NURS310 Lecture Notes - Lecture 2: Hypersensitivity, Homicide, Dissociative Identity Disorder
22 Jun 2018
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Chapter 28
Child, Older Adult, and Intimate Partner Abuse
•Types of Abuse
•Physical abuse
•Sexual abuse
•Emotional abuse
•Neglect
•Economic abuse
• Epidemiology and Comorbidity
•Prevalence
•Half of all Americans have experienced violence in their families
•Comorbidity
•Secondary effects of violence
•Anxiety
•Depression
•Suicidal ideation
•Child Abuse
2008: U.S. Department of Health and Human Services (USDHHS) and the Centers for Disease
Control and Prevention (CDC)
•Of the deaths that occurred among children, 80% were younger than 4
years of age.
•Majority of these were infants of 1 year of age or younger.
•Of the deaths that occurred among children, 10% were
4 to 7 years of age.
•Parents are thought to account for nearly 80% of child abuse. (Pillado et
al., 2010).
•Siblings can be perpetrators of emotional, physical, and sexual
abuse.
•Statistics concerning this common and unrecognized abuse are less available.
•Child Abuse (continued)
•A report of child abuse is made every 10 seconds, and almost five children die every
day as a result of child abuse. (Childhelp, 2011)
•The actual occurrence rates of child abuse are grossly underreported.
•Teen Dating Violence
•Teen dating violence (TDV) is a disturbing trend.
•Between 25% and 33% of adolescents report verbal, physical, emotional, or sexual
abuse from a dating partner each year.
•Approximately 1 in 11 teenagers report being a victim of physical dating violence each
year.
•In teen relationships, girls and boys abuse each other about equally.
•Teen Dating Violence (continued)
•Abuse is high among college students.
•Previous partners are responsible for 32% of the violence; current partners are
responsible for 21%.
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•One in five high school girls are physically or sexually abused by a dating partner.
•One in four female students will experience sexual assault over their college career.
•Teen abuse takes many forms:
•Extreme possessiveness, jealousy, stalking (inclusive
of technology), manipulation, devaluation, humiliation, threatening suicide,
unwanted touching, pushing, and forcing unwanted sex, among other forms.
•Teen Dating Violence (continued)
•An abusive relationship is all about instilling fear and wanting to have power and
control in the relationship.
•Anger is one way the abuser tries to gain authority; anger may turn to physical violence.
•Women are five to eight times more likely to be victimized than men.
•Depression, post-traumatic stress disorder (PSTD), anxiety disorders, and suicide and
suicidal ideation may follow battering in all age groups.
•Intimate Partner Violence
•Is the number one cause of ED visits by women.
•Is drastically underreported.
•Between 25% and 37% of all women experience battering.
•In 2007, 2340 deaths were the result of IPV (70% women and 30% men).
•Prevalence of IPV by women against men is increased.
•It also occurs in lesbian, gay, bisexual, and transgender (LGBT) communities.
•Is the leading cause of homelessness among women.
•Child, Partner, and Elder Violence
•Family violence is prevalent among all ethnic, religious, age, and social and
socioeconomic groups.
•Intimate Partner Violence (IPV) occurs in mansions tucked away on acres and in middle-
class homes in “good” neighborhoods.
•More visibly, IPV occurs in lower socioeconomic groups, such as ghettos and project
buildings, and all areas in between.
•Besides family abuse, trusted authority figures are part of the picture of violence in our
society.
•Child, Partner, and Elder Violence
(continued)
The nurse is often the first point of contact for people experiencing family violence and is in the
ideal position to contribute to prevention, detection, and effective intervention. All forms of
interpersonal abuse can be devastating. Abuse can take the form of emotional, physical, or
sexual abuse and neglect.
•Theory
•IPV is extremely complex.
•No single theory explains IPV.
•Is most likely the interaction of societal, cultural, psychologic, and neurobiological
factors.
•Social learning theory
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•Learning theory or intergenerational violence theory of family violence relies on
role modeling, identification, and human interaction.
•Child learns violence as a behavioral norm.
•Theory (continued)
•Societal and cultural factors
•Poverty or unemployment
•Communities with inadequate resources
•Overcrowding
•Social isolation of families
•Classic frustration-aggression hypothesis is when frustration is high in response to
societal situations; aggression follows.
•Not all individuals respond to frustration with violence; some respond with despair,
depression, resignation, or try to change the situation.
•Theory—cont’d
•World Health Organization (WHO)
•Female genital mutilation (FGM)
•http://www.who.int/reproductivehealth/topics/fgm/en
•Patriarchal theory—Male dominance in our political and economic structure enforces
the differential status of men and women.
•In many subcultures, women are
viewed as “belonging to” men,
are subservient, and are kept
relatively powerless.
•Theory: Psychologic Factors
•Personality traits “cause” abusiveness.
•Legal or illegal drugs and alcohol may co-exist with family violence.
•Some abusers argue a “loss of control,” but this is not supported by behavior as
evidenced by:
•Perpetrators of violence most likely choose not to hit bosses or policeman, no
matter how angry.
•Abusers often plan where (in the home), when (no one is around), and how
(leave no visible marks) they inflict violence.
• Occurrence of Violence
•Requires
•Perpetrator/Batterer
•Vulnerable person
•Crisis situation
•Characteristics of Perpetrators
•Narcissistic (their needs are most important, lacks compassion)
•Hypersensitivity (sees self as victim)
•Poor social skills
•Extreme pathological jealousy
•Likely to abuse alcohol or drugs
•Relationship with partner enmeshed and codependent
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Prevalence: half of all americans have experienced violence in their families. 2008: u. s. department of health and human services (usdhhs) and the centers for disease. Parents are thought to account for nearly 80% of child abuse. (pillado et al. , 2010). Siblings can be perpetrators of emotional, physical, and sexual abuse. Statistics concerning this common and unrecognized abuse are less available. Child abuse (continued: a report of child abuse is made every 10 seconds, and almost five children die every day as a result of child abuse. (childhelp, 2011) The actual occurrence rates of child abuse are grossly underreported. Teen dating violence (tdv) is a disturbing trend. Between 25% and 33% of adolescents report verbal, physical, emotional, or sexual abuse from a dating partner each year: approximately 1 in 11 teenagers report being a victim of physical dating violence each year. In teen relationships, girls and boys abuse each other about equally.
