TORTURED BRAINS

www.vivo.org
vivo – victims‘ voice
University of
Konstanz
TORTURED
BRAINS
Torture experiences in a sample of survivors of
organized violence seeking asylum in Germany
65
being stripped naked
20
rape /penetration with object
45
twisting/ mutilation of genitals
57
being beaten on genitals
39
being hung
23
being burned
29
being submersed under water
52
48
strangling
mock execution
% subjects
84
death threats
39
38
being forced to witness torture
electric shock
71
being blindfolded
50
Falanga/Falaka
84
84
being beaten on the body
being beaten on the head
0
20
40
60
80
100
Torture experiences of refugees in a Ugandan refugee camp
0%
10%
20%
30%
40%
50%
60%
70%
80%
witnessed beatings or torture
witnessed injury by weapon
witnessed abduction
confiscation of property by officials
witnessed robbery / extorsion
witnessed murder
witnessed accident
witnessed rape of a woman
witnessed act of suicide
witnessed combat situation
dangerous evacuation
beatings or torture
witnessed forced circumcision
robbery / extorsion
Series1
harassment of armed personel
accidents
combat situation
imprisonment
abduction
forced isolation
experienced injury by weapon
forced marriage
child marriage
beatings from spouse
rape
forced circumcision
sex for food or security
forced prostitution / sex. slavery
POST-TRAUMATIC
STRESS DISORDER
(PTSD)
reexperiencing
avoidance
hyperarousal
vivo outpatient clinic for refugees
University of Konstanz, Germany
Prevalence of
Post-traumatic Stress Disorder (PTSD)
Refugees
Torture survivors
37%
93%
PTSD
vivo outpatient clinic for refugees, Germany
no PTSD
Ongoing epidemiological survey on traumatic life
experiences and mental health of refugees & asylum
seekers in Northern Italy
COUNT RY OF ORIGIN
Sierra Leone; 3%
Costa d'Avorio; 6%
Guinea; 3%
Liberia; 3%
Bosnia; 9%
Irak; 3%
Turkey; 3%
ngo - Dem. Rep.; 6%
Kossovo; 3%
Togo; 12%
Camerun; 38%
Etiopia; 3%
Sudan (Darfur); 9%
Î
PTSD was more frequently diagnosed in torture survivors
compared to other refugees/ asylum seekers.
Predictors of PTSD Symptom Severity
in torture survivors
BETA
St. Err.
Constant
p
0,7
age
0,07
0,16
0,66
Sex (female)
0,43
0,16
< 0,05
Years of education
0,01
0,16
0,93
Number of arrests
-0,21
0,17
0,25
Months since event
0,31
1,16
0,06
Tot. number of war- and torture related
event types ever experienced
0,59
0,17
< 0,005
Linear Regression on ‘PTSD symptom score’ (R² corr.= .33; p < .01)
Î
Strongest predictors of PTSD symptom severity were
female sex and number of war and torture event types
Dose – Effect of traumatic stress
Sudanese refugees, Imvepi
refugee camp, Uganda
Tamil school children,
North-East Sri Lanka
(Neuner et al. 2004, BMC Psychiatry)
(Catani et al., 2005, ESTSS)
ABNORMAL SLOW WAVE ACTIVITY (ASWA)
IN TORTURE VICTIMS WITH PTSD
Abnormal slow-wave rhythms (delta range 1.5 – 4 Hz) in the brain
have been found to be related to brain pathology or dysfunctional
neural tissue.
Also, ASWA was found in conditions of psychopathology, such as
depression and schizophrenia.
⇒ ASWA can be produced by both structural
and functional neural networks that are
deprived of their inputs.
⇒ Neural generators of slow-wave rhythms
can be identified through magnetic source
imaging by using dipole density
measurements from MEG.
(Rockstroh, B. et al.. submitted)
Prefrontal &
temporal
ASWA focus
in torture
victims with
PTSD
SPEECHLESS TERROR - Indicators of decoupling of
frontal affective processors from left cortical language
areas in torture victims
Psychological dissociation in torture victims and its manifestation
within neural networks in the brain
⇒ Dissociative experiences associated with ASWA generated in
the left ventrolateral frontal cortex.
(Ray, Odenwald et al., 2006)
Torture victims
showed elevated
production of
focally generated
slow waves,
particularly in left
temporal brain
regions (peak in
the insular
cortex).
(Kolassa, Wienbruch, Neuner et al., submitted)
AFFECTIVE STIMULUS PROCESSING IN
TORTURE SURVIVORS WITH PTSD
Pleasant picture (2 s)
ISI & fixation (4-10 s)
Neutral picture (2 s)
t
Unpleasant picture (2 s)
Pictures taken from the
International Affective
Picture System (IAPS)
Subjective affective ratings and heart rate
responses to emotional visual stimuli
Î sustained heart rate
acceleration for high
arousing unpleasant
pictures in PTSD
patients
Î unpleasant
pictures rated
significantly more
arousing by PTSD
patients
PTSD patients
Significantly
enhanced late
P3 component
for arousing
pictures in PTSD
patients.
Controls
Saleptsi et al, in prep.
MEG data:
Grand Mean
Activity (rms)for
each affective
category
Schizophrenia patients
MEG in the EPN-M time interval
FAST PICTURE
PROCESSING IN TORTURE
SURVIVORS WITH PTSD
fMRI
Areas of significant
group effect
in the 60-110ms time interval
PTSD; Aversive
PTSD; Neutral
Controls; Aversive
Controls; Neutral
0
100
200
300 ms
Junghöfer et al., 2001
Neuner, Junghöfer et al., in prep.