PSYC 372 - Defining Abuse

Abuse is…

any recent act or failure to act on behlaf of the caregiver, resulting in death, serious emotional or physical harm, sexual abuse or exploitation.

How to determine: accident or abuse?

1. Physical evidence/technology

   • Physical exam

   • Lab imaging

   • Probability that injuries could be accidental

2. Medical History/Development status of child

   • Age of child

   • Social context

3. Eyewitness accounts

   • Do stories change over time?

   • Likely biases or motives

   • Do different caretakers tell different stories?

What factors increase concern that injury is from abuse?

1. Absence of credible history

2. Very young age of patient

3. Other abusive injuries accompany fracture

4. Delay in seeking medical care

5. Explanation provided does not make medical sense

Distinguishing accidental injuries from abusive injuries

Location of Bruises

Likely Inflicted:

• Upper arms

• Trunks

• Upper anterior legs

• Sides of face

• Ears & neck

• Genitalia & buttocks

Likely accidental:

• Shins

• Hips

• Lower arms

• Prominences of spine

• Forehead

• Under chin