Hidden scars: the persistent multifaceted health and psychosocial consequences for Syrian torture survivors

Eur J Psychotraumatol. 2024;15(1):2400833. doi: 10.1080/20008066.2024.2400833. Epub 2024 Oct 1.

Abstract

Background: The impact on the physical and mental health of those who survived torture and their close circles in the Syrian regime's detention facilities remains under-studied.Objective: This qualitative study explored Syrian refugees' narrations of captivity and torture, and the consequences of such extreme traumatic events on their physical and psychosocial health.Method: Thirteen audio-recorded interviews were conducted in Arabic with Syrian refugees. Study participants were at least 19 years of age, resided in diverse urban areas of Jordan, had experienced captivity and torture in Syrian detention facilities, and voluntarily agreed to participate in the study. Participation was anonymous, only oral consent was required, and no incentives were provided to participants. Interviews were transcribed and translated into English by a team of researchers, followed by analysis of repetitive themes according to the narrative paradigm.Results: Analysis of interviews elicited three major themes: extreme traumatic experiences of torture, and its physical and psychosocial health consequences. The first major theme was divided into two sub-themes: torture experienced by the participants themselves, and torture experienced by participants' close circles. The second major theme, pertaining to physical health, was divided into two sub-themes: acute and chronic health sequelae. The third major theme, related to psychosocial health, was divided into four sub-themes: mental health symptomatology, impacts on professional life, impacts on interpersonal relationships, and social consequences.Conclusions: Torture experiences of Syrian refugees had adverse consequences for the physical and psychosocial health, functioning, and the overall well-being of survivors and their close circles. Interventions may seek to improve both the acute and chronic health consequences, as well as the mental health symptoms and associated impacts on livelihood, professional, and relationship dynamics. They should span clinical, legal, and advocacy spheres, given that a holistic approach may contribute immensely to survivors' healing process.

Antecedentes: El impacto en la salud física y mental de las personas, y de sus círculos cercanos, que sobrevivieron a la tortura en los centros de detención del régimen sirio, sigue siendo poco estudiado.

Objetivo: Este estudio cualitativo exploró las narraciones de cautiverio y tortura de los refugiados sirios, y las consecuencias de estos eventos traumáticos extremos en su salud física y psicosocial.

Método: Se realizaron trece entrevistas grabadas en árabe con refugiados sirios. Los participantes del estudio tenían al menos 19 años, residían en diversas zonas urbanas de Jordania, habían experimentado el cautiverio y la tortura en centros de detención sirios y aceptaron voluntariamente participar en el estudio. La participación fue anónima, solo se requirió el consentimiento verbal y no se proporcionaron incentivos a los participantes. Las entrevistas fueron transcritas y traducidas al inglés por un equipo de investigadores, seguidas de un análisis de temas repetitivos según el paradigma narrativo.

Resultados: El análisis de las entrevistas arrojó tres temas principales: Experiencias traumáticas extremas de tortura y sus consecuencias para la salud física y psicosocial. El primer tema principal se dividió en dos subtemas; tortura experimentada por los propios participantes, y tortura experimentada por los círculos cercanos de los participantes. El segundo gran tema, relativo a la salud física, se dividió en dos subtemas: secuelas agudas y crónicas de salud. El tercer gran tema relacionado con la salud psicosocial se dividió en cuatro subtemas: sintomatología de la salud mental, impactos en la vida profesional, impactos en las relaciones interpersonales y consecuencias sociales.

Conclusiones: Las experiencias de tortura de los refugiados sirios tuvieron consecuencias adversas para la salud física y psicosocial, el funcionamiento y el bienestar general de los sobrevivientes y sus círculos cercanos. Las intervenciones pueden tratar de mejorar tanto las consecuencias agudas como las crónicas para la salud, así como los síntomas de salud mental y los impactos asociados en las dinámicas profesional, relacional y del sustento económico. Deben abarcar las esferas clínica, jurídica y de defensa, dado que un enfoque holístico puede contribuir enormemente al proceso de curación de los sobrevivientes.

Keywords: Siria; Syria; Tortura; Torture; mental health; physical health; refugees; refugiados; salud física; salud psicosocial; trauma.

Plain language summary

The torture endured and witnessed by survivors and their close circles in the Syrian regime’s detention facilities was severely traumatizing and had persistent, life-altering implications.Survivors suffered from both acute and chronic physical health consequences as a result of abuse inflicted during torture and detention facility conditions. The psychosocial health ramifications included mental health symptoms, impact on interpersonal relationships, professional challenges, and social difficulties, posing multifaceted barriers to healing.Survivors and their close circles would benefit from a holistic approach to trauma-informed interventions that may require a multidisciplinary network of services with specialized providers for extended periods.

MeSH terms

  • Adult
  • Female
  • Humans
  • Interviews as Topic
  • Jordan
  • Male
  • Mental Health
  • Middle Aged
  • Qualitative Research*
  • Refugees* / psychology
  • Stress Disorders, Post-Traumatic / psychology
  • Survivors* / psychology
  • Syria / ethnology
  • Torture* / psychology

Grants and funding

The study was funded by the Mack Center on Mental Health and Social Conflict, School of Social Welfare at the University of California Berkeley, under grant SEGAL awarded to Steven P. Segal. This study was also partially funded by a grant from the Al-Falah Program of the Center for Middle Eastern Studies, the University of California Berkeley, awarded to Niveen Rizkalla. Publication was made possible in part by support from the Berkeley Research Impact Initiative (BRII) sponsored by the UC Berkeley Library.