interpersonal violence Flashcards
interpersonal or domestic violence
a pattern of coercive behavior in which one person attempts to control another through threats or actual use of physical violence, sexual assault and/or verbal and psychological abuse.
what is one of the most common causes of injury to women
battering
what has changed over the years as far as domestic violence
Increased awareness, ability to obtain help, and more readily available information have helped in raising the rate of reporting.
Increasing incidence of men reporting victimization at the hands of women.
effects of family violence
•It isolates the person being abused and robs inner strength, self-worth and the ability to make personal choices. Often people experiencing abuse begin to feel responsible for the abuse.
•
•It traumatizes children, destroying their ability to feel safe in the world and causing them to feel responsible for the abuse.
effect on children with domestic violence
–Development adversely affected
Energy needed to accomplish developmental tasks successfully goes
to coping with family violence
effect on adolescents domestic violence
–Poorer coping and social skills
–Higher incidence of dissociative
identity disorder
–Poorer impulse control
secondary effects of violence
- Anxiety
- Depression
- Suicidal ideation
Types of maltreatment
- Physical violence: infliction of physical pain or bodily harm
- Sexual violence: any form of sexual contact or exposure without consent
- Emotional violence: infliction of mental anguish; threatening, humiliating, intimidating, isolating behavior
- Physical neglect: failure to provide medical, dental, or psychiatric care as needed
- Developmental neglect: failure to provide nurturing and stimulation needed to ensure meeting developmental milestones
- Educational neglect: depriving a child of an education
- Economic maltreatment: illegal or improper exploitation of funds or other resources for own person gain or withholding of support
actual occurence of violence requires
- Perpetrator
- Vulnerable person
- Crisis situation
characteristic of perpetrator
- Their needs are more important than the needs of others
- Extreme pathological jealousy
- May control family finances
- Likely to abuse alcohol or drugs
- Poor social skills, relationship with partner enmeshed and codependent
characteristics of vunerable person (partner)
- Legal marriage or pregnancy may initiate or increase violence
- Greatest risk for violence when partner attempts to leave relationship
characteristics of a vunerable person (child)
- Younger than 3 years
- Perceived as different
- Product of an unwanted pregnancy
- Premature
- Prolonged illness
characteristics of a vulnerable person (elderly)
- Poor mental or physical health
- Dependent on perpetrator
- Female, older than 75 years, white, living with a relative
- Daughter is caring for elderly father who abused her when she was a child
- Elderly woman cared for by husband who has abused her in the past
what is a crisis situation
•Situation that puts stress on a family with a violent member
cycle of violence
•Process of escalation/de-escalation
Tension-building stage
Attempts to reduce tension by both partners
Acute battering stage
Honeymoon stage
Tension builds and cycle continues
phase I (tension building phase)
•Abuser:
–Demonstrates increased tension by lashing out at victim/minor battering
–Has increased fear of abandonment, jealousy, possessiveness
–Interprets victim’s withdrawal as rejection -> more anger
Victim:
Becomes nurturing & compliant to prevent escalation
Often accepts abuse as legitimate
Denies own anger/rationalizes abuser’s behavior
Increased battering -> decreased ability to cope -> withdrawal
phase II (acute battering incident)
•Abuser:
–Justifies behavior to self – wants to “just teach a lesson” -> severe battering
–Cannot understand what happened, doesn’t know how control was lost
–Often minimizes severity of battering
Victim:
May intentionally provoke abuser’s behavior because tension of Phase I has become unbearable
Knows from experience that once acute phase is over things will be better
Beating is severe & victim can often describe violence in detail, dissociating self from own body
Help is sought if severe injury, victim fears for own life or severe injury/death to children
PHASE III: Calm, Loving, Respite (Honeymoon)
•Abuser:
–Loving, kind, contrite
–Promises to never repeat behavior
–Begs forgiveness, fears losing victim so attempts to charm
–Believes can control behavior & now that “lesson has been taught”, victim will not “act up” again
–Plays on victim’s feelings of guilt for having “provoked” the incident
Victim:
Desperately wants to believe abuse won’t happen again
Relives dream of “ideal” love & chooses to believe that the “ideal” is really what is shared with abuser
This loving phase becomes victim’s perception of relationship
Victim bases staying in the relationship on this “magical” ideal phase.
Which rationale best explains why a nurse needs to be aware of feelings while working with a family experiencing family violence?
a.
Self-awareness protects one’s own mental health.
b.
Strong negative feelings interfere with assessment and judgment.
c.
Strong positive feelings lead to underinvolvement with the victim.
d.
Positive feelings promote the development of sympathy for patients.
b.
Strong negative feelings interfere with assessment and judgment.
A person at the emergency department reports severe headaches. The individual is
accompanied by a spouse who insists on staying in the room during the examination and answering all questions. The patient avoids eye contact, has a sad affect, and has slumped shoulders. A concussion is diagnosed. Assessment of which additional problem has
priority?
a.
Risk of domestic abuse
b.
Phobia of crowded places
c.
Major depression
d.
Migraine headaches
a.
Risk of domestic abuse
A married individual has recently been absent from work for 3-day periods on several occasions. Each time, the individual returned to work wearing dark glasses. Facial and body bruises were apparent. The assessment priority when the occupational health nurse interviews the patient is:
a.
interpersonal relationships.
b.
work responsibilities.
c.
socialization skills.
d.
physical injuries.
d.
physical injuries.
A patient has a history of physical violence against family when frustrated and then periods of remorse after each outburst. The plan of care would be considered successful when the patient:
a.
expresses frustration verbally instead of physically.
b.
agrees to seek counseling.
c.
explains the rationale for behaviors to the victim.
d.
identifies three personal strengths.
a.
expresses frustration verbally instead of physically.
A woman was grabbed by a man as she walked home from work. The attacker put a gun to her head, taped her mouth, tied her hands, took her to a remote location, and raped her. When she was found she was taken to the emergency department, where she received care. Which aspect of this crisis produced the greatest amount of psychological trauma?
a.
The threat to her life
b.
The memory of the event
c.
The physical pain experienced
d.
The collection of evidence
a.
The threat to her life
A patient was abducted and raped at gunpoint by an unknown assailant. Which assessment finding best indicates the patient is in the acute phase of the Rape-trauma syndrome?
a.
Confusion and disbelief
b.
Flashbacks and dreams
c.
Decreased motor activity
d.
Fears and phobias
a.
Confusion and disbelief
