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. 2022 Aug 17;19(16):10233. doi: 10.3390/ijerph191610233
Block 1. Attacks on Basic Human Functions NO L-C YES I
1. Starvation, torture by hunger 1
□ Insufficient food (less than 1000 calories/day, check L-C; less than 500 calories/day, check Yes)
☐ Less than three mealtimes
☐ Unhealthy/Bad quality
☐ Lack of specific nutrition (babies, specific medical needs)
☐ Waiting lines of more than one hour to receive the meal
☐ If food is dependent on the person, lack of resources to buy or obtain it
2. Restriction of urination, defecation, or hygiene 1
☐ Access prohibited, arbitrary, or used as a form of punishment or pressure
☐ Dirt—extreme unhealthiness
☐ Difficulty of access to the toilets (distance over 1 km or risk of attack or aggression on the way...)
☐ Overcrowding
☐ Lack of privacy shower/toilet—security-intimacy
☐ Absence of elementary hygiene products (soap, sanitary towels...)
☐ Lack of replacement clothing/inability to wash
3. Dehydration or torture by thirst 1
☐ Insufficient water (less than 2 L/person/day, mark L-C; less than 1 L/person/day mark Yes)
☐ Difficulty of access to water point (distance over 1 km, risk of attack or aggression on the way...) or less than one water point (tap) per 500 people
4. Induction of disease by exposure, intoxication, or inoculation
  • Exposure to fecal water

  • Exposure to airborne pathogens

  • Exposure to chemical or radiation pathogens

5. Habitability conditions 1:
☐ In detention, less than 4 m2 in individual cells, less than 3 m2 in group cells, less than 2 m2 in camp areas
  • In non-confinement, the whole area including shared areas in overcrowded conditions (LC if less than 20 m2/person, yes, when less than 10 m2/person)

  • Impossibility of privacy/being alone at any time

  • 24 h camera monitoring. Radical absence of privacy

6. Exposure to extreme temperature or humidity conditions (with no possibility of protection against them):
☐ Cold.
☐ Heat.
☐ Humidity—Moisture.
☐ Water leak due to rain without any protection possible.
7. Sleep deprivation (LC: On average less than 6 h of uninterrupted daily sleep, yes: average less than 4 h):
☐ Primary deprivation (intentional—deliberate actions to prevent or interrupt sleep, such as nighttime rounds, interrogations, music, or sounds intended to break sleep)
☐ Secondary or incidental deprivation (not clearly intentional—resulting from the conditions of detention: absence of bed, mattress, blankets in insanitary conditions, incidental shouting or shooting at night...)
8. Refusing medical treatment:
☐ Analgesia in severe pain.
☐ Necessary treatments for survival (e.g., insulin)
☐ Necessary treatments for alcohol/drug abstinence
☐ Psychiatric or psychological treatment requested and denied in serious mental disorder, including suicide
☐ Access to urgent health care
Block 3. Actions Producing Extreme Fear—Anguish NO L-C YES I
1. Direct or indirect threats against the person to inflict, repeat, or increase acts of torture or death.
2. Threats against relatives, friends, or acquaintances or threats against other detainees (e.g., rape, detention, punishment, reprisals).
  • Extortion or threats to family members through phone calls

  • Family separation.

3. Situations of perceived imminent death (e.g., mock executions).
4. Intimidating, grotesque, or terrifying environments that produce fear
  • Oppressive spaces, threatening objects, or decoration

  • Dramatization, building scenarios, or role playing by the people in charge, aimed at provoking terror.

5. Exposure to the violent actions of others
  • Forced accommodation with other people who by their nature (gender, ethnicity, ideology, role...) will plausibly exercise violence or create terror in the person

