ANN ARBOR---Widespread human rights abuses in apartheid-era South Africa have been extensively detailed, most recently in hearings conducted by the Truth and Reconciliation Commission (TRC). However, what is the psychological effect of testifying before the TRC among victims of human rights abuses? A University of Michigan researcher and a team of investigators in South Africa are about to launch the first study to examine that question.
"Previous research has suggested that disclosure of severe trauma can be healing," says Jeffrey Sonis, M.D., M.P.H., assistant professor of family medicine and assistant professor of epidemiology at the U-M. "However, there is also some concern that victims of profound trauma, such as human rights violations, can be re-traumatized by the experience of testifying. The purpose of our study is to determine which of these two effects has occurred in the setting of the TRC."
Sonis and Dan Stein, M.D., director of the Medical Research Council Unit on Anxiety and Stress Disorders, University of Stellenbosch, South Africa, will examine the following questions in a three-year study, "Forgiveness and the Truth and Reconciliation Commission in South Africa":
¤ Did the victims of apartheid-era human rights abuses who testified before the TRC in South Africa develop indicators of psychological healing, including forgiveness, to a greater extent than those victims of human rights abuses who did not testify?
¤ Among those who testified, what characteristics of the experience of testifying were associated with psychological healing?
¤ Did people who testified have psychological symptoms---anxiety, fear or depression---actually worsen? "We hypothesize that testifying before the TRC produced a short-term increase in anxiety and depression, but we suspect that it will produce a long-term improvement in psychological distress," says Sonis. There have been more than a dozen TRCs set up in response to human rights abuses around the world in the last 20 years. Their common aim is to identify previous abuses and accountability without criminal punishment of the perpetrators. The unique feature of the South African TRC, directed by Archbishop Desmond Tutu, is that one of its explicit goals is to foster forgiveness. Sonis and his team will determine the degree to which that occurred.
Investigators will use a list compiled by the TRC to recruit subjects who testified and will assemble another list, with the help of local authorities, of people who were victims of human rights abuses but did not testify in front of the TRC.
The research team will interview subjects and test them using various standard psychological instruments to measure indicators of psychological distress and forgiveness. The first set of data will be used as a baseline measure. Subjects will be re-tested a year later and the responses of the testifiers will be compared to those of non-testifiers after controlling for confounding factors---including the severity of abuse, motive for testifying or not testifying, demographic characteristics, and previous psychiatric treatment received.
Sonis says his team will develop two new instruments for the study:
¤ An instrument to measure characteristics associated with the development of forgiveness.
¤ An instrument that measures the various aspects of testifying, both positive and negative. The team will then look to see which of the factors on the scale predict positive outcomes---development of forgiveness and hope---as well as those that are associated with negative outcomes---depression, anxiety and post-traumatic stress disorder.
Sonis says he believes the study will result in at least three important benefits. "This is the first empirical evaluation of the truth commission process," says Sonis. "Our findings will help South Africa determine if the TRC actually helped foster reconciliation. We also hope this will help other countries set up truth commissions in a way that will promote healing. Finally, I see important theoretical advances coming out of the study---primarily in the understanding of the measurement of forgiveness and of the characteristics of testifying."
Sonis has a longstanding interest in the connection between health and human rights. He was a member of a human rights fact-finding mission by Physicians for Human Rights that went in 1993 to the former Yugoslavia to document and study human rights violations there---work that was used by the International Criminal Tribunal of the Former Yugoslavia to help indict people for war crimes. Stein is a distinguished psychiatric researcher in South Africa, and author and editor of 14 books and more than 190 scientific papers. His recent work has focused on post-traumatic stress disorder, particularly in the setting of human rights violations.
The study is supported through an international research program for Scientific Studies on the Subject of Forgiveness, funded by several organizations, including the John Templeton Foundation. Broad areas of research funded through the program include projects on healing and reconciliation in Rwanda, marriage and family, end-of-life issues, a twin-family study, and primate cultures.
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