Skip to main content
Erschienen in: Current Neurology and Neuroscience Reports 3/2018

01.03.2018 | Neurology of Systemic Diseases (J Biller, Section Editor)

The Neuropsychological Consequences of Armed Conflicts and Torture

verfasst von: Pedro Weisleder, Caitlin Rublee

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

At any point in time, there are hundreds of armed conflicts throughout the world. Neuropsychological disorders are a major cause of morbidity during and after armed conflicts. Conditions such as closed and open head injuries, acute stress disorder, post-traumatic stress disorder, depression, anxiety, and psychosis are prevalent among survivors. Herein, we summarize information on the various forms of torture, the resultant neuropsychological pathology, and treatment strategies to help survivors.

Recent Findings

Strategies to address the needs of individuals who experienced neuropsychological trauma due to armed conflicts and torture include pharmacological and psychological interventions. The former includes antidepressant, antianxiety, and antipsychotic medications. The latter includes narrative exposure therapy and trauma-focused cognitive-behavioral therapy.

Summary

Neuropsychological disorders are major causes of morbidity among survivors of armed conflicts and torture. Treatment strategies must be affordable, applicable across cultures, and deliverable by individuals who understand the victims’ psychosocial and ethnic background.
Literatur
2.
Zurück zum Zitat • Jaung M, Jani S, Banu S, Mackey JM. International Emergency Psychiatry challenges: disaster medicine, war, human trafficking, displaced persons. Psychiatr Clin North Am. 2017;40(3):565–74. https://doi.org/10.1016/j.psc.2017.05.015. Neuropsychological disorders are major causes of morbidity among survivors of armed conflicts and torture. Treatment strategies must be affordable, applicable across cultures, community-based, and deliverable by individuals who understand the victims’ psychosocial and ethnic background CrossRefPubMed • Jaung M, Jani S, Banu S, Mackey JM. International Emergency Psychiatry challenges: disaster medicine, war, human trafficking, displaced persons. Psychiatr Clin North Am. 2017;40(3):565–74. https://​doi.​org/​10.​1016/​j.​psc.​2017.​05.​015. Neuropsychological disorders are major causes of morbidity among survivors of armed conflicts and torture. Treatment strategies must be affordable, applicable across cultures, community-based, and deliverable by individuals who understand the victims’ psychosocial and ethnic background CrossRefPubMed
3.
Zurück zum Zitat American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-5. 5th ed. ed. Washington, D.C. 2013. American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-5. 5th ed. ed. Washington, D.C. 2013.
6.
Zurück zum Zitat United Nations High Commissioner for Refugees (UNHCR). Global Trends Forced Displacement in 2016. Geneva, Switzerland. 2017. United Nations High Commissioner for Refugees (UNHCR). Global Trends Forced Displacement in 2016. Geneva, Switzerland. 2017.
7.
Zurück zum Zitat United Nations General Assembly. Convention against torture and other cruel, inhuman or degrading treatment or punishment: Resolution 39/46 1984. United Nations General Assembly. Convention against torture and other cruel, inhuman or degrading treatment or punishment: Resolution 39/46 1984.
8.
Zurück zum Zitat United Nations High Commissioner for Refugees (UNHCR). Strengthening refugee resettlement and other pathways to admission and solutions 2016. United Nations High Commissioner for Refugees (UNHCR). Strengthening refugee resettlement and other pathways to admission and solutions 2016.
11.
Zurück zum Zitat Member Centers of the National Consortium of Torture Treatment Programs (NCTTP). Descriptive, inferential, functional outcome data on 9,025 torture survivors over six years in the United States. Torture. 2015;25(12):34–60. Member Centers of the National Consortium of Torture Treatment Programs (NCTTP). Descriptive, inferential, functional outcome data on 9,025 torture survivors over six years in the United States. Torture. 2015;25(12):34–60.
16.
