Publications September 2007
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While the ESTSS is preparing to set up a new task force dedicated to human rights and trauma, we see a crop of interesting new articles and research into a subject that is of increasing political and clinical urgency.
In particular, a series of four articles in The Lancet (starting with Vol 370, August 4) tackles the health implications of the human rights agenda from three perspectives - the impact on health and the way human rights are implemented; the effect of health issues on what it terms the delivery of human rights; and the effect of public health policies and programmes on human rights.
The series gives a frame for the management of traumatic stress: in countries respecting human rights; when working in delivery of health programmes to countries with a record of human rights violations; and in dealing with refugees.
The articles do not just look at the clinical implications of the human rights agenda. They point out the importance also of advocating and promoting respect for human rights as an integral part of working with traumatic stress.
The Lancet series begins with an overview on HIV/AIDS in the context of human rights, and includes an article discussing the health dimensions of human rights abuses in Myanmar (Burma).
The articles continue with an examination of legal issues relating to human rights and health. The authors describe examples from India and South Africa, pointing out the benefits to public health of good laws and a healthy legislative environment.
A Lancet editorial comment by Hannah Brown looks at the current conflict in Darfur through the lens of human rights and health, highlighting improvements within the last two years, but also risks and difficulties for the future.
The focus on human rights and trauma continues in the Journal of Nervous & Mental Disease (195(7):572-579, July 2007) with an article by Mollica et al on the "Longitudinal Study of Posttraumatic Stress Disorder, Depression, and Changes in Traumatic Memories Over Time in Bosnian Refugees."
The study examines traumatic memory consistency over a 3-year period within a sample of highly traumatised Bosnian refugees, with a focus on demographic factors, types of trauma, Post-Traumatic Stress Disorder (PTSD) and depression.
On two occasions (1996 and 1999), 376 Bosnian refugees were interviewed about 54 wartime trauma and torture events, and symptoms of PTSD and depression. The reports were compared for both time periods and the changed responses analysed for significance.
The authors report that there was consistency in reporting over time. When change occurred, it was in the direction of decreased reports at follow-up - a trend not associated with any particular diagnosis.
However, PTSD alone, without comorbid symptoms of depression, was associated with the group that exhibited an upward trend. This implies that increased reporting is related specifically to the presence of PTSD symptoms, and that PTSD may be distinctly associated with the failed extinction of traumatic memories (subscribers only)
The British Journal of Psychiatry (2007) 191: 75-81 also publishes a study on the Impact of Sexual Violence on Disclosure during Home Office Interviews.
Authors Diana Bögner, Jane Herlihy and Chris R. Brewin aimed to find out whether and how sexual violence affects asylums seeker disclosure when giving personal information during Home Office Interviews, as late disclosure is usually cited as a reason to doubt the credibility of the asylum seeker.
The results of the interviews (n=27 asylum seekers) show that the majority have difficulties with disclosure, highlighting the importance of shame, dissociation and psychopathology as well as the need for support in immigration and asylum procedures. (subscribers only)
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