D., Tay, A. K., Lavelle, J.,
& Lindert, J. (2019). The HTQ-5: Revision of the Harvard
Trauma Questionnaire for measuring torture, trauma and
DSM-5 PTSD symptoms in refugee populations. European
Journal of Public Health, 29(3), 468–474. https://doi.
org/10.1093/eurpub/cky256
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris,
C. A. (1996). Psychometric properties of the PTSD checklist
(PCL). Behaviour Research and Therapy, 34(8), 669–673.
http://www.sciencedirect.com/science/article/B6V5W-
VWPX4H-X/2/d73c43a854e0d0743ca6e854118b6155
Bolton, P., Michalopoulos, L., Ahmed, A. M. A., Murray, L. K., &
Bass, J. (2013). The mental health and psychosocial problems
of survivors of torture and genocide in Kurdistan, Northern
Iraq: a brief qualitative study. Torture : Quarterly Journal on
Rehabilitation of Torture Victims and Prevention of Torture,
(1), 1–14.
Bovey, M., Hosny, N., Dutray, F., & Heim, E. (2024). PTSD
and complex PTSD manifestations in Sub-Saharan Africa:
A systematic review of qualitative literature. SSM - Mental
Health, 5(September 2023), 100298. https://doi.org/10.1016/j.
ssmmh.2024.100298
Bustan, S., Gonzalez-Roldan, A. M., Kamping, S., Brunner, M.,
Löffler, M., Flor, H., & Anton, F. (2015). Suffering as an
independent component of the experience of pain. European
Journal of Pain (United Kingdom), 19(7), 1035–1048. https://
doi.org/10.1002/ejp.709
Chhim, S. (2013). Baksbat (Broken Courage): A Trauma-Based
Cultural Syndrome in Cambodia. Medical Anthropology: Cross
Cultural Studies in Health and Illness, 32(2), 160–173. https://
doi.org/10.1080/01459740.2012.674078
Chhim, S. (2014). A Place for Baksbat (Broken Courage) in Forensic
Psychiatry at the Extraordinary Chambers in the Courts of
Cambodia (ECCC). Psychiatry, Psychology and Law, 21(2),
–296. https://doi.org/10.1080/13218719.2013.809652
Costanzo, C., & Verghese, A. (2018). The Physical Examination as
Ritual: Social Sciences and Embodiment in the Context of the
Physical Examination. Medical Clinics of North America, 102(3),
–431. https://doi.org/10.1016/j.mcna.2017.12.004
Davies, J. (2018). The Making Of Psychotherapists. Routledge.
https://doi.org/10.4324/9780429482373
de C Williams, A. C., & Baird, E. (2016). Special Considerations
for the Treatment of Pain from Torture and War. Current
Anesthesiology Reports, 6(4), 319–326. https://doi.org/10.1007/
s40140-016-0187-0
Dow, J. (1982). Universal Aspects of Symbolic Healing : American
Anthropologist, 88(1), 56–69.
Einterz, E. (2018). Recognizing culturally related findings on
refugee physical examinations. Journal of the American Board
of Family Medicine, 31(4), 653–657. https://doi.org/10.3122/
jabfm.2018.04.170375
Fabian, K., Fannoh, J., Washington, G. G., Geninyan, W. B.,
Nyachienga, B., Cyrus, G., Hallowanger, J. N., Beste, J., Rao, D.,
& Wagenaar, B. H. (2018). “My Heart Die in Me”: Idioms of
Distress and the Development of a Screening Tool for Mental
Suffering in Southeast Liberia. Culture, Medicine, and Psychiatry,
(3), 684–703. https://doi.org/10.1007/s11013-018-9581-z
Fox, S. H. (2003). The Mandinka Nosological System in the
Context of Post-Trauma Syndromes. Transcultural Psychiatry,
(4), 488–506. https://doi.org/10.1177/1363461503404002
Greene, M. C., Ventevogel, P., Likindikoki, S. L., Bonz, A. G.,
Turner, R., Rees, S., Misinzo, L., Njau, T., Mbwambo, J. K.
