Torture Journal https://tidsskrift.dk/torture-journal <p>The Torture Journal is a scientific journal that provides an interdisciplinary forum for the exchange of original research and systematic reviews by professionals concerned with the biomedical, psychological and social interface of torture and the rehabilitation of its survivors. It is fully Open Access online, but donations are encouraged to ensure the journal can reach those who need it (www.irct. org). Expressions of interest in the submission of manuscripts or involvement as a peer reviewer are always welcome. The Torture Journal is published by the International Rehabilitation Council for Torture Victims which is an independent, international organisation that promotes and supports the rehabilitation of torture victims and the prevention of torture through its over 150 member centres around the world. The objective of the organisation is to support and promote the provision of specialised treatment and rehabilitation services for victims of torture.</p> International Rehabilitation Council for Torture Victims en-US Torture Journal 1018-8185 <p>We accept that some authors (e.g. government employees in some countries) are unable to transfer copyright. The Creative Commons Licence&nbsp;&nbsp;<span class="cc-license-title">Attribution-NonCommercial-NoDerivatives 4.0 International</span>&nbsp;<span class="cc-license-identifier">(CC BY-NC-ND 4.0)&nbsp;</span>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.</p> Children who survive torture: A systematic review of screening, documentation and treatment of torture injuries in children https://tidsskrift.dk/torture-journal/article/view/143968 <p>Background: Children all over the world are subjected to torture, but few are identified as victims of these actions. Knowledge that facilitates identification, documentation, and treatment of torture injuries in children can allow redress and rehabilitation for more children in need. Objective: To synthesise research regarding screening, documentation, and treatment of child survivors of torture. Methods: A systematic literature review was conducted. A total of 4795 titles and/or abstracts were screened, of which 80 articles were included. Grey literature was also included. Results: Screening for torture exposure usually consisted of questions that were included in trauma questionnaires. Questions about perpetrators in the traumatic events were missing from more than half of the studies. Although children were screened mainly for psychological injuries, it was primarily physical injuries that were documented. The evidence on treatment effects was limited. However, there was a tendency that Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Narrative Exposure Therapy (NET) significantly reduced PTSD up to three months to one year after the end of treatment. Treatments with individual and group-based formats, as well as those with normal and more intensified approaches, were found to have an effect on PTSD.</p> Catarina Nahlén Bose Ronak Tamdjidi Copyright (c) 2024 Torture Journal http://creativecommons.org/licenses/by-nc-nd/4.0 2024-12-27 2024-12-27 34 3 15 40 10.7146/torture.v34i3.143968 Overcrowding in prisons: Health and legal implications https://tidsskrift.dk/torture-journal/article/view/147571 <p style="font-weight: 400;">Introduction: Prison overcrowding can be defined in different ways, and no universal definition exists. More than 120 countries report prison occupancy rates above their own capacity. This paper provides an overview of legal and health implications of overcrowding, analyses potential causes, and provides examples of how different countries utilised non-custodial measures to reduce overcrowding to disseminate good practices as inspiration for other contexts. Methods: Desk study based on literature searches in medical (Pubmed and Medline) and legal sources, including Google Scholar on legal opinions, Global Lex and decisions of UN treaty bodies and regional human rights mechanisms supplemented by online searches for grey literature. In addition, examples from other countries were sought to corroborate and illustrate the points made. Results: A range of international standards exist that provide for the conditions and treatment of people in prisons to prevent prison overcrowding and protect them from its consequences. Nonetheless, overcrowding is persistent across many countries. It is often associated with violations of human rights, including, among others, the right to be free from torture and ill-treatment, the right to health, and the right to liberty and security. The underlying factors contributing to overcrowding vary and include, among others, overuse of imprisonment, excessive use of pre-trial detention, lack of access to a lawyer and underutilisation of non-custodial measures as an alternative to detention. Non-custodial measures can be applied throughout the criminal justice process, and some countries have successfully managed to reduce their prison populations by implementing such measures. Discussion: Overcrowding affects many aspects of prison life, impeding the provision of a humane and rehabilitative environment. Beyond the harm caused to persons in prisons, this may negatively impact society at large in terms of security, public health, and economy. Political will is essential in reducing prison overcrowding.