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Self-Assessment and Quiz

  1. All medical evaluations and documentation of torture and ill treatment should include a detailed psychological evaluation because:
    1. One of the primary objectives of torture and ill treatment is destruction of the psychological and social integrity of victim
    2. Torture and ill treatment often cause devastating psychological symptoms
    3. Torture and ill treatment may leave no physical signs or symptoms
    4. Psychological symptoms are often more persistent and troublesome than physical symptoms
    5. All of the above
  2. Which of the following is/are true about psychological sequelae of torture and ill treatment?
    1. Not everyone who has been tortured develops a diagnosable mental illness
    2. Distress and suffering associated with traumatic experiences are not in themselves pathological conditions
    3. Clinical diagnoses of Major Depression, anxiety disorders and PTSD are not specific for torture and ill treatment
    4. Fear, shame, mistrust, guilt and rage are common emotional reactions among survivors of torture and ill treatment
    5. All of the above
  3. Torture and ill treatment may have profound effects on individuals, but rarely affect families and society.
    1. True
    2. False
  4. Which of the following reasons may explain why survivors of torture and ill treatment may not trust examining clinicians?
    1. Clinicians may have participated in their torture and ill treatment
    2. Survivor’s fear of not being believed
    3. Survivor’s fear of being overwhelmed by psychological symptoms
    4. Survivor’s fear that information revealed in the context of an evaluation cannot be safely kept from being accessed by persecuting governments
    5. All of the above
  5. It is important for clinicians to be aware of potential countertransference reactions because such reactions may result in:
    1. Underestimating the severity of consequences of torture and ill treatment
    2. Forgetting details of the case
    3. Leading to disbelief regarding the veracity of alleged torture and ill treatment
    4. Failure to establish necessary empathic approach
    5. Over-identification with survivor
    6. Vicarious traumatisation, burn-out
    7. Difficulty in maintaining objectivity
    8. All of the above
  6. Diagnostic criteria for PTSD include the following categories:
    1. Phobias
    2. Re-experiencing symptoms
    3. Hyperarousal symptoms
    4. Psychosis
    5. Aviodance/Numbing symptoms
    6. All of the above
  7. Symptoms of PTSD commonly increase or recur under which of the following circumstances?
    1. Anniversary of traumatic experiences
    2. Prior to a medical evaluation for torture and ill treatment
    3. After gaining asylum in another country
    4. When individuals have any interactions with police or security forces
    5. All of the above
  8. Which of the following symptoms is/are characteristic of Major Depressive Disorder?
    1. Depressed mood
    2. Anhedonia
    3. Appetite disturbance
    4. Sleep disturbance
    5. Psychomotor retardation or agitation
    6. Fatigue, poor energy
    7. Feelings of worthlessness
    8. Poor attention, concentration and memory
    9. Thoughts of death
    10. Suicidal ideation
    11. Suicide attempts
    12. All of the Above
  9. Psychological effects of torture should not be oversimplified. In addition to PTSD and Major Depression, the following should be consider:
    1. Anxiety Disorders
    2. Substance Abuse
    3. Enduring Personality Change
    4. Somatoform Disorders
    5. Dissociation
    6. Psychosis
    7. All of the above
  10. Repeated presentation of physical symptoms together with persistent requests for medical investigations, despite repeated negative findings and reassurances by doctors that the symptoms have no physical basis are characteristic of?
    1. Anxiety disorders
    2. Somatiform disorders
    3. Neurotic disorders
    4. Affective disorders
  11. Neuropsychological assessment may be useful in evaluating individuals suspected of having brain injury and in distinguishing brain injury from PTSD.
    1. True
    2. False
  12. Which of the following are not components of the mental status examination?
    1. General appearance
    2. Motor activity
    3. Speech
    4. Mood and affect
    5. Thought content
    6. Thought process
    7. Cranial nerve assessment
    8. Suicidal and homicidal ideation
    9. Cognitive exam
    10. Insight and judgment
    11. None of the above
  13. Severe torture always results in significant psychological symptoms.
    1. True
    2. False
  14. In the course of your psychological evaluation of a 26 year-old women, you learn of several inconsistencies in her account of torture and ill treatment. What should you do next?
    1. Ask for further clarification
    2. Document your suspicion and continue the interview
    3. Refer to another clinician to ask for second opinion
    4. Use a standardized psychological instrument to assess for possible malingering
  15. Obtaining detailed pre-torture psycho-social information is often helpful in establishing trust during a medical evaluation, but such information should not be included in the interpretation of psychological evidence.
    1. True
    2. False
  16. According to Istanbul Protocol guidelines, which of the following types of psychological instruments should be routinely administered in medico-legal evaluations?
    1. Clinician-administered instruments such as CAPS (Clinician-Administered PTSD Scale)
    2. Self-administered instruments that the alleged victim fills out
    3. Both clinician-administered and self-administered instruments
    4. None of the above
  17. In conducting the psychological evaluation, the assessment and interpretation should always be made with awareness of cultural, political and social context as well as conditions of the interview and assessment.
    1. True
    2. False
  18. According to the Istanbul Protocol, interpretations of psychological evidence of alleged torture and ill treatment should include:
    1. Consistency between psychological symptoms and allegations of alleged torture and ill treatment
    2. Consistency between expected reactions to extreme stress within the cultural and social context of the individual
    3. The temporal relationship between psychological symptoms and alleged torture and ill treatment
    4. Identification of coexisting stressors and their impacts on the individual
    5. Physical conditions complicating the clinical picture
    6. Comments on the possibility of false allegations of torture and ill treatment
    7. All of the above
  19. Evaluation for documentation of torture for medico-legal reasons should be combined with an assessment for other needs of the individual. Those who appear to be in need of further medical or psychological care should be referred to the appropriate services.
    1. True
    2. False
  20. Which of the following is true about the effects of torture on children?
    1. Children often express their thoughts and emotions regarding trauma behaviorally rather than verbally
    2. If a child has been physically or sexually assaulted it is important, if at all possible, for the child to be seen by an expert in child abuse
    3. A child’s reactions to torture depends on age, developmental stage and cognitive skills
    4. The symptoms can be similar to those observed in adults but the clinician must rely more heavily on observations of the child’s behavior than on verbal expression
    5. In order to preserve cohesion in the family, dysfunctional behaviors and delegation of roles may occur
    6. All of the above