K., & Tol, W. A. (2023). Why local concepts matter: Using
cultural expressions of distress to explore the construct
validity of research instruments to measure mental health
problems among Congolese women in Nyarugusu refugee
camp. Transcultural Psychiatry, 60(3), 496–507. https://doi.
org/10.1177/13634615221122626
Harris, M. (1976). History and Significance of the EMIC/ETIC
Distinction. Annual Review of Anthropology, 5(1), 329–350.
https://doi.org/10.1146/annurev.an.05.100176.001553
Heim, E., Karatzias, T., & Maercker, A. (2022). Cultural concepts
of distress and complex PTSD: Future directions for research
and treatment. Clinical Psychology Review, 93(March), 102143.
https://doi.org/10.1016/j.cpr.2022.102143
Hinton, D. E., & Lewis-Fernández, R. (2011). The cross-cultural
validity of posttraumatic stress disorder: Implications for
DSM-5. Depression and Anxiety, 28(9), 783–801. https://doi.
org/10.1002/da.20753
IIDH. (2010). Acceso a la justicia de los pueblos indígenas: los peritajes
culturales y la visión de pobreza desde su cosmovisión. Instituto
Interamericano de derechos Humanos,.
Jobson, L., & O’Kearney, R. (2006). Cultural differences in
autobiographical memory of trauma. Clinical Psychologist, 10(3),
–98. https://doi.org/10.1080/13284200600939892
Jubany, O. (2017). Screening asylum in a culture of disbelief: Truths,
denials and skeptical borders. In Screening Asylum in a Culture
of Disbelief: Truths, Denials and Skeptical Borders. https://doi.
org/10.1007/978-3-319-40748-7
Kaiser, B. N., Haroz, E. E., Kohrt, B. A., Bolton, P. A., Bass,
J. K., & Hinton, D. E. (2015). “Thinking too much”: A
systematic review of a common idiom of distress. Social
Science & Medicine, 147, 170–183. https://doi.org/10.1016/j.
socscimed.2015.10.044
Kaiser, B. N., McLean, K. E., Kohrt, B. A., Hagaman, A. K.,
Wagenaar, B. H., Khoury, N. M., & Keys, H. M. (2014).
Reflechi twòp--thinking too much: description of a cultural
syndrome in Haiti’s Central Plateau. Culture, Medicine and
Psychiatry, 38(3), 448–472. https://doi.org/10.1007/s11013-
-9380-0
Kaiser, B. N., & Weaver, L. J. (2022). Culture-bound syndromes,
idioms of distress, and cultural concepts of distress: New
directions for an old concept in psychological anthropology.
Transcultural Psychiatry, 59(4), 395–398. https://doi.
org/10.1177/13634615221110665
Khalsa, S. S., Adolphs, R., Cameron, O. G., Critchley, H. D.,
Davenport, P. W., Feinstein, J. S., Feusner, J. D., Garfinkel, S.
N., Lane, R. D., Mehling, W. E., Meuret, A. E., Nemeroff, C.
B., Oppenheimer, S., Petzschner, F. H., Pollatos, O., Rhudy, J.
L., Schramm, L. P., Simmons, W. K., Stein, M. B., … Zucker,
N. (2018). Interoception and Mental Health: A Roadmap.
Biological Psychiatry: Cognitive Neuroscience and Neuroimaging,
(6), 501–513. https://doi.org/10.1016/j.bpsc.2017.12.004
Kidron, C. A., & Kirmayer, L. J. (2019). Global Mental Health
and Idioms of Distress: The Paradox of Culture-Sensitive
Pathologization of Distress in Cambodia. Culture, Medicine and
Psychiatry, 43(2), 211–235. https://doi.org/10.1007/s11013-
-9612-9
Kirmayer, L. J., Ban, L., & Jaranson, J. (2018). Cultural logics
of emotion: Implications for understanding torture and its
sequelae. Torture Journal, 28(1), 84–100.
Kirmayer, L. J., Rousseau, C., & Lashley, M. (2007). The place of
culture in forensic psychiatry. Journal of the American Academy
of Psychiatry and the Law, 35(1), 98–102.
Kleinman, A. (1988). Rethinking Psychiatry: From Cultural Category
to Personal Experience. Free Pres.