</p> Eva Nudd Maha Aon Kalliopi Kambanella Marie Brasholt Copyright (c) 2024 Torture Journal http://creativecommons.org/licenses/by-nc-nd/4.0 2024-12-27 2024-12-27 34 3 41 53 10.7146/torture.v34i3.147571 Acceptability and Preliminary Effects of Intensive Brief Trauma-Focused PTSD Treatment for Refugees https://tidsskrift.dk/torture-journal/article/view/147953 <p><strong>Background:</strong> Post-Traumatic Stress Disorder (PTSD) is a significant mental health concern in refugee populations exposed to trauma and displacement. Traditional treatments for PTSD often involve lengthy interventions. However, there's a growing interest in exploring more condensed, intensive treatments to improve outcomes and accessibility for refugees.</p> <p><strong>Objective: </strong>This study aimed to evaluate the acceptability, and preliminary effects of an intensive brief trauma-focused PTSD treatment (ITT) program delivered to refugees at the Swedish Red Cross Treatment Center for Persons Affected by War and Torture in Uppsala, Sweden.</p> <p><strong>Method:</strong> Ten participants were enrolled in the study and received ITT over five consecutive weekdays comprising Eye Movement Desensitization and Reprocessing Therapy (EMDR), prolonged exposure (PE), and physical activity (PA). Acceptability was assessed by analyzing journal notes, and clinicians’ and patients’ open-ended responses to sets of questions designed to elicit the patients’ experiences and potential adverse events. Baseline and follow-up data regarding PTSD (i.e., PCL-5 and CAPS-5), disability (i.e., Whodas-12), and anxiety or depression (i.e., HSCL-25) were collected and analyzed.</p> <p><strong>Results: </strong>The study demonstrated that ITT is an acceptable and viable treatment option for refugees with PTSD<strong>. </strong>No serious adverse events were reported, although some found the treatment very taxing. Overall, the ordeals were perceived as worthwhile. The statistical analyses showed substantial and significantly reduced PTSD symptoms, and anxiety levels i.e., CAPS-5 (Cohen’s d 1,91; CI 95% 0.77-3.02), PCL-5 (Cohen’s d 1,31; CI 95% 0.43 -2.15) Anxiety subscale of HSCL-25 (Cohen’s d 1.47; CI 95% 0.49 -2.41). Reductions in depression symptoms and disability were also observed but were non-significant.</p> <p><strong>Conclusions:</strong> The results suggest that this brief and massed treatment program for refugees with PTSD is a well-received and preliminary effective treatment option. Identifying less suitable candidates and conducting larger, controlled studies with longer follow-up periods are needed to establish ITT's efficacy in this population.</p> Petter Tinghög Lina Vågbratt Julia Jennstål Maria Bragesjö Niklas Möller Copyright (c) 2024 Torture Journal http://creativecommons.org/licenses/by-nc-nd/4.0 2024-12-27 2024-12-27 34 3 54 63 10.7146/torture.v34i3.147953 “The state has a debt to us, it ended our dreams, our life projects”: Reconstructing life projects after torture https://tidsskrift.dk/torture-journal/article/view/147785 <p><em>Introduction:</em> The concept of ‘life project’ is at the core of several decisions in the inter-American human rights system. The concept has also become part of the legal consciousness of torture survivors in Peru and is often referred to when they describe the impact of torture and imprisonment on their lives and on the lives of their children.</p> <p><em>Methods: </em>The paper is based on qualitative interviews with seven Peruvian torture survivors.</p> <p><em>Results: </em>The concept of ‘life project’ has been included in the legal consciousness of torture survivors in in Peru, and is used to address the ways in which torture and imprisonment has impacted not only on the life project of the person targeted, but also on the lives of their children. The interviewees describe damage to their life project both regarding health and the impact of stigma, but place special emphasis on the ways in which the life projects of their children have been impacted: as a result of being imprisoned, they have been unable to take care of their children for longer periods of time, their children have been subjected to violence, and they have had less access to education. Still, the interviewees describe how they reconstruct their life projects, as well as how the concept of life project serves as a starting point for demanding reparations.