violence

Question 1

Intimate Partner Violence (IPV) or Domestic Violence (DV)

Answer 1

any combo of physical or sexual violence, threats or emotional abuse. Behaviors aimed at establishing control. Can be same or opposite sex

Question 2

Sexual Assault

Answer 2

any sexual act performed without a person’s consent

Question 3

2. Cite statistics regarding the epidemiology of IPV and its presentations.

Answer 3

lifetime prevalence is 36% women, 29% men. The percentage of homicides due to IPV are 33% for women, 4% for men. Lifetime prevalence of rape is18% of women and 1.4% of men. Most female rapes are by an intimate partner. 28% of male rapes occur before age 10

Question 4

Which countries have highest rate of physical or sexual abuse

Answer 4

peru, tanzania, ethiopia, bangladesh

Question 5

3. List risk factors associated with being abused and describe why the use of risk factors is considered controversial.

Answer 5

victim: pregnancy, youth, single/ divorced/ separating. Perpetrator: being male, abuse or witnessing marital violence as child, absent father, alcohol use.

Question 6

What are NOT risk factors for IPV victims

Answer 6

socioeconomic status, race, level of education, employment, insurance staus

Question 7

consequences of IPV for the victim

Answer 7

poor general health- chornic pain, migraines, IBS, arthritis, BP problems, PID, cervical cancer, depression, suicide. Poor compliance with care.

Question 8

how to determine age of injury/ broken bone

Answer 8

1. resolution of soft tissue inflammation 4-10 days. 2. subperiosteal new bone formation 10-14d. 3. soft and hard callus 14-42 d. 4. remodelilng 1 yr

Question 9

bruise dating

Answer 9

Pink/ red, tender to blue/ purple in hours. Fades to violet, green, dark yellow then pale yellow over 2 weeks

Question 10

medical clues for violence

Answer 10

1. non specific complains without clear etiology- headaches, chest pain, GI problems, sleep disturbance. 2. mental health complaints- depression, anxiety. 3. OB/GYN complaints- 10% incidence of IPV during pregnancy.. Pelvic pain, STDs, dyspareunia

Question 11

stages of change

Answer 11

precontemplation (no intention to change) > contemplation (aware of problem, considering change) > action (modify behavior or environment) > maintenance (work to prevent relapse) > relapse (return to behavior or environment)

Question 12

recommended strategies for IPV prevention

Answer 12

•Dating violence prevention curriculum (middle/high school)

Question 13

promising strategies for IPV prevention

Answer 13

Couples counseling, Substance abuse rx (for couples) , Community services (esp. advocacy), Sentencing (BIPs)

Question 14

insufficient evidence strategies for IPV prevention

Answer 14

Media campaigns, Substance abuse rx (for individuals), IPV screening, Police responses (e.g. mandatory arrest), Court interventions, Coordinated community response

Question 15

Batterer Intervention Programs (BIPs)

Answer 15

Programs range from 12 to 52 weeks; often a group format; combination of punishment and rehabilitation

Question 16

batterer intervention programs- models

Answer 16

Often a combo of the two: 1. Feminist (Duluth model): target men’s sexist/patriarchal view of women; interventions focused on examining these beliefs & modes of control. 2. Cognitive Behavioral Therapy: based on assumption that batterers lack skills in relationships, communication and anger management

Question 17

problems with BIPs

Answer 17

high drop out rates and no shows, forced treatment (denial remains inntact), no specific treatment of co existing substance abuse or psychopathology

Question 18

Mandatory reporting

Answer 18

varies by state- In colorado- All acute injuries thought to be due to injury due to an intimate partner must be reported to the police in jurisdiction of your office (not jurisdiction where injury occurred). The exceptions would be if the act of reporting will place the victim in imminent danger (may defer report but must document this and it should be rare)