Violence

Question 1

What is trauma?

Answer 1

A person has been exposed to a traumatic event where they experience, witness, or are confronted with death, serious injury, or threat to physical integrity. The person responds with fear, helplessness, or horror.

Question 2

What are common traumatic events?

Answer 2

Motor vehicle accidents, natural disasters, sexual assault, childhood sexual abuse, domestic violence, combat, elder abuse, homicide, suicide of a loved one…

Question 3

Trauma - practical definition

Answer 3

Nonconsensual; the victim is in discomfort and fear, and feels intimated, bodily integrity is threatened.

Question 4

Why focus on trauma and violence?

Answer 4

Unaddressed trauma affects individuals, families, and communities. Unaddressed trauma impacts the overall health and economy of the nation

Question 5

What are rape and sexual assault?

Answer 5

A statutory offense where the offender knowingly causes another person to engage in unwanted sexual acts by force or threat of force

Question 6

Prevalence of rape and sexual assault

Answer 6

22% of women and 3.8% of men report adult sexual assault

Question 7

What is child abuse?

Answer 7

Any recent act or failure to act on the part of a caretaker or parent which results in death, serious physical/emotional harm, sexual abuse or exploitation OR an act of failure to act which represents an imminent risk of serious harm

Question 8

Prevalence of child abuse

Answer 8

• More than 5 children die every day as a result of child abuse
• About 80% of children that die from abuse are under the age 4

Question 9

What is the prevalence of child sexual abuse?

Answer 9

16.8% of adult women and 7.9% of adult men report a history of childhood sexual abuse

Question 10

What is intimate partner violence?

Answer 10

A violent confrontation between family or household members including physical harm, sexual assault, or fear of physical harm

Question 11

What is the prevalence of intimate partner violence?

Answer 11

• About 25% of women in the US report experiencing violence by a current/former spouse or boyfriend in her lifetime
• About 3 women/day are murdered by their husbands or boyfriends in the US
• Men who witnessed their parents’ domestic violence are two times more likely to abuse their own partners
• Girls who have witnessed domestic violence are more likely to stay in an abusive relationship as an adult
• More than 50% of batterers also abuse their children or their victim’s children

Question 12

What is elder abuse?

Answer 12

The physical, sexual, or emotional abuse of an elderly person, usually who is disabled and frail

Question 13

What is the prevalence of elder abuse?

Answer 13

• 6% of elders reported significant abuse within the last month
• 35% of vulnerable elders reported significant levels of psychological abuse
• 5% of caregivers reported physical abuse towards care recipients with dementia in a year, and 33% reported significant abuse
• 16% of care home staff admitted significant psychological abuse

Question 14

What is the prevalence of combat?

Answer 14

10-20% of men and 2-10% of women have been exposed to combat (as a soldier or a civilian)

Question 15

What is the immediate aftermath of violence?

Answer 15

• Psychological: disbelief, numbness, shame, guilt, anxiety, anger, confusion, difficulty concentrating
• Physical: appetite/sleep changes, bodily aches, pains
• Behavioral: difficulty trusting others, not keeping up with responsibilities, using alcohol or drugs as a way to cope

Question 16

How does acute stress become chronic stress?

Answer 16

Persistent stress changes the architecture of the brain with the number of neuronal connections; physiological process of stress such as the HPA axis are overly activated and damaging to the body (because the chronic increase in blood pressure can lead to damaged blood vessels and heart disease)

Question 17

What is stress and the HPA axis?

Answer 17

The amygdala senses stress/threat -> hypothalamus releases corticotropin releasing hormone -> pituitary releases adrenocorticotropic releasing hormone -> adrenal cortex released glucocorticoids (including cortisol)

Question 18

Physical health and trauma

Answer 18

Chronic pain, GI disorders, fibromyalgia, obesity, substance abuse, smoking. Trauma survivors are less likely to obtain regular mammograms, cervical cancer screenings, and dental appointments (more sick care but less preventative care)

Question 19

Who is resilient?

Answer 19

Someone with no prior trauma history, who has social support, a sense of life purpose, and a feeling of mastery (religious coping)

Question 20

What is secondary victimization?

Answer 20

Being retraumatized (though not physical) due to the lack of institution’s approach to the issue