20 A practical guide to the Istanbul Protocol – for psychologists should be noted • Specific questions about the most common symptoms and diagnostic criteria for most common diagnosis need to be asked. (See § 277 in the Istanbul Protocol.) 3. POST-TORTURE HISTORY The clinician should inquire current life circumstances, including: • Sources of additional stress, traumas, losses, difficulties • Formal and/or informal social support resources • Marital and family situation • Employment status, livelihood • Vocational, social status and conditions • Life conditions and quality of life of the interviewee and his/her family. (See § 278 in the Istanbul Protocol.) 4. PRE-TORTURE HISTORY If relevant, describe: constraints and other problems, all this information can not be obtained. The clinician usually has to decide which information is indispensable or has higher priority and make a careful decision. In some situations background information can be left for the end of the interview since to ask for it in the beginning may have a negative effect on the interview process. (See §§ 279-280 in the Istanbul Protocol.) 5. MEDICAL HISTORY Medical history should include: • • • • Pre-trauma health conditions Current health conditions Body pain, somatic complaints Physical injuries and findings. Physical findings that might be related to trauma should be noted. It is important that the health professional who is making the psychological evaluation should also look for and document the physical findings of trauma. In some instances, the one who makes the psychological evaluation can be the first or the only health professional that the victim can come into contact with. • The victim’s past story (childhood, adolescence, early adulthood), family background, family illnesses and family composition • The victim’s educational and occupational history • Any history of past trauma • The victim’s cultural and religious background. • Use of medications and their side effects or obstacles in using medications • Relevant sexual history • Past surgical procedures and other medical data. Assessment of mental health status and level of psychosocial functioning prior to traumatic events gives the interviewer the opportunity to compare the current health conditions of the individual with that of before torture. 6. PSYCHIATRIC HISTORY It should be noted that often due to time (See § 281 and chapter V, section B, for Medical history; for Physical evidence of torture see chapter V, sections C and D in the Istanbul Protocol.) History of any mental or psychological disturbances, including the nature and degree of problems, treatment (or non treatment)