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VI. PSYCHOLOGICAL EVIDENCE OF TORTURE AND ILL-TREATMENT ISTANBUL PROTOCOL

and a cognitive examination (orientation, long-term specific situations. The lack of standardization for the
memory, intermediate recall and immediate recall). specific group of reference, the lack of cross-cultural
validity, and linguistic differences can severely limit
(i) Assessment of social function the meaningfulness and reliability of the results.
Little published data exist on the use of projective
538. Trauma and torture can directly and indirectly and objective personality tests in the assessment of
affect a person’s ability to function. Torture can also torture survivors and their use should therefore be
indirectly cause impairment or loss of functioning and evaluated with special care. There is no evidence
disability, if the psychological consequences of the that specific personality traits as measured in these
experiences impair the ability of individuals to care tests typically result from the experience of torture
for themselves, earn a living, support a family and or that certain personality traits are inconsistent with
pursue an education. The clinician should assess the having been tortured. Also, psychological tests of
individual’s current level of functioning by inquiring personality lack cross-cultural validity. Personality
about daily activities, social role (e.g. student, worker tests have frequently been misused to stigmatize
or parent), social and recreational activities and alleged victims, question their overall credibility or
perception of health status. The interviewer should ascribe the emotional state to personality traits. In
ask individuals to assess their own health conditions, any case, psychological testing can only complement
to state the presence or absence of feelings of chronic the clinical interview, it can never be a substitute for a
fatigue and to report potential changes in overall comprehensive psychological evaluation as described
functioning. Because social function, by definition, in the present chapter. The use of psychological tests
encompasses an individual’s behaviour, social skills, should not be considered as an imperative, nor as
feelings and overall well-being, it is important to generally more objective or more evidentiary than
assess social function through multiple dimensions. the clinician’s evaluation. Nevertheless, they can be
Changes in social function could stem from the an important source of additional information and,
physical consequences of torture (such as the inability when inconsistent with the clinical impression, this
to lift weights due to shoulder joint dysfunction) or be should cause further exploration of the phenomena
related to the psychological consequences of torture. in question. Neuropsychological testing may,
For example, an individual’s activity level (including however, be helpful in assessing cases of brain
one’s willingness to engage in previously enjoyable injury resulting from torture, although issues of
activities), as well as an individual’s participatory reliability, validity and cultural relevance must be
level (including involvement in family reunions considered seriously (see paras. 549–565 below).
or engagement in society), could be detrimentally
affected. Thus, the interviewer should take these (k) Interpretation of findings
dimensions into consideration during the interview.
540. The psychological findings resulting from the
(j) Psychological testing and the use of checklists evaluation include all self-reported information offered
and questionnaires by the alleged victim as well as objective findings
observed or recollected by the clinician during the
539. Individuals who have survived torture may have evaluation. In order to interpret the psychological
trouble expressing in words their experiences findings for the purpose of delivering an opinion on
and symptoms. In some cases, it may be helpful the possibility of torture, the following important
to use trauma event and symptom checklists or questions should be considered by the evaluator:
questionnaires. 470 If the clinician believes that it
may be helpful to use these, there are numerous (a) Are the psychological findings consistent with the
questionnaires available, although none are specific alleged report of torture?
to torture victims. Before using psychological tests/
questionnaires, the clinician must take special (b) Are the psychological findings expected or typical
care to evaluate their cultural appropriateness and reactions to extreme stress within the cultural and
potential negative impact on torture survivors in social context of the individual?

470 Joseph Westermeyer and others, “Comparison of two methods of inquiry for torture with East African refugees: single query versus checklist”, Torture, vol. 21, No. 3 (2011),
pp. 155–172.

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