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Book Forum: Posttraumatic Stress   |    
The Mental Health Consequences of Torture
Am J Psychiatry 2002;159:687-687. doi:10.1176/appi.ajp.159.4.687
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Tryon, N.C.

Edited by Ellen Gerrity, Terence M. Keane, and Farris Tuma. New York, Kluwer Academic/Plenum, 2001, 374 pp., $49.50.

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This information-packed book is broken down into six parts with 21 chapters in all. Part 1, The Impact of Torture, includes the first three chapters. Chapter 1 is an introduction, chapter 2 gives the survivors’ perspective, and chapter 3 is a research overview. Part 2, Conceptual Models for Understanding Torture, includes chapters titled “Psychosocial Models,” “Neurobiological Models of Posttraumatic Stress Disorder,” and “Economic Models.” Part 3, Torture and the Trauma of War, has chapters titled “Refugees and Asylum-Seekers,” “Veterans of Armed Conflicts,” “Former Prisoners of War: Highlights of Empirical Research,” “Holocaust Trauma and Sequelae,” and “Survivors of War Trauma, Mass Violence, and Civilian Terror.”

Part 4, Torture and the Impact of Social Violence, includes chapters titled “Rape and Sexual Assault,” “Homicide and Physical Assault,” “Children, Adolescents, and Families Exposed to Torture and Related Trauma,” and “Domestic Violence in Families Exposed to Torture and Related Violence and Trauma.” Part 5, Clinical Issues for Survivors of Torture, includes the chapter “Assessment, Diagnosis, and Intervention,” which is of particular interest to the clinician. Also in this section are chapters titled “Measurement Issues,” “Mental Health Services Research: Implications for Survivors of Torture,” “Provider and Caregiver Issues,” and “Torture and Human Rights Violations: Public Policy and the Law.” Finally, Part 6, Discussion, includes a chapter titled “Future Directions,” which presents a summary of selected research findings and conclusions.

Because of the clarity of the writing, this book, based on a report prepared in March 1998 by a 24-member National Institute of Mental Health Working Group on the Mental Health Consequences of Torture, Related Violence, and Trauma, turned out to be easier to read than I had anticipated. The editors enlisted the help of 23 contributors whose impressive biographical data are listed at the back of the book. They obviously “know whereof they speak.” The subject matter of the book is enriched by the fact that the perspective of the survivor of torture is integrated throughout. Most of the chapters in the book conclude with a list of research recommendations, and all are followed by copious references. There is a 26-page index section.

Space considerations naturally limit the amount of detail that can be included in a review of this sort, but I would be remiss if some of the psychological, behavioral, and medical problems that can result from torture were not mentioned. These are posttraumatic stress disorder, depression, anxiety disorder, psychosis, sleep disorders, sexual dysfunction, chronic irritability, physical illness, impaired interpersonal relationships, and impaired social, occupational, and family functioning.

In the second to last paragraph of the last chapter, the editors state, “Finally, we conclude with the hope that many who work in the field will find the information in this book of value in their work.” In my opinion, there is little doubt that people working in the field will find this book of value. Indeed, it could be considered a sine qua non for those doing research in this area.




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