Zurück zum Zitat • Zandieh S, Bernt R, Knoll P, Wenzel T, Hittmair K, Haller J, et al. Analysis of the metabolic and structural brain changes in patients with torture-related post-traumatic stress disorder (TR-PTSD) using (1)(8)F-FDG PET and MRI. Medicine. 2016;95(15):e3387. https://doi.org/10.1097/MD.0000000000003387. In this observational study, the authors analyzed brain structures with magnetic resonance imaging and positron emission tomography in patients with torture-related PTSD and healthy controls. Results suggested metabolic and structural changes in patients with torture-related PTSD CrossRefPubMedPubMedCentral • Zandieh S, Bernt R, Knoll P, Wenzel T, Hittmair K, Haller J, et al. Analysis of the metabolic and structural brain changes in patients with torture-related post-traumatic stress disorder (TR-PTSD) using (1)(8)F-FDG PET and MRI. Medicine. 2016;95(15):e3387. https://​doi.​org/​10.​1097/​MD.​0000000000003387​. In this observational study, the authors analyzed brain structures with magnetic resonance imaging and positron emission tomography in patients with torture-related PTSD and healthy controls. Results suggested metabolic and structural changes in patients with torture-related PTSD CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat O'connor M. Sexual violence in armed conflict: the least condemned of war crimes. J Law Med. 2014;21(3):528–42.PubMed O'connor M. Sexual violence in armed conflict: the least condemned of war crimes. J Law Med. 2014;21(3):528–42.PubMed
21.
Zurück zum Zitat •• Perez-Sales P, Navarro-Lashayas MA, Plaza A, Morentin B, Salinas OB. Incommunicado detention and torture in Spain, part III: 'Five days is enough': the concept of torturing environments. Torture. 2016;26(3):21–33. The authors describe torturing environments and the psychological methods of torture in victims of incommunicado detention in Spain. Western civilizations have increasingly adopted psychological torture methods PubMed •• Perez-Sales P, Navarro-Lashayas MA, Plaza A, Morentin B, Salinas OB. Incommunicado detention and torture in Spain, part III: 'Five days is enough': the concept of torturing environments. Torture. 2016;26(3):21–33. The authors describe torturing environments and the psychological methods of torture in victims of incommunicado detention in Spain. Western civilizations have increasingly adopted psychological torture methods PubMed
22.
Zurück zum Zitat Gudjonsson GH. The psychology of interrogations and confessions: a handbook. Wiley & Sons, Ltd: England; 2003. Gudjonsson GH. The psychology of interrogations and confessions: a handbook. Wiley & Sons, Ltd: England; 2003.
23.
Zurück zum Zitat Istanbul Protocol Project in the Basque Country Working Group. Incommunicado detention and torture in Spain, part I: the Istanbul Protocol Project in the Basque Country. Torture. 2016;26(3):3. Istanbul Protocol Project in the Basque Country Working Group. Incommunicado detention and torture in Spain, part I: the Istanbul Protocol Project in the Basque Country. Torture. 2016;26(3):3.
25.
Zurück zum Zitat Bryant RA, Harvey AG. Acute stress disorder: a handbook of theory, assessment, and treatment. Washington DC: American Psychological Association; 2000.CrossRef Bryant RA, Harvey AG. Acute stress disorder: a handbook of theory, assessment, and treatment. Washington DC: American Psychological Association; 2000.CrossRef
26.
Zurück zum Zitat •• Navarro-Lashayas MA, Perez-Sales P, Lopez-Neyra G, Martinez MA, Morentin B. Incommunicado detention and torture in Spain, Part IV: Psychological and psychiatric consequences of ill-treatment and torture: trauma and human worldviews. Torture. 2016;26(3):34–45. The authors report on the enduring psychological effects (PTSD, depressive disorder, anxiety, personality changes) of short-term incommunicado detention in Spain •• Navarro-Lashayas MA, Perez-Sales P, Lopez-Neyra G, Martinez MA, Morentin B. Incommunicado detention and torture in Spain, Part IV: Psychological and psychiatric consequences of ill-treatment and torture: trauma and human worldviews. Torture. 2016;26(3):34–45. The authors report on the enduring psychological effects (PTSD, depressive disorder, anxiety, personality changes) of short-term incommunicado detention in Spain
