Ch. 25: Survivors of Abuse or Neglect Flashcards
Intro
- 1 in 5 women experienced rape. 1 in 6 stalked. 1 in 4 reported intimate partner violence.
- most often occur before the age of 25 for both genders
Predispose: Neurophysiological
- Temporal lobe
- Limbic system
- Amygdaloid nucleus
Predispose: Biochemical
- Norepinephrine
- Serotonin
- Dopamine
Predispose: Genetic
- Possible hereditary factor
- Genetic karyotype XYY has been implicated
Disorders of the brain
- Organic brain syndromes
- Brain tumors/trauma
- Encephalitis
- Temporal lobe epilepsy
Predispose: Psychological theories
- Unmet needs for satisfaction and security result in an underdeveloped ego and a poor self-concept
- Aggression and violence supply the individual with a dose of power and prestige that increases self-esteem
Predispose: Learning theory
- Children learn to behave by imitating their role models
- Individuals who were abused as children or whose parents disciplined with physical punishment are more likely to behave in an abusive manner as adults
Predispose: societal influences
- Aggressive behavior is primarily a product of one’s culture and social structure
- The American culture was founded on a general acceptance of violence as a means of solving problems
Background assessment data
- Battering may be defined as a pattern of coercive control founded on and supported by physical and/or sexual violence or threat of violence of an intimate partner
- 85% of victims are women
Intimate partner violence: profile of the victim
- Battered women represent all age, racial, religious, cultural, educational, and socioeconomic groups.
- Low self-esteem
- Inadequate support systems
- Some grew up in abusive homes
Intimate partner violence: Assessment of the victimizer
- Low self-esteem
- Pathologically jealous
- “Dual personality”
- Limited coping ability
- Severe stress reactions
- Views spouse as a personal possession
Assessment: The cycle of battering
- Phase 1: Tension-building phase
- Phase 2: Acute battering incident
- Phase 3: Calm, loving, respite (honeymoon) phase
Intimate partner violence: Why do they stay?
- Fear of their lives or the lives of their children
- Fear of retaliation by the partner
- Lack of financial resources
- More on slides
Child abuse
- Physical abuse: Any non-accidental physical injury caused by the parent or caregiver
- S&S: unexplained injuries, child is frightened of adults, child reports injury by parent or caregiver, conflicting or unconvincing explanation for injuries
More info on child abuse:
- Emotional abuse: A pattern of behavior on the part of the parent of caretaker that results in serious impairment of the child’s social, emotional, or intellectual functioning
- Indicators of abuse:
- Extremes of behaviors
- Delayed physical or emotional development
- Lack of attachment to parent
Definitions of physical neglect (child abuse)
- Refusal of or delay in seeking health care
- Abandonment
- Expulsion from the home
- Refusal to allow a runaway to return home
- Inadequate supervision
Emotional neglect (Child abuse)
- Failure to provide the child with the hope, love, and support necessary for the development of a sound, healthy personality
Behavioral indicators of neglect (Child abuse)
- Is frequently absent from school
- Begs or steals food or money
- Lacks needed medical or dental care, immunizations, or glasses
- Is consistently dirty and has severe body odor
- lacks sufficient clothing for the weather
- Abuses alcohol or other drugs
- States that there is no one at home to provide care
Sexual abuse of a child
- Sexual exploitation of a child
- Incest
- Indicators of sexual abuse –>
- Has difficulty walking or sitting
- Suddenly refuses to change for gym or to participate in physical activities
- Reports nightmares or bedwetting
- Experiences a sudden change in appetite
- Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior
- Becomes pregnant or contracts a sexually transmitted disease
Characteristics of the child abuser
- Parents who abuse their children were likely abused as children themselves
- Other influences include: Stressors, poverty, social isolation, absence of support systems, lack of knowledge of child dev. or care needs
Child abuse. The incestuous relationship.
- Often there is an impaired spousal relationship.
- Father: Domineering, impulsive, physically abusive
- Mother: Passive, submissive, and denigrates her role of wife and mother
- Will often use denial
The adult survivor of incest
- A fundamental lack of trust that arises out of an unsatisfactory parent-child relationship
- Low self-esteem and a poor sense of identity
- Absence of pleasure with sexual activity
- Promiscuity
Sexual assault
- Rape is an act of aggression, not passion. It is the expression of power and dominance by means of sexual violence, most commonly by men over women, although men may also be rape victims.
- Acquaintance rape
- Marital rape
- Statutory rape
Profile of the victimizer (sexual assault)
- It is difficult to profile a rapist
- Saddock and others identify four groups:
- Sexual sadists: aroused by inflicting pain
- Exploitative predators: Use victim to gratify needs of dominance and power
- Inadequate men: those who are obsessed with fantasies of sex and believe force is necessary
- Those displacing anger and rage
Rape can occur at any age
- The highest risk group appears to be between 16 and 34 years of age
- Most victims are single women
- The attack often occurs near their own neighborhoods
- Victim likely experiences a sense of violation and helplessness
The long term effects of sexual assault…
…depend on the individual’s ego strength, social support system, and the way he or she was treated as a victim.
Victim responses to sexual assault
- Expressed response
- Controlled response pattern
- Compounded rape reaction
- Silent rape reaction
Planning/implementation
- Nursing intervention for the victim of abuse or neglect is to provide shelter and promote reassurance of his or her safety:
- Tending to physical injuries
- Staying with the client to provide security
- Assisting the client to recognize options
- Promoting trust
- Reporting to authorities when there is reason to suspect child abuse or neglect
Treatment modalities
- Crisis intervention
- Safe house or shelter
- Family therapy