Self-reports of trauma and torture are often not believed or are felt to be distortions or exaggerations for secondary gain. Self-reported physical and psychological symptoms can also be construed as fabrications or exaggerations.
However, there is evidence that cognitive disturbances can follow a range of types of trauma. Many torture survivors have been subjected to physical injury to the brain from blows to the head, suffocation (including near- drowning), and starvation and other forms of prolonged nutritional deficiencies. These may lead to persistent cognitive impairment. Additionally, depression and PTSD affect cognition.
Memory impairment as a result of these factors may affect the accuracy of the details an individual is asked to provide about his/her torture. The inability consistently to reproduce detailed and precise recollections about times, places and incidents can reflect negatively on the individual’s credibility. However, most of these factors are sufficiently well researched to allow the reasons for such discrepancies to be understood if they are explained properly to a court. It is the proper function of an expert witness to assist the court by reference to relevant research and other material within his or her field of expertise.
Lapses in memory
Memory loss or variation in history can happen due to misinterpretation of events, waning of memory of events over time, giving importance to some events over others and therefore forgetting details of one while remembering another. there can be a feeling that the doctor wants to hear certain things, then this becomes the focus.
Any head injury can lead to loss of episodic memory (memory of events or incidents from a person's past), even if there is no loss of consciousness. There will be a degree of retrograde amnesia (loss of memory for events immediately prior to the trauma) because the information stored in the short-term memory is not transferred into one of the permanent memory stores. There will then be some further prospective memory loss (loss of memory of the period immediately after the trauma) until the memory processes are functioning normally again. The period of memory loss is longer than the period of unconsciousness, and classically there are islands of memory from periods when the individual is more alert.
Some survivors of torture experience episodes on which they appear withdrawn and unresponsive for a short time, and when they return to normal they have no memory of the episode. One possible diagnosis is complex partial seizures, but there are several possible alternative psychological causes (although they could co-exist with epilepsy). One of these causes is panic attacks, although these generally last longer than a couple of minutes, and the sufferer is usually aware that he or she has not lost consciousness. Complex partial seizures (also known as temporal lobe epilepsy, TLE) have been misdiagnosed as panic attacks, and vice-versa. Brain tumours can mimic both syndromes. Also psychiatric problems such as depression and PTSD can interfere with normal memory processes (see above).
Absences associated with memory loss are also seen in dissociation states. These are psychological states which usually start during severe stress (perhaps as a psychological protection mechanism), and recur with memories of the incident. Symptoms can be similar to those felt rarely in the aura of complex partial seizures, such as déjà-vu (the feeling of having experienced something before), mystical experiences, and awareness of the absence of thoughts. The main difference is that episodes of dissociation are much longer than those of complex partial seizures, lasting at least fifteen minutes, and normally for several hours.
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