Interpersonal Violence Flashcards
What are the co-morbidities/secondary effects of violence?
- Depression
- Suicidal ideation
- Chronic post-traumatic stress symptoms
- Dissociation
- Interpersonal disturbances
- Substance abuse
- Revictimization
Describe phase one in the cycle of violence: tension building phase
- Accusations, arguments, complaints, silent treatment
- Can last for years before violence erupts
- Characterized by belittling and condemnation
- Perpetrator may become withdrawn, make unrealistic demands – victims works hard to satisfy which works for a while, but perpetrator frustration escalates anyway
- May see ridicule, slapping, shoving, pinching
- If abuse not confronted, severity escalates
- Victim begins blaming self – powerless, alone, ashamed to seek help.
Describe phase two in the cycle of violence: acute battering
- Explosion of violent/abusive behaviour/attack
- Often triggered by minor event
- Violence can last from 2-24 hours
- Victim rarely able to stop abuse
- Fighting back may fuel perpetrator rage
- After, victim is in state of shock – may not see severity of injuries – no treatment
- Perpetrator downplays injuries, may prevent victim from seeking care – perpetrator doesn’t want to be found out.
Describe phase three in the cycle of violence: honeymoon phase
- Period of remorse or contrition, reconciliation
- Occurs a few hours to several days post incident – victim senses beating is over
- Abuser is loving, regretful and apologizes, promises it won’t happen again
- May buy presents and flowers – tries to win back affection, may take victim to hospital
- Victim falls in love again, hopeful violence is over and the ‘honeymoon’ will last, vulnerable to accepting blame, drops charges if laid, denies it could happen again.
- Perpetrator may successfully make victim feel guilty for action.
What are the conditions for violence to occur?
- A perpetrator
- A person vulnerable to abuse (e.g., child, woman, older adult, mentally ill or physically challenged person)
- A crisis situation
What are the risk factors for violence?
- Poverty
- Social isolation
- Alcohol/substance use
- Access to firearms
What are the characteristics of a perpetrator?
- Consider their own needs more important than the needs of others
- Poor social skills
- Extreme pathological jealousy
- May control family finances
- Dominance, power, and control are the primary drives
What are the characteristics of vulnerable persons: women?
- Pregnancy may trigger or increase violence
- Violence may escalate when women makes move toward independence
- Greatest risk for violence when the woman attempts to leave the relationship
What are the characteristics of vulnerable persons: children?
- Younger than 3 years
- 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 the characteristics of vulnerable persons: older adults?
- Poor mental or physical health
- Dependent on perpetrator
- Female, older than 75 years, white, living with a relative
- Older adult father cared for by a daughter he abused as a child
- Older adult woman cared for by a husband who has abused her in the past.
What are indicators of elder abuse?
- Sudden change in behaviour or appearance
- Sudden onset of physical injuries
- A change in financial resources
- The strongest indicator that an elderly person is being abused is that he or she will tell someone.
The Mnemonic Tool ABCD-ER
A - attitude and approachability
B - belief
C - confidentiality
D - documentation
E - education
R - respect and recognition
Assessment factors
- Violence indicators
- Level of anxiety and coping responses
- Family coping patterns
- Support systems
- Suicide or homicide potential (or both)
- Drug and alcohol use
What are some clinical indicators of possible interpersonal violence?
- A delay between the time of injury and time of seeking help
- Reports vague, chronic, non-specific health concerns
- Chronic pelvic pain, headaches, irritable bowel syndrome
- History of depression, substance use, suicide attempts, anxiety, unintended pregnancy
- Vague historian
- An overbearing or dominant partner
- Reluctant to have community health nurse visit
- Reluctance to be hospitalized
- Defers decisions to their partner regarding their health
What does the acronym ‘SAFE’ stand for regarding questions?
S - stress/safety
A - afraid/abused
F - friends/family
E - emergency plan
Stress/Safety questions
- Do you feel safe in your relationship?
- What stress do you experience in your relationships?
- Should I be concerned for your safety?
Afraid/Abused questions
- Have there been situations in your relationships where you have felt afraid?
- Has your partner ever threatened or abused you or your children?
- Are you in a relationship like that now?
- Has your partner ever forced you to have sex?
- What happens when you and your partner disagree?
Friends/Family questions
- Are your friends/family aware of the abuse?
- Could you tell them? Would they support you?
Emergency plan questions
- Do you have a safe place to go and resources you need in an emergency?
- If in danger now, would you like help in locating a shelter?
- Would you like to talk to someone (counsellor/social worker) to develop an emergency plan?
Interventions
- Reporting abuse*
- Counselling—safety plan
- Case management
- Therapeutic environment
- Promotion of self-care activities
- Health teaching and health promotion
How to prevent abuse?
Primary prevention
- Measures taken to prevent the occurrence of abuse
Secondary prevention
- Early intervention in abusive situations to minimize their disabling or long-term effects
Tertiary prevention
- Facilitating the healing and rehabilitative process
- Providing support
- Assisting survivors of violence to achieve their optimal level of safety, health, and well-being
What is sexual assault?
- Legal term
- Any sexual activity, physical or psychological, for which consent is not obtained or freely given
- Also referred to as sexual violence, though sexual violence encompasses a broader spectrum of violence
What three drugs are associated with date rape?
Gamma Hydroxybutinate (GHB) – liquid ecstasy
Rohypnol
Ketamine
What are psychological effects of sexual assault
- Depression
- Suicide
- Anxiety
- Fear
- Difficulties with daily functioning
- Low self-esteem
- Sexual dysfunction
- Somatic complaints
- Substance abuse