Kohrt, B. a, & Hruschka, D. J. (2010). Nepali concepts of
psychological trauma: the role of idioms of distress,
ethnopsychology and ethnophysiology in alleviating suffering
and preventing stigma. Culture, Medicine and Psychiatry, 34(2),
–352. https://doi.org/10.1007/s11013-010-9170-2
Lasch, K. E. (2000). Culture, pain, and culturally sensitive pain
care. Pain Management Nursing, 1(3), 16–22. https://doi.
org/10.1053/jpmn.2000.9761
Leff, J. (1988). Psychiatry around the globe: A transcultural view.
Gaskell/Royal College of Psychiatrists.
Levi-Strauss, C. (1964). Anthropologie structurale/Structural
anthropology. Penguin.
Lewis-Fernández, R., Aggarwal, N. K., & Kirmayer, L. J. (2020). The
Cultural Formulation Interview: Progress to date and future
directions. Transcultural Psychiatry, 57(4), 487–496. https://
doi.org/10.1177/1363461520938273
Lin, K., & Lin, M. T. (2015). Psychopharmacology: Ethnic and
Cultural Perspectives. Psychiatry, 2041–52.
Marsella, A. J. (2005). Culture and conflict: Understanding,
negotiating, and reconciling conflicting constructions of reality.
In International Journal of Intercultural Relations (Vol. 29, pp.
–673). https://doi.org/10.1016/j.ijintrel.2005.07.012
Meger, S. (2010). Rape of the Congo: Understanding sexual violence
in the conflict in the Democratic Republic of Congo. Journal
of Contemporary African Studies, 28(2), 119–135. https://doi.
org/10.1080/02589001003736728
Moreno, A., & Peel, M. (2004). Posttraumatic seizures in survivors
of torture: manifestations, diagnosis, and treatment. Journal
of Immigrant Health, 6, 179–186. https://doi.org/10.1023/
B:JOIH.0000045255.64395.d1
Nicolas, G., Wheatley, A., & Guillaume, C. (2014). Does one
trauma fit all? Exploring the relevance of PTSD across cultures.
International Journal of Culture and Mental Health, March
, 1–12. https://doi.org/10.1080/17542863.2014.892519
Patel, A. R., & Hall, B. J. (2021). Beyond the DSM-5 Diagnoses: A
Cross-Cultural Approach to Assessing Trauma Reactions . Focus,
(2), 197–203. https://doi.org/10.1176/appi.focus.20200049
Pedersen, D., Kienzler, H., & Gamarra, J. (2010). Llaki and Ñakary:
Idioms of Distress and Suffering Among the Highland Quechua
in the Peruvian Andes. Culture, Medicine, and Psychiatry, 34(2),
–300. https://doi.org/10.1007/s11013-010-9173-z
Pedersen, D., Tremblay, J., Errázuriz, C., & Gamarra, J. (2008).
The sequelae of political violence: Assessing trauma, suffering
and dislocation in the Peruvian highlands. Social Science
and Medicine, 67(2), 205–217. https://doi.org/10.1016/j.
socscimed.2008.03.040
Perez-Sales, P. (2004). Psicologia y Psiquiatria Trasncultural. Bases
prácticas para la accion. Desclee de Brower.
Pérez-Sales, P., Durán-Pérez, T., & Herzfeld, R. B. (2000). Longterm
psychosocial consequences in first - degree relatives of
people detained - disappeared or executed for political reasons in
Chile. A study in Mapuce and Non-Mapuce persons. Psicothema,
(SUPPL. 1).
Raingruber, B., & Kent, M. (2003). Attending to Embodied
Responses: A Way to Identify Practice-Based and Human
Meanings Associated With Secondary Trauma. Qualitative
Health Research, 13((4)), 449–468.
Ramcharan, B. G. (1998). How Universal Are Human Rights?. A
Debate About Power Rather Than Rights. IPG, 423–438.
Rasmussen, A., Katoni, B., Keller, A. S., & Wilkinson, J. (2011).
Posttraumatic idioms of distress among Darfur refugees: Hozun
and Majnun. Transcultural Psychiatry, 48(4), 392–415. https://
doi.org/10.1177/1363461511409283
Rechtman, R. (2000). Stories of Trauma and Idioms of Distress:
From Cultural Narratives to Clinical Assessment. Transcultural
Psychiatry, 37(3), 403–415.
