Abuse and Violence Flashcards
Define abuse
the wrongful use of maltreatment of a person by another
Define violence
threatened or actual physical force by a person or group against another
What are advanced-practice interventions for violence?
-individual psychotherapy
-family psychotherapy
-group psychotherapy
What are the types of violence?
-youth violence
-family violence (intimate partner, child, and elder abuse)
-rape and sexual assault
What are some secondary effects (co-morbidities) of violence?
-depression
-suicidal ideation
-chronic post-traumatic stress symptoms
-dissociation
-interpersonal disturbances
-substance abuse
-revictimization
What does the occurrence of violence require to take place?
-perpetrator
-vulnerable person
-crisis situation
What are the risk factors of families with abuse and violence?
-poverty
-social isolation
-abuse of power and control
-access to firearms
-intergenerational transmission
What are the common characteristics of perpetrators of violence?
-own needs are considered more important than the needs of others (antisocial personality disorder)
-poor social skills
-extreme pathological jealousy
-may control family finances
-dominance, power, and coercive control are the primary drives
-behaviour includes emotional abuse, degradation, restrictions on freedom, threats, stalking and isolation from family
What types of women are at greater vulnerability for violence?
-single, divorced and separated women
-MMIWG
Describe the cycle of violence
Phase 1: tension building (verbal abuse, isolation, degradation, monitoring activities and contacts)
Phase 2: Violence erupts (severe injury)
Phase 3: Remorse ensues (perpetrator becomes kind, loving, asking for forgiveness)
Cycle repeats
What are the characteristics of vulnerable children?
-younger than 3 years old
-perceived as different
-remind parents of someone they do not like
-product of an unwanted pregnancy
-interference with emotional bonding between parent and child
What are some warning signs of abused/neglected children?
-serious injuries (burns, fractures, etc.)
-delay in seeking treatment for a significant injury
-history inconsistent with severity of injury
-inconsistencies or change in the history during the evaluation
-unusual injuries for the child’s age or developmental level
-increase incidence of UTIs, bruised or tearing of genitals or rectum
-evidence of old injuries not reported that caregiver cannot explain
What are some trauma and stressor related disorders that are responses to abuse?
-Acute Stress Disorder (ASD)
-Reactive Attachment Disorder (children)
-Adjustment Disorder (doesn’t warrant PTSD Dx)
-Post-traumatic stress disorder (PTSD)
What are the Dissociative disorders that are responses to abuse?
-Dissociative Identity Disorder (DID)
-Dissociative amnesia
-Depersonalization/derealization disorder
Describe the relationship between substance abuse and survivors of violence
-association between childhood abuse, PTSD and substance abuse is well-established
-survivors who experience PTSD, depression and other forms of hyperarousal or emotional distress often abuse substances that inhibit noradrenergic activity and decreases stress
What are some psychological responses to abuse?
Low self-esteem:
-alienation from self (painful feelings that go to the core)
-alienation from others (painful feelings from being disconnected to others)
Guilt and shame:
-blame self for abuse
-prevent victims from seeking medical care and reporting abuse
Anger:
-chronic irritability, unexpected or uncontrollable feelings of anger
Define Alexithymia
a personality trait that makes it difficult to identify, understand and express emotions
Define sexual assault
any sexual activity or bodily contact for which consent is not obtained or freely given
–>includes any sexual activity between an adult and a child
What are the date-rape drugs?
Rohypnol: causes muscle relaxation and amnesia
Gama hydroxybutyrate (GHB): CNS depressant
Ketamine hydrochloride (special K): CNS depressant
What happens in the days and weeks following sexual assault?
Survivors may experiencce insomnia, crying, eating problems, menstrual irregularities, become withdrawn, sullen, mistrustful, experience guilt and shame
When does emotional distress peak and last for sexual assault survivors?
emotional distress tends to peak about three weeks after the assault and tends to remain high for a month or two before abating
What are the possible lasting problems that may happen for sexual assault survivors?
-feeling powerless to affect their own fates
-encountering problems at work
-impaired relationships with partners
-sexual problems
What are the psychological effects of sexual assault?
suicide
depression
anxiety
fear
difficulties with daily functioning
low self-esteem
sexual dysfunction
somatic complaints
substance abuse
What psychological disorders result from sexual assault?
Anxiety disorders and depression
Alcohol and substance abuse
Lower self-esteem
Acute trauma disorder
Rape trauma syndrome
Post-traumatic stress disorder
What are the sexual violations that apply only to victims under 18 years old?
-luring a child via the computer
-sexual exploitation
-sexual interference
-invitation to sexual touching
-making sexually explicit material available to a child
Define sexual harassment
deliberate or repeated unsolicited and unwelcome comments, gestures, or physical contact of a sexual nature
may include: verbal harassment, verbal abuse, leering or ogling, brushing against a persons body, etc.
What are Sexual Assault Nurse Examiners (SANE’s)?
-RNs with specialized training in caring for sexual assault patients
-demonstrated competency in conducting medical and legal evaluations
-ability to be an expert witness in court
What is a Sexual Assault Response Team (SART)?
comprehensive and collaborative services involving social, health, policing, justice and community agencies
What are the 5 steps that a SANE follows?
1) head to toe physical assessment for signs of injury
2) detailed genital examination
3) evidence collection and preservation
4) documentation of physical findings
5) treatment, discharge planning, and follow-up care
What is needed for a sexual assault survivor to be considered recovered?
to be considered “recovered” they are relatively free of any signs or symptoms of acute stress disorder and PTSD
