Ch 28: Child, Older Adult, and Intimate Partner Violence

What is physical abuse in the context of domestic violence?

The infliction of physical pain or harm such as slapping, punching, choking, pushing, biting, or burning.

Give examples of behaviors that constitute physical abuse.

Hitting, restraining, throwing, and burning.

How is sexual abuse defined in domestic violence cases?

Any form of sexual contact or exposure without consent or when the victim is unable to give consent

What terms are commonly used to describe sexual abuse?

Sexual assault or rape.

What constitutes emotional abuse?

Undermining a person’s self-worth through criticism, humiliation, name-calling, intimidation, and isolation.

Give examples of emotional abuse tactics.

Constant criticism, isolating the victim, damaging relationships, and intimidation.

What is neglect in the context of abuse?

Failing to provide for a person’s physical, emotional, educational, or medical needs.

What are examples of needs that may be neglected?

Food, shelter, emotional support, medical care, and education

Define economic abuse.

Controlling access to financial resources to make the victim financially dependent.

How might an abuser use economic abuse to maintain control?

By forbidding employment or school attendance to enforce dependence.

What is a crisis situation in the context of abuse risk?

A stressful situation that overwhelms coping skills, increasing the risk for violence in families with a violent member.

Which factors reduce the risk of violence during a crisis?

Effective impulse control, problem-solving skills, and a strong support system

How can social isolation contribute to crisis-related abuse?

Isolation (e.g., from frequent moves or lack of friendships) weakens coping ability, making violence more likely.

Who is considered a perpetrator in a domestic violence context?

Any household member (parent, partner, sibling, etc.) who is violent toward another member.

What are common traits of perpetrators of abuse?

Poor social skills, self-centeredness, and lack of supportive relationships outside their partner.

How do perpetrators often describe their relationship with their victim?

As the closest relationship they have ever had.

What is meant by the term vulnerable person?

The family member who is abused (also referred to as the victim, survivor, or victim/survivor).

Why is the term survivor often preferred over victim?

It emphasizes healing and recovery and avoids connotations of passivity.

What is an act of commission in child abuse?

A deliberate action that harms a child, including physical, sexual, or emotional abuse.

What is an act of omission in child abuse?

Neglect—failing to meet a child’s physical, emotional, educational, or safety needs.

What are examples of omission in child abuse?

Physical neglect, emotional neglect, medical/dental neglect, educational neglect, and lack of supervision.

Which racial or ethnic group had the highest rate of abuse cases per 1,000 victims in 2018?

American Indian or Alaska Native (15.2 per 1,000 victims)

What is a strong predictor for the occurrence of multiple types of abuse?

the presence of one type of abuse

What are common long-term mental health effects of abuse?

anxiety, depression, and suicidal ideation

What are the two most prevalent disorders resulting from childhood trauma?

Major depressive disorder and posttraumatic stress disorder (PTSD)

What types of individuals often have childhood histories of family violence?

juvenile offenders, runaways, violent criminals, prostitutes, and those violent toward others

How does abuse affect a child’s developmental progress?

it diverts energy away from developmental tasks toward coping with the abuse

What psychopathological changes are common in abused adolescents?

Poorer coping and social skills, dissociative identity disorder, and poor impulse control

What is more likely in women with a history of prolonged childhood sexual abuse?

major psychiatric distress

What child characteristics increase the risk of abuse?

Temperamental traits, congenital abnormalities, chronic illness, being different, or reminding the parent of someone they dislike

How does being the result of an unwanted pregnancy affect a child’s risk?

It increases the risk of abuse

How can interference with emotional bonding increase abuse risk?

Events like premature birth or prolonged hospitalization may disrupt bonding and increase future abuse risk

Why is abuse in adolescents often overlooked?

Society often views adolescents as capable of defending themselves

What is intimate partner violence (IPV)?

Abuse within an intimate relationship where one partner uses power and control over the other

what behaviors are included in IPV?

Physical violence, rape, stalking, and psychological aggression by a current or former partner

who can be considered an “intimate partner” in IPV cases?

A spouse, boyfriend/girlfriend, dating partner, or ongoing sexual partner

what belief is often held by men who abuse their partners?

belief in male dominance and the need to be in control

what are some early influences that support male dominance in relation ships?

parent-child interactions, peer group experiences, media portrayals, and observations of other couples

what is pathological jealousy in the context of IPV?

extreme control behaviors like monitoring partner’s location, friendships, and accusing them of infidelity without cause

what are common controlling behaviors exhibited by IPV perpetrators?

Not allowing the victim to work, monitoring transportation and odometers, controlling finances, forbidding outside activities or friendships

how does substance use relate to IPV?

substance use lowers inhibitions and may lead to violence, though violence often even continues even if substance use stops

how can pregnancy influence IPV?

it can trigger or increase violence due to resentment or jealousy

when is a victim at the greatest risk of violence in an IPV relationship?

when they attempt to leave or threaten to leave the relationship

what early life experience is common among abusive parents?

A history of abuse, neglect, or emotional depredation in their own childhood.

what parenting style is often seen in abusive families?

family authoritarianism

what emotional traits are common in abusive parents?

low self-esteem, feelings of worthlessness, and depression

how are coping skills typically affected in abusive parents?

they often have poor coping skills

how does social behavior often present in abusive parents?

social isolation and suspicion of others

what situational factors often contributes to abusive behaviors?

involvement in a crisis situation

what expectations do abusive parents often have about their children?

unrealistic expectations of the child’s behavior

what type of discipline do abusive parents frequently use?

harsh punishment

What mental health history may be present in abusive parents?

