Long-term effects of political imprisonment on men in the occupied Palestinian territory: a retrospective cohort study

Abstract

BackgroundLong-term effects of political imprisonment on functioning are unknown. This retrospective study explored the association between economic, political, psychological, physical, community, and family functioning and political imprisonment during a span of 25 years in a population-based sample of Palestinian men aged 32–43 years in the West Bank, East Jerusalem, and the Gaza Strip. MethodsEvent-history calendars and surveys of present level of functioning were given by the Palestinian Center for Policy and Survey Research to a representative sample of 884 men who completed it. Informed consent was obtained from all participants. Latent class models were used to identify patterns of imprisonment across 25 years (1987–2011). We compared mean scores of 13 measures of functioning across five latent classes of political imprisonment representing the main trajectories of imprisonment during the 25 years. To assess these 13 measures, we used previously established and validated scales for four measures, whereas others we assessed with scales we had developed and validated ourselves. FindingsThe overall response rate was 97%. Of the 884 men who completed the study, 26% (233 men) had been politically imprisoned at some point. Men imprisoned mainly during the first Intifada (1987–93; 87 men) or the Oslo period (1994–99; 78 men) did not significantly differ from men who had never been imprisoned (651 men) with respect to 12 indicators of functioning. Men who had been politically imprisoned reported higher trauma-related stress: during first Intifada mean stress was scored 1·32 (95% CI 1·05–1·58), and Oslo mean of 1·54 (95% CI 1·29–1·80), compared with men not imprisoned mean of 1·04 (95% CI 0·96–1·13; range score of 0–3; p=0·030 and p<0·001, respectively). Men imprisoned during 2006–11 (21 men), reported lower functioning than never-imprisoned men on six measures: work insecurity (mean 2·06 [95% CI 1·70–2·42] vs 2·52 [95% CI 2·40–2·65], p=0·017, range 1–5), ability to pay for their children's education (mean 2·88 [95% CI 2·31–3·44] vs 3·47 [95% CI 3·35–3·59], p=0·05, range 1–5), community belonging (mean 3·08 [95% CI 2·77–3·38] vs 3·42 [95% CI 3·34–3·51], p=0·036, range 1–5), feelings of depression (mean 1·25 [95% CI 1·03–1·47] vs 0·96 [95% CI 0·90–1·03], p=0·015, range 0–3), feeling broken or destroyed (a locally defined measure of suffering suggesting that their morale is damaged; mean 3·71 [95% CI 3·27–4·14] vs 2·99 [95% CI 2·60–3·38], p=0·035, range 1–5), and functional limitations (mean 2·84 [95% CI 2·39–3·30] vs 2·28 [95% CI 2·19–2·38], p=0·015, range 1–5). InterpretationFindings suggest long-term resilience of these men after political imprisonment. Efforts to support previous political prisoners in the occupied Palestinian territory should provide support to those recently released from political imprisonment to promote long-term recovery. FundingThe Jacobs Foundation, Switzerland.