28.
Zurück zum Zitat •• Nygaard M, Sonne C, Carlsson J. Secondary Psychotic features in refugees diagnosed with post-traumatic stress disorder: a retrospective cohort study. BMC Psychiatry. 2017;17(1):5. https://doi.org/10.1186/s12888-016-1166-1. The authors conducted a retrospective cohort study in refugees with PTSD and revealed that 40% had secondary psychotic features. Patients with psychotic features were more likely to having had experienced torture and imprisonment CrossRefPubMedPubMedCentral •• Nygaard M, Sonne C, Carlsson J. Secondary Psychotic features in refugees diagnosed with post-traumatic stress disorder: a retrospective cohort study. BMC Psychiatry. 2017;17(1):5. https://​doi.​org/​10.​1186/​s12888-016-1166-1. The authors conducted a retrospective cohort study in refugees with PTSD and revealed that 40% had secondary psychotic features. Patients with psychotic features were more likely to having had experienced torture and imprisonment CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat •• Slobodin O, de Jong J. Mental health interventions for traumatized asylum seekers and refugees: what do we know about their efficacy? Int J Soc Psychiatry. 2015;61:17–26. https://doi.org/10.1177/0020764014535752. In this review, the authors highlight the shortage of guiding frameworks available to investigators and clinicians who are interested in tailoring interventions to work with refugees and asylum seekers. The authors discuss theoretical, ethical, and methodological considerations for future research CrossRefPubMed •• Slobodin O, de Jong J. Mental health interventions for traumatized asylum seekers and refugees: what do we know about their efficacy? Int J Soc Psychiatry. 2015;61:17–26. https://​doi.​org/​10.​1177/​0020764014535752​. In this review, the authors highlight the shortage of guiding frameworks available to investigators and clinicians who are interested in tailoring interventions to work with refugees and asylum seekers. The authors discuss theoretical, ethical, and methodological considerations for future research CrossRefPubMed
33.
Zurück zum Zitat • Patel N, Kellezi B, Williams AC. Psychological, social and welfare interventions for psychological health and well-being of torture survivors. Cochrane Database Syst Rev. 2014(11):CD009317. doi: 10.1002/14651858.CD009317.pub2. Health and welfare agencies offer varied rehabilitation services to survivors of torture. These include conventional mental health treatment and needs-based interventions. Narrative exposure therapy and trauma-focused cognitive-behavioral therapy have been found to confer at least moderate benefits in reducing distress and symptoms of PTSD. • Patel N, Kellezi B, Williams AC. Psychological, social and welfare interventions for psychological health and well-being of torture survivors. Cochrane Database Syst Rev. 2014(11):CD009317. doi: 10.1002/14651858.CD009317.pub2. Health and welfare agencies offer varied rehabilitation services to survivors of torture. These include conventional mental health treatment and needs-based interventions. Narrative exposure therapy and trauma-focused cognitive-behavioral therapy have been found to confer at least moderate benefits in reducing distress and symptoms of PTSD.
Metadaten
Titel
The Neuropsychological Consequences of Armed Conflicts and Torture
verfasst von
Pedro Weisleder
Caitlin Rublee
Publikationsdatum
01.03.2018
Verlag
Springer US
Erschienen in
Current Neurology and Neuroscience Reports / Ausgabe 3/2018
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-018-0818-6

Weitere Artikel der Ausgabe 3/2018

Current Neurology and Neuroscience Reports 3/2018 Zur Ausgabe

Neuro-Oncology (LE Abrey, Section Editor)

Liquid Biopsy in Primary Brain Tumors: Looking for Stardust!

Neurology of Systemic Diseases (J Biller, Section Editor)

Neurological Complications of Acute and Chronic Otitis Media

Epilepsy (CW Bazil, Section Editor)

Treating Immune-Related Epilepsy

Movement Disorders (S Fox, Section Editor)

Progressive Supranuclear Palsy: an Update

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.