Intimate partner violence (IPV)

Question 1

CDC definition of intimate partner violence

Answer 1

physical violence, sexual violence, stalking and psychological aggression (including coercive
acts) by a current or former intimate partner. An intimate partner is a person with whom one has a close personal relationship

Question 2

Injury-related indicators of Abuse (IPV) (8)

Answer 2

1. Injury inconsistent with history provided
2. Injury related to motor vehicle accident
3. Multiple injuries in various stages of healing
4. Injuries covered up by clothing, make-up, or sunglasses
5. Patterned injuries, such as belt marks or implement imprint
6. Pregnancy injuries, especially to abdomen and chest
7. Injuries suggestive of defensive posture (inner aspect of forearms or top of head)
8. Common injuries that may indicate abuse: black eyes and injuries to teeth, neck, or head

Question 3

Medical- related indicators of abuse (5)

Answer 3

1. Somatic complaints (headache, gastrointestinal problems, stomach aches)
2. Evidence of strangulation
3. Acute psychiatric manifestations (suicide attempts)
4. Chronic psychiatric symptoms (anxiety, depression, posttraumatic stress disorder)
5. Chronic pain
6. Malnutrition, poor hygiene

Question 4

Emotional indicators of IPV Abuse (5)

Answer 4

1. Fearfulness of partner
2. Hypervigilance of the woman and/or partner
3. Woman appears frightened, embarrassed, ashamed, or disoriented
4. Excessive distress about a minor injury, or little emotion apparent about a serious injury
5. Delay in seeking care

Question 5

Recommendations for conduction IPV Screening (5)

Answer 5

Screening should
1. Be framed with an introductory sentence that establishes screening is a universal practice
and not unique to the patient11
Example: “We’ve started talking to all of our women about safe and healthy relationships
because it can have such a large impact on your health.”11
Example: “I don’t know if this is a problem for you but many of my female patients are
dealing with abusive relationships. Some are too afraid or uncomfortable to bring it up
themselves, so I’ve started asking about it routinely.”19
2. Discuss confidentiality with her and disclose state mandated laws11
Example: “Before we get started, I want you to know that everything here is confidential,
meaning that I won’t talk to anyone else about what is said unless you tell me
that.(insert the laws in your state about what is necessary to disclose).”11
3. Use questions that are direct, specific, and easy to understand
Example: “Has your partner ever hit, choked, or physically hurt you?” (Hurt includes being
hit, slapped, kicked, bitten, pushed, or shoved.)11
4. Use gender-neutral terms, such as “your partner” instead of “your boyfriend”
5. Be presented in the woman’s primary language and be culturally appropriate (If an
interpreter is needed locate a professional interpreter, do not use a family member or
friends

Question 6

Recommendations for how to responds to a positive screen for IPV abuse

Answer 6

1. Thank her for having enough trust to disclose the abuse.
   Example: “Thank you for telling me. I am concerned for your safety.”
2. Acknowledge it is not her fault.
   Example: “It is not your fault. There is help available.”
3. Assess for immediate danger, assist with development of a safety plan, or consult with
   specialists who can provide this service.
4. Offer community resources and referrals for safety, education, caretaking, and support
   services. Remember that a local advocacy agency for domestic violence is among the most
   reliable resources.
5. Provide her with the national and/or local domestic violence hotline telephone number and
   other educational materials related to IPV.
6. Assist her with the processes for informing law enforcement, if the woman is agreeable, or
   when mandated by state law.
7. Document the abuse, health effects, or injuries relevant to her care using recognized
   forensic guidelines.
8. Maintain appropriate clinical follow-up.
9. Consider making a report to child protective services if children are involved and when
   required by state law.

Question 7

Medical documentation recomendations for IPV

Answer 7

1. Photographs of injuries related to IPV
2. A body map to further identify the location of injuries
3. Documentation that is clearly written and legible
4. Document history of the abuse and description of how injuries were received using the
   woman’s own words (in quotation marks)
5. Avoid using judgmental words such as “alleges” and “patient claims”
6. Use phrases such as “patient reports” or “patient states”
7. Record her demeanor
8. Document her perception of safety and risk

Question 8

General preparation Safety planning for IPV victims

Answer 8

1. discuss who to call during a crisis
2. Encourage planning an escape route and a place to go in a crisis
   3.Identify the important documents the woman needs to have readily available (ie, birth
   certificates, Social Security cards, marriage and driver’s license, school records, credit
   cards)
3. Recommend having clothing, keys, medications, telephone numbers, and money readily
   available in a secure location

Question 9

Recommendations for safety planning during explosive incidents

Answer 9

1. Plan for how to exit the home from different rooms in the house. If an argument is in
   progress, consider staying out of the kitchen where there are potential weapons, such as
   knives; or bathrooms, where the space is limited and there is a potential for increased
   injuries related to falls.
2. During an explosive event, find a room with a lock.
3. Document the abuse and take pictures of injuries.
4. Create a code word that will alert family, friends, and neighbors to contact law
   enforcement.
5. Have a plan for where to go if leaving is imminent and consider having clothes at that site
   for yourself and children, if applicable.
6. Instruct children not to get involved in the argument, despite a desire to help.

Question 10

Recommendations for the woman for safety planning when she decides to leave

Answer 10

1. Open bank accounts or set up credit cards in your name only
2. Change telephone number and block caller identification
3. Create new email account, change all passwords and personal identification (PIN) numbers
4. Leave important documents, money, keys, and clothes with a trusted person
5. Identify people you can stay with or who can lend money
6. Keep national and local hotline numbers available
7. Keep the number of community agencies available
8. Review, revise, and rehearse safety plan as needed
9. If children are involved, notify the school about any changes and advise them not to
   disclose address information
10. Inform employer of situation; to prevent access to you during work hours, provide a picture
    of the abuser
11. Change daily habits
12. Discuss safety plan with children related to times when they are not with you

Question 11

Recommendations for the woman for safety planning when protection order is in place (5)

Answer 11

1. Keep restraining order or order of protection on you at all times
2. Give a copy to a trusted friend or family member
3. Inform family, friends, health care providers, employers, schools (if children are involved),
   and neighbors that you have a protective order
4. Call law enforcement if abuser violates the order
5. Consider alternate ways of staying safe until law enforcement arrives

Question 12

In a study of IPV in Trans people Which race/ ethnicity had the highest and lowest level of IPV accross most subtypes

Answer 12

Highest American Indian/ Native Alaskan

Lowest: Aisian Pacific Islander

Question 13

In a study of IPV in trans people Which race/ ethnicity had the lowest level of IPV in stalking?

Answer 13

White participants

Question 14

In a study of IPV in Trans people Which race/ ethnicity had the lowest level of IPV in force sex?

Answer 14

Black participants

Question 15

Which subtypes of IPV were highest among trans men?

Answer 15

psychological and physical IPV