  • Absence of protection, tolerance, or passivity in the face of aggressions by others.
    • Threats of sexual violence
    • Threats of physical violence—cruel acts
6. Forced to witness the death or torture of others.
7. Lack of information:
☐ Denial of information to the person.
☐ Denial of information to the family.
☐ Relatives, friends, or colleagues of missing persons.
8. Use of situations that cause extreme fear
☐ Phobias (exposure to snakes, rats, infectious diseases, blood, etc.)
☐ Claustrophobia (mock burial, confinement in coffins, etc.)
Block 4. Actions That Produce Helplessness and Despair NO L-C YES I
1. Arbitrariness and unpredictability of living conditions (e.g., arbitrary meals, changing sleep cycles, etc.)
2. Denying information about the rules. Imposing absurd or grotesque rules. Arbitrary, illogical, or contradictory rewards and sanctions.
3. Forcing the victim to participate in their own torture without the possibility of avoiding it.
4. Lies or deceptions that cause disorientation or confusion (e.g., unfounded, fabricated, or false information, accusations, or evidence regarding motives or place of detention, family, witnesses, or perpetrators).
5. Detention of indefinite duration.
6. Empty times or long waiting times between threats, between interrogations, or between episodes of violence.
7. General suppression of all rights during a detention (e.g., right to notify family, medical care, legal assistance, interpreter...). Includes incommunicado detention.
8. Lack of fair legal procedure
  • Possibility of claiming ill treatment

  • Judicial arbitrariness (e.g., manipulation or dismissal of evidence, unjustified decisions, etc.).

Block 5. Actions That Produce Physical Pain NO L-C YES I
1. Punching, kicking, and/or slapping. Being shaken, dragged, or thrown.
2. Flagellation, whipping, or beating with batons, sticks, or cables that do not leave permanent marks. Falanga.
3. Ear slaps with open hands. Pressure on the eyeballs.
4. Being forced to be permanently in the sun, ice, extreme electrical heating/blinding light, etc.
5. Prolonged restriction of movement, straitjackets, flanges, shackles, or loops.
  • Restraint in the context of punitive detention

  • Mechanical restraints in institutions with a punitive purpose (minors, psychiatry, geriatrics, functional difference)

6. Being forced to stand, sit in a forced position, or kneel for hours; chairs and other implements with restraints
7. Strenuous exercises (specify):
☐ Forced to run, military training.
☐ Forced labor.
☐ Pushups, squats, sit-ups.
☐ Others:
8. Dry/wet suffocation—asphyxia (plastic bag, waterboarding...)
Block 7. Attacks on Sexual Integrity NO L-C YES I
1. Humiliations of a sexual nature or related to sexual orientation (e.g., forced nudity, debasing treatment, etc.)
2. Harassment with signs, suggestions, or threats of sexual assault.
3. Sexual abuse (e.g., touching, groping, etc.)
4. Anglerfish
5. Recording or dissemination of photographs with sexual content
6. Forced breaking of taboos of a sexual nature (incestuous relationships, forced intercourse with friends, animals, etc.).
7. Reproductive violence (block abortion in cases of rape, forced abortion, non-aid in birth, forced sterilization, etc.)
8. Attacks based on sexual or gender identity or orientation (e.g., genital mutilation, conversion therapies, forced virginity tests, honor killings, etc.).
Block 8. Attacks on Identity and the Need to Belong NOT L-C YES I
1. Attacks against the self or sense of self (e.g., forcing a break with the past and previous identity, questioning basic values, breaking relevant worldviews)
  • De-ideologization or forced ideologization

  • Actions that go against a person’s previous moral principles

  • Impede or attack faith-based beliefs or rituals

2. Prolonged periods in environments of inescapable and complete submission and obedience to a person, a group, or an institution
  • Lack of protection in the hands of adults or guardians

  • Social groups with rules of radical obedience

  • Total institutions including concentration camps or religious or psychiatric institutions

3. Manipulation of affect (e.g., actions that promote a traumatic bond with those who exercise dominance or control
  • Simultaneous actions of care and repudiation, occasional arbitrary favors

  • Emotional confusion and ambivalence feelings (love alternating with hate; fear with protection; strong accusation with forgiveness)

4. Induction of guilt (e.g., forcing the detainee to do or cause harm to others, induced denunciation or betrayal, failure to protect family or friends, etc.).
5. Induction of humiliation and/or shame not linked to sexual integrity (e.g., treatment as an animal, impeding personal hygiene, forcing humiliating acts, exhibited in public, repeated vexations, etc.)
6. Prolonged solitary confinement (more than 15 days).
7. Prolonged isolation from sources of affect, breaking of social, cultural, or political ties and networks of belonging. Cultural isolation. Separation from relatives (i.e., children, parents) if they are in the same space.
8. Stigmatization or social criminalization by individuals or by the state, including public attacks, threats, or denigration through the media or social networks or through community or relevant networks of belonging
1 Calculated as 50% of the minimum required for refugee or displaced populations in the Sphere Project Guidelines.