Rees, S., & Silove, D. (2011). Sakit Hati: A state of chronic
mental distress related to resentment and anger amongst
West Papuan refugees exposed to persecution. Social Science
and Medicine, 73(1), 103–110. https://doi.org/10.1016/j.
socscimed.2011.05.004
Shoeb, M., Weinstein, H., & Mollica, R. (2007). The Harvard
Trauma Questionnaire: Adapting a Cross-Cultural Instrument for
Measuring Torture, Trauma and Posttraumatic Stress Disorder in
Iraqi Refugees. https://doi.org/10.1177/0020764007078362
Simons, R. C., & Hughes, C. C. (2012). The Culture-Bound
Syndromes: Folk Illnesses of Psychiatric and Anthropological
Interest. Springer Science & Business Media.
Sökefeld, M. (1999). Debating self, identity, and culture in
anthropology. Current Anthropology, 40(4), 417–447. https://
doi.org/10.1086/200042
The Body Keeps the Score: Brain, Mind, and Body in
the Healing of Trauma: Bessel van der Kolk MD:
: Amazon.com: Books. (n.d.). Retrieved
May 9, 2014, from http://www.amazon.com/Body-
Keeps-Score-Healing-Trauma/dp/0670785938/
ref=sr_1_1?s=books&ie=UTF8&qid=1399676469&sr=1-1
Theidon, K. (2004). Entre prójimos: El conflicto armado interno y
la política de la reconciliación en el Perú. In Instituto de Estudios
Peruanos (Vol. 1, Issue 1).
Trang, K., Hiott, C., Rahim, A. K., Rahman, S., & Wuermli, A.
J. (2024). A qualitative study of cultural concepts of distress
among Rohingya refugees in Cox’s Bazar, Bangladesh. Conflict
and Health, 18(1), 1–11. https://doi.org/10.1186/s13031-024-
-4
Tsakiris, M., & Preester, H. De. (2019). The interoceptive mind. From
homeostasis to awareness. Oxford University Press.
UNHR. (2022). Istanbul Protocol. Manual on the effective
investigation and documentation of torture and other cruel,
inhuman o degrading treatment or punishment. Office of
the High Commissioner of Human Rights. https://doi.
org/10.2307/j.ctt207g8gw
Vargas-Forman, R., Viera-Bravo, P., & Pichún-Collonao, J.
(2022). Pueblo mapuche vs Estado de Chile ante la Corte
Interamericana de Derechos Humanos: experiencia del
lof Temulemu. Revue Québécoise de Droit International,
-June(Special issue), 81–104. https://doi.
org/10.7202/1091081ar
Vargas, R. (2017). Pewmas / Sueños de Justicia. Lonkos y dirigentes
mapuche vs Chile en la Corte Interamericana: Testimonios y
evidencia de los efectos psicosociales de la Ley Antiterrorista. LOM
Ediciones.
Weathers, F. W., Huska, J. A., & Keane, T. M. (1991). The PTSD
Checklist-Civilian Version (PCL-C). National Center for PTSD
– Behavioral Science Division.
Weaver, L. J., Krupp, K., & Madhivanan, P. (2022). Conceptual
and methodological challenges in idioms of distress
research: Common questions and a step-by-step guide.
Transcultural Psychiatry, 59(4), 399–412. https://doi.
org/10.1177/13634615211042235
WHO. (1996). WHOQOL-BREF introduction, administration,
scoring and generic version of the assessment [document on the
inter- net]. Geneva: World Health Organization; 1996. www.
who.int/mental_health/media/en/76.pdf
Williams, L. H. (2021). Negotiating languages of suffering in
northern Uganda. Qualitative Studies, 6(1), 142–157. https://
doi.org/10.7146/qs.v6i1.124456
Yoder, H. N. C., de Jong, J. T. V. M., Tol, W. A., Duncan, J. A.,
Bayoh, A., & Reis, R. (2021). Child witchcraft confessions as
an idiom of distress in Sierra Leone; results of a rapid qualitative
inquiry and recommendations for mental health interventions.
Child and Adolescent Psychiatry and Mental Health, 15(1), 1–15.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Torture Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
We accept that some authors (e.g. government employees in some countries) are unable to transfer copyright. The Creative Commons Licence Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) covers both the Torture Journal and the IRCT web site. The publisher will not put any limitation on the personal freedom of the author to use material contained in the paper in other works which may be published, provided that acknowledgement is made to the original place of publication.
