L21: Intimate Partner Violence

Question 1

Key characteristics of an abused pt

Answer 1

• women: single, separated, divorced - those who recently sought some form of protective order - adolescent/ young adults - poor/suffering economic loss - person in home where alcohol and or drugs abuse occurs - pregnant women who have been previously abused - those w/ excessively jealous/possessive partners

Question 2

Key characteristics of an abuser

Answer 2

• actual or threatened physical injury - sexually assaulted - psychologically abused - economically controlling - socially isolated - stalking - destructive of person’s property or personal possession - abuse of animals / pets

Question 3

Reasons victims remain in abusive relationships

Answer 3

• Fear - Economic and logistical constraints - Social isolation - Feelings of failure - Promises of change - Prior lack of intervention

Question 4

Prevalence of IPV between heterosexual and homosexual relationships

Answer 4

• lesbian couples less likely than females in heterosexual relationships - gay males more likely than miles in heterosexual relationships

Question 6

Is abuse typically conscious or unconscious for abuser?

Answer 6

• Limbically driven, not cortically, therefore not always conscious - Power and control and aim, psychological reason is emotional regulation and self-esteem creation and maintenance

Question 7

What is aim of abuse in relationships?

Answer 7

• power and control

Question 7

Describe cycle of violence.

Answer 7

• Tension building phase - Violence episode - Promises and hope of change

Question 8

Screening techniques / physician tasks for treating victims of IPV

Answer 8

• RADAR (remember to inquire, ask directly, document findings, assess safety, review options incl resources) - Ask routinely and nonjudgmentally - Don’ts: use of domestic violence, abused, battered words. Also don’t question in front of friend, partner, family. Don’t break confidentiality, don’t insist or recommend ending relationship, don’t recommend coupe counseling unless partner acknowledges and wants to change, don’t use alleged, don’t ask victim what they did to cause or bring upon violence, don’t ask why he/she hasn’t left. - Dos: use of hurt, frightened, treated badly - Assess pts level of fear and appraise immediate and future safety needs - Pts role is to decide when its safe to leave and when economic and emotional resources are in place. Not physician’s role

Question 9

What is the most likely predictor of victimization?

Answer 9

• partner who is verbally abusive

Question 10

Barriers to recognition and intervention by physicians

Answer 10

• Fear - Shame - Assumptions about health care systems - Language, culture, religion - Immigration status - Sexual orientation - Abuser threats and control

Question 11

Percentage of women in US whose 1st sexual experience was forced? Result?

Answer 11

• 4% - PTSD

Question 12

Common health problems associated with IPV

Answer 12

• if during pregnancy: antepartum hemorrhage, IU growth retardation, prenatal death - female victims of rape, stalking or physical violence: asthma, DM, IBS - male and female victims of rape, stalking or physical violence: headaches, chronic pain, sleep difficulties, activity limitations, poor physical health, poor mental health - both: PTSD, suicidal ideation/attempts, unwanted pregnancy, STDS, HIV/AIDS

Question 13

What are indicators of escalating risk in IPV?

Answer 13

• increase in frequency or severity of assaults - increase or new threats of homicide/suicide by partner - presence of availability of firearm - new or increasingly violent behavior by perpetrator outside the relationship