— The distress caused by a variety of torture techniques (Source: Metin Basoglu et al)
Prisoners subjected only to psychological torture report as much mental anguish as those who are beaten, according to new research.
The study of nearly 300 survivors of torture from the former Yugoslavia found that those who experienced no physical torment later developed equally high levels of post-traumatic stress disorder (PTSD) as those who did. The survivors also rated the distress caused at the time by the two types of torture equally highly. Researchers say the findings provide a strong argument against the use of psychological maltreatment of prisoners - referred to by some as "torture lite".
The UN convention against torture came into force in 1987, prohibiting acts that cause severe pain or suffering in order to gain information from prisoners. Nevertheless, torture still appears widespread around the world: a 2005 report by Amnesty International found that systematic torture occurred in 104 out of 150 countries surveyed.
Since the attacks on the US on 11 September 2001, the nation received severe criticism for torturing suspected terrorists abroad, such as in the Abu Ghraib prison and at the Guantanamo Bay naval station. Officials claimed that the psychological torture used against detainees there - such as sleep deprivation - were legal as these did not cause direct physical harm.
"These techniques were designed to break down prisoners to get information without leaving a physical mark on them," explains Leonard Rubenstein, executive director of Physicians for Human Rights.
To investigate the impact of purely psychological torture, Metin Basoglu of Kings College London, UK, and colleagues surveyed 279 survivors of torture from the former Yugoslavia, including both soldiers and civilians from the previously war-torn region.
Between 2000 and 2002 the survivors answered questions about the nature of the torture they endured. The majority of them had endured beating and other forms of physical torture, including electric shocks, tooth extractions and suffocation. But about 20 of the survivors experienced purely psychological manipulations, such as sham executions or the torturing of family members and threats of rape.
The researchers collected medical assessments of whether the torture survivors showed signs of PTSD - a form of lasting anxiety. They found no difference in the prevalence of this disorder between the two groups.
Mind and body
They also asked the participants to rate their distress during torture on a scale of zero (no distress) to four (maximum distress). Both those who suffered physical torture and those who experienced physiological torment alone rated their overall level of stress as 3.5.
Basoglu says the findings challenge the common perception that psychological torture is less distressing than physical torture. "Implicit in this distinction is a difference in the distressing nature of the events. The evidence takes issue with that," he says. "And since psychological torture is as bad as physical torture, we shouldnt use it."
The findings chime with previous work, say others. "The conclusions are completely consistent with what those subjected to these draconian practices have reported," Rubenstein says. He points out that US Senator John McCain, who experienced torture as a prisoner of war in Vietnam, has said that if he were forced to make a decision between enduring psychological or physical torture, he would not hesitate to pick the latter.
McCain and fellow lawmakers pushed for an explicit ban on the US using any form of torture. In 2005, US president George W Bush signed the bill outlawing the torture of detainees. And officials later revised the Army Field Manual to explicitly ban certain treatments of detainees, such as forced nudity and sex acts, hoods or duct tape on the eyes, and electric shock. "We dont know what the CIA is doing, though," Rubenstein notes.
Beyond question of human rights violations, recent reports have also raised doubt over whether any form of torture produces reliable information, he adds.
"Torture generates extremely bad intelligence data" and is "enormously counterproductive", according to bioethicist Steven Miles at the University of Minnesota in Minneapolis, US. He gives the example that some of the information linking Iraq to Al-Qaeda, which later proved wrong, came from a man named Ibn al-Shaykh al-Libi during CIA interrogations in Egypt that involved torture.
Journal reference: Archives of General Psychiatry (vol 64, p 277)