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The National Institute of Mental Health (NIMH) recently formed a working group to prepare an official NIMH report on the psychobiological consequences of torture and extreme trauma, at the request of members of the South African Truth and Reconciliation Commission (TRC). The report will focus on what is known about the acute and enduring psychobiological effects of torture and extreme trauma, including imprisonment, war and combat experiences, mass violence and rape, as well as a discussion of the resultant disability and associated social and economic impact of such trauma. Significant attention will also be given to assessment and treatment issues for survivors and recommendations for future research.

Since early 1996, the South African Truth and Reconciliation Commission has heard testimony from more than 10,000 survivors and perpetrators of torture and violence but has not had the resources to carefully assess the consequences of the torture and trauma that adults and children have experienced in South Africa. Both bureaucratic and practical hurdles have made it difficult for the TRC to draft policy recommendations based largely on the testimony of victims.

The NIMH report stems from converging mental health research, services and human rights interests that came together in April 1997 at an NIMH-cosponsored conference on mental health research and services for survivors of torture. This two-day conference involved leading researchers in the field of trauma and refugee mental health, representatives of treatment centers providing physical and mental health services, survivors of torture and representatives of relevant international human-rights and governmental organizations.

As a result of the Survivors of Torture conference, representatives of the TRC who participated in the conference asked Steven Hyman, MD, director of NIMH, to support the preparation of a scientific document summarizing the psychobiological impact of torture and extreme trauma, including issues of psychiatric diagnosis, disability, functioning, economic cost, treatment and research needs. The TRC representatives felt that such a report would be of great benefit to the treatment, policy and rehabilitation efforts underway in South Africa.

The report is scheduled for completion by the end of 1997 and is intended to be a focused review of the scientific knowledge base in areas of torture and extreme trauma. NIMH and the working group members hope it will be a useful document for individuals and countries in similar situations throughout the world.

The working group is led by Co-Chairs Terence Keane, PhD (president of ISTSS), Ellen Gerrity, PhD (NIMH), and Farris Tuma, ScD (NIMH). As of this writing, the group includes 18 members: Metin Basoglu, MD, PhD; Brian Engdahl, PhD; John Fairbank, PhD; Matthew Friedman, MD, PhD; Merle Friedman, PhD; James Jaranson, MD; Marianne Kastrup, MD, PhD; Dean Kilpatrick, PhD; J. David Kinzie, MD; Mary Koss, PhD; Kathryn Magruder, PhD, MPH; Anthony Marsella, PhD; Richard Mollica, MD; Sr. Dianna Ortiz, OSU; Robert Pynoos, MD; Agnes Rupp, PhD; Derrick Silove, MD; and Steven Southwick, MD. Additional NIMH officials involved are Steven Hyman, MD; Darrel Regier, MD; Ellen Stover, PhD; and Kenneth Lutterman, PhD. *