</p> <p><em>Discussion: </em>The concept of “life project”, originating from the inter American Court of Human Rihgts, is useful for grasping how peoples’ lives are impacted by imprisonment and torture, and has become part of the legal consciousness of persons affected by serious and systematic human rights violations in Peru.</p> Anne M Sønneland Copyright (c) 2024 Torture Journal http://creativecommons.org/licenses/by-nc-nd/4.0 2024-12-27 2024-12-27 34 3 64 73 10.7146/torture.v34i3.147785 The Global Standards on Rehabilitation of Torture Survivors: From adoption to practice https://tidsskrift.dk/torture-journal/article/view/145944 <p>This paper examines the implementation of the Global Standards on Rehabilitation (GSR) by members of the International Rehabilitation Council for Torture Victims (IRCT) and their impact on the quality of rehabilitation services provided to torture survivors. Methods: Qualitative and quantitative data were collected through surveys, post-training evaluations, and member feedback to assess the impact of the GSR on rehabilitation practices. Findings: Results show significant improvements, including more holistic rehabilitation, increased survivor participation, and stronger advocacy. Key challenges such as resource limitations, political barriers, and resistance to change were identified, alongside recommendations for future focus on survivor engagement, holistic support, and staff training. The paper concludes that the GSR roll-out has strengthened the capacity of IRCT members to provide quality rehabilitation services, highlighting the need for continued support and sustainable funding to expand impact.</p> Berta Soley Hugo Marboeuf Copyright (c) 2024 Torture Journal http://creativecommons.org/licenses/by-nc-nd/4.0 2024-12-27 2024-12-27 34 3 74 86 10.7146/torture.v34i3.145944 Ocular injuries by less-lethal weapon: a view from Switzerland https://tidsskrift.dk/torture-journal/article/view/150109 <p>Dear Editor-in-chief: Thank you for focussing on this troubling subject in your issue 1/2024. It confirms that many of the difficulties involved are similar worldwide. Countries that use less-lethal weapons include Switzerland, the only Western European democracy besides France to employ multiple kinetic impact projectiles. Our rubber scattershot is comparatively small and light but has led to an uninterrupted series of severe eye injuries since 1980. Legal authorities have long questioned whether these were due to rubber ammunition, though ophthalmologists always knew what was going on. Communication channels were non-existent, and monitoring remains a challenge. Please see my recent open-access review in Eye (Fierz, 2024) for details. I would like to add the odd point to your commendable editorial (Pérez-Sales et al., 2024). The common denominator is that eye injuries require eye doctors.</p> Anna Fierz Copyright (c) 2024 Torture Journal http://creativecommons.org/licenses/by-nc-nd/4.0 2024-12-27 2024-12-27 34 3 89 90 10.7146/torture.v34i3.150109 Denial of abortion rights as a form of ill-treatment or torture https://tidsskrift.dk/torture-journal/article/view/152020 <p>The paper presents a review of the evolution of sexual and reproductive rights within the context of the international human rights framework.<br>Subsequently, an analysis is presented of the extant data on legislation by country, statistics on unsafe abortion and evidences on the relationship between abortion and mental health. <br>In the second section, the text reviews the legal grounds for two situations: firstly, the denial of health services in relation to the termination of pregnancy as cruel, inhuman or degrading treatment; and secondly, those cases in which the denial of abortion could constitute a violation of the Convention against Torture.</p> <p>Consequently, the position of the relevant international bodies is examined, and the manner in which each assumption of the definition of torture is satisfied is analysed, as well as the significance attributed to each element by the various committees. This information is then used to present elements related to forensic documentation in accordance with the Istanbul Protocol.</p> Pau Pérez-Sales Sara Lopez-Martin Copyright (c) 2024 Torture Journal http://creativecommons.org/licenses/by-nc-nd/4.0 2024-12-27 2024-12-27 34 3 3 14 10.7146/torture.v34i3.152020 Historic Abu Ghraib verdict: U.S. Contractor held accountable for torture https://tidsskrift.dk/torture-journal/article/view/152171 <p>After years of legal battles, three Iraqi survivors of torture in the Abu Ghraib prison have secured justice in a historic victory in U.S. courts. The jury ruled in favour of the Iraqi plaintiffs, holding a private contractor, CACI, accountable for its role in the abuse and torture of detainees during the Iraq War.</p> Andrea Mølgaard Copyright (c) 2024 Torture Journal http://creativecommons.org/licenses/by-nc-nd/4.0 2024-12-27 2024-12-27 34 3 87 88 10.7146/torture.v34i3.152171