Shukrije Gashi spent nearly two years as a political prisoner in Kosovo. Strictly speaking, she was not tortured, but 2 1/2 decades later it still feels that way.
A pro-independence activist when Yugoslav authorities jailed her in 1983, Gashi was confined to a cramped, unventilated cell. She was fed small rations of often-rotten food, allowed to shower just once a month, and endured frequent beatings and verbal abuse.
Today, she still trembles whenever she sees the police. Her ordeal, she says, is "a spiritual burden that stays with you forever."
Prisoners who endure poor or degrading treatment suffer much of the same long-term psychological distress as do captives who are physically tortured, suggests a study published Monday in the U.S.-based Archives of General Psychiatry. Experts said the findings underscore the need for a broader definition of torture.
"What is the basis for the distinction between torture and other cruel and degrading treatment? Science should inform this debate," the study's lead author, Metin Basoglu of the Institute of Psychiatry at King's College in London, told The Associated Press in a telephone interview Monday.
Steve H. Miles of the University of Minnesota's Center for Bioethics, who was not involved in the study, said the findings "show that the severity of long-lasting adverse mental effects is unrelated to whether the torture or degrading treatment is physical or psychological."
"The wrongness of these inflicted harms is compounded by the fact that most abused prisoners, including those in the present war on terror, are innocent or ignorant of terrorist activities," Miles said.
The administration of U.S. President George W. Bush has said the U.S. uses legal interrogation techniques not torture to gain information that could head off terror attacks. It insists that the U.S. complies with the U.N. Convention Against Torture.
Yet Washington's definition of torture, as interpreted by the U.S. Justice Department after reports of American abuses at Guantanamo Bay and in Iraq and Afghanistan surfaced, is fairly narrow.
It excludes mental pain and suffering created by certain acts that do not cause severe physical pain, such as blindfolding, hooding, forced nudity, isolation and deprivation of sleep or light, the researchers said, citing a Dec. 30, 2004, Justice Department memo. It also contends that for an act to be considered torture, there must be proof that it inflicts "prolonged mental harm."
"The implications of such a narrow definition of torture have raised serious concerns in the human rights community," said Monday's study. "These findings suggest that physical pain per se is not the most important determinant of traumatic stress in survivors of torture."
The study involved interviews with 279 victims who suffered various forms of ill treatment and torture while imprisoned in the 1990s in the former Yugoslavia.
The researchers said they found that aggressive interrogation techniques, humiliating treatment, verbal abuse, threats against a captive's family and being forced to watch an acquaintance being tortured produced much of the same long-term mental trauma as physical torture.
"Sham executions, witnessing torture of close ones, threats of rape, fondling of genitals and isolation were associated with at least as much if not more distress than some of the physical torture stressors," they wrote.
Such experiences were just as likely as physical torture to lead to depression or post-traumatic stress disorder, the study said.
"Ill treatment during captivity ... does not seem to be substantially different from physical torture in terms of the severity of mental suffering they cause," it concluded. "These procedures do amount to torture, thereby lending support to their prohibition by international law."
Gashi, the Kosovo activist, copes by writing poetry and running a center for conflict management, reports AP.
But 24 years later, she still can't erase the indelible memories of what she endured.
"The treatment in prison was horrific," she said. "I remain psychologically burdened. Memories of the violence follow me like a shadow."