Severe mental illness such as schizophrenia.

What is a common emotional regulation problem in abusive parents?

Violent temper outbursts.

How do abusive parents sometimes view their children emotionally?

They expect the child to meet their emotional needs (love, support, reassurance).

How do abusive parents often externalize responsibility?

They project blame onto the child for their own problems.

What prevents abusive parents from accessing support?

inability to seek help from others

How do abusive parents sometimes perceive their child?

as bad or evil

What substance use issues are common among abusive parents?

History of drug or alcohol misuse.

What belief about control is common in abusive parents?

They feel they have little or no control over their life.

what is a common trait related to stress in abusive parents?

low tolerance for frustration

what behavioral control issue is typical in abusive parents?

poor impulse control

what are the three stages of the cycle of violence?

tension-building stage, acute battering stage, honeymoon stage

what typically occurs during the tension-building stage?

minor incidents like pushing, shoving, or verbal abuse; the victim often minimizes the abuse, and the abuser rationalizes the behavior

How might both the abuser and victim attempt to reduce tension in the tension-building stage?

The abuser may use alcohol or drugs; the victim may try to placate the abuser or minimize the incident.

What triggers the acute battering stage?

tension peaks and is triggered by an external event or the abuser’s emotional state; the victim may sometimes provoke the abuse to move past the fear

What behaviors are common during the acute battering stage?

Violent outbursts, physical assault, or extreme abuse.

What is the honeymoon stage in the cycle of violence?

a period of calm where the abuser is loving, apologetic, and may offer gifts or promises; the victim hopes for change

how does the victim typically feel during the honeymoon stage?

loved, hopeful, and may abandon plans to leave or press charges

What happens to the cycle of violence over time if there is no intervention?

the calm periods become shorter, and violence escalates in intensity and frequency

What psychological effects can repeated cycles of abuse have on the victim?

Decreased self-esteem, feelings of blame, depression, hopelessness, immobilization, and self-deprecation.

Why is intervention critical in the cycle of violence?

without it, the pattern continues and worsens, causing greater harm to the victims mental, emotional, and physical health

what is the definition of older adult mistreatment?

Intentional actions that cause harm or create a risk of harm to a vulnerable older adult, including failure to provide for basic needs or protection from harm

who are common perpetrators of older adult abuse?

family members, custodians, and care facility personnel

what types of abuse can older adults experience?

physical abuse, sexual abuse, financial abuse, neglect, and self-neglect

what are examples of financial abuse in older adults?

Theft of cash, credit cards, coercion to transfer property or accounts, loss of belongings, vehicles, medication, or food stamps.

why might many cases of older adult abuse go unreported?

due to isolation, dependency, fear of retaliation, or the older adult caring for themselves (self-neglect)

in what setting does older adult abuse occur?

both institutional and family settings

Who are the most common perpetrators of older adult abuse?

family members

What is the typical profile of an older adult abuse victim?

Female, over 75 years old, white, living with a relative, with physical and/or mental impairment.

How can a history of family violence affect older adult abuse risk?

parents who abused their children may be abused by them later; abused spouses may retaliate when their abuser becomes frail or cognitively impaired

What common conditions increase vulnerability to abuse in older adults?

poor physical or mental health and disruptive behavior due to conditions like Alzheimer’s disease

Why should all patients be screened for abuse in healthcare settings?

because victims of violence are encountered in all settings and symptoms may be vague

what physical or behavioral symptoms may indicate abuse?

chronic pain, insomnia, hyperventilation, gynecological problems

what is the most important element in interviewing a patient about abuse?

establishing trust and rapport

what type of questions should be used when assessing for abuse?

open-ended, non-threatening, descriptive questions

Why is it better to ask about discipline methods rather than using the term "abuse"?

it makes the patient feel safer and reduces defensiveness

What are covert signs of physical abuse?

headaches, back trouble, dizziness, frequent accidents

what are overt signs of physical abuse?

bruises, burns, scars in various stages of healing

what is a key indicator of shaken baby syndrome?

Bulging fontanels, retinal hemorrhages, seizures, vomiting

what are signs of sexual abuse in children?

sexualized behavior, drawings, masturbation, nightmares

what are emotional indicators of abuse?

low self-esteem, anxiety, withdrawal, poor impulse control

how is neglect often identified?

poor hygiene, undernourishment, untreated medical issues

what is economic abuse?

withholding resources despite having funds, preventing independence

what nonverbal cues suggest anxiety in an abuse victim?

agitation, poor eye contact, vague responses

why do some victims remain in abusive relationships?

coping mechanisms, shame, isolation, flawed beliefs

what may contribute to abuse in caregiving families?

unresolved stress, prior history of family violence, isolation

Why is assessing support systems important in abuse cases?

victims often rely on their abuser and have limited resources

what factors increase suicide risk in abuse victims?

despair, hopelessness, repeated abuse, identity of abuser

what increases the risk for homicide in abuse cases?

gun in home, drug/alcohol abuse, extreme jealousy, prior violence

Why might victims use alcohol or drugs?

to self-medicate for stress, fear, or trauma