PART D – Psychological consequences of torture on individuals pre-existing psychological disorders, pre-existing psychosocial functioning, family history of psychopathology, personality traits, patterns of coping. 4. HISTORY AFTER TORTURE EVENT (POST-TORTURE HISTORY) • Concurrent and/or consequent additional traumas, (such as imprisonment, civilian attacks,[...]) • Traumatic conditions after torture • Losses: –– Family, friends –– Home, possessions, personal belongings –– Employment, livelihood, social status • Separations (family, country, friends) • Flight from his/her own settlement or forced migration • Additional difficulties: –– Difficulties in the new settlement (such as acculturation, language bar- • • • • 25 riers, discrimination in the host settlement) –– Decrease in the quality of life –– Deprivation of food, shelter, medical attention The weakness of restorative justice, impunity Social and/or cultural isolation Concern for the safety of him/herself and/or other family members or significant others Intense fear and/or suspicion about being re-arrested, forced to go underground to avoid being arrested again. (See § 234, § 280 and § 288 in the Istanbul Protocol and American Psychiatric Association (APA), 2004; Australian Centre for Posttraumatic Mental Health (ACPMH), 2007; Ehrenreich, 2003; Gurr & Quiroga, 2001; Iacopino, et. al., 2001; Kira, 2002; Mayou et al., 2002; Mc Farlane, 1995; McFarlane & Yehuda, 1996; National Institute for Clinical Excellence (NICE), 2005; Peel et al., 200, 2005; Somnier et al., 1992; Summerfield, 1995; Summerfield, 2000; Turner et. al., 2003; van der Kolk et al., 1996; Varvin, 1998; Vesti, 1996a, 1996b; Yehuda & McFarlane, 1995.) II. FREQUENTLY SEEN PSYCHOLOGICAL RESPONSES “Before entering into a technical description of symptoms and psychiatric classifications, it should be noted that psychiatric classifications are generally considered to be Western medical concepts, and that their application to non-Western populations presents, either implicitly or explicitly certain difficulties[…]. The idea that mental suffering represents a disorder that resides in an individual and features a set of typical symptoms may be unacceptable to many members of non-Western societies” (Istanbul Protocol, § 240). What is considered disordered behaviour or a disease in one culture may not be viewed as pathological in another (Kagee, 2005). While some symptoms may be present across differing cultures, they may not be the symptoms that concern the individual most. Symptoms need to be understood in the context in which they occur and through the meaning they represent to the individual experiencing them. Distress and suffering are not in themselves pathological conditions, the symptoms are sometimes a “normal” response to societal pathology (Gurr & Quiroga, 2001). “[...]Additional problems arise when trying to assess whether psychological symptoms or behaviours are pathological or adaptive. When a person is examined while in deten-