may be passed on to others (children) who do not fully understand the abusive situation. As a result, they may seek more medical services, which further burdens the healthcare system. The cost of healthcare services is also increased
because of patients seeking care in the emergency room or complaining of vague symptoms, often causing increased unnecessary diagnostic testing, services, and medications.
Healthcare Consideration: Understanding the perspective of abused individuals regarding their health is essential for healthcare providers, as it facilitates the implementation of appropriate interventions and facilitates effective follow-up care. By gaining insight into how survivors perceive their health, healthcare providers can tailor interventions to address their specific needs and experiences. This patient-centered approach enhances the effectiveness of healthcare interventions, promotes trust, and fosters a supportive environment for individuals affected by abuse. PTSD AND DOMESTIC VIOLENCE
Post-traumatic stress disorder (PTSD) is a complex disorder that develops in some individuals after highly traumatic events, such as combat, crime, sexual violence, accidents, or natural disasters (APA, 2022). PTSD associated with domestic violence is considered complex PTSD and may not respond to standard PTSD treatments. The following are factors generally associated with PTSD in victims of domestic violence (APA, 2022): ● Chronic threats ● Personal meaning associated with trauma ● Age ● Duration of trauma ● Feeling guilt or blame for the violence ● Lack of social support ● Inability to stop abuse or violence ● Having an immediate physiological response, such as increased blood pressure or bruising, or a psychological response, such as avoidance PTSD treatments typically have the patient recall the experience and discuss the event to decrease fear associated with the trauma. However, with domestic violence patients, reliving the trauma often re-instills fear, and they may experience the threat of revictimization, thus making this specific treatment inappropriate (APA, 2022).
Healthcare Consideration: Post-traumatic stress disorder (PTSD) can develop in response to both actual and perceived threats, emphasizing the importance of early recognition and intervention to optimize outcomes. When engaging with individuals experiencing PTSD, healthcare providers should approach them with empathy and utilize therapeutic communication techniques. These person- centered approaches foster trust, create a safe space for expression, and enhance the effectiveness of interventions aimed at supporting individuals with PTSD. continued for years, beginning when she was a young child and continuing through her high school years. She is currently seeing a therapist to help her deal with the trauma of sexual violence. Under these circumstances, the therapist is not surprised that Shona is exhibiting all of the following EXCEPT: a. Heart palpitations. b. Abstaining from alcohol. c. Signs of depression. d. Chain smoking. Self-Assessment Quiz Question #2 Shona is a survivor of sexual violence. The abuse
CHILDREN AND SEXUAL VIOLENCE
● Preference for impersonal sex and sexual risk-taking ● Exposure to sexually explicit media ● Adherence to traditional gender role norms ● Prior sexual victimization or perpetration ● Suicidal behaviors
According to the CDC (2022), the risk factors for sexual violence against children include the following: ● Alcohol and drug use ● Delinquency ● Early sexual initiation ● Coercive sexual fantasies Recognition of child abuse According to Boos (2018), trends over time in the United States, Canada, Sweden, Australia, New Zealand, and the United Kingdom suggest that “child maltreatment syndrome or assault, physical abuse deaths, and admissions for injuries related to child abuse have not changed significantly since the mid-1970s despite increased child protection activities” (para. 4). Clinicians must be familiar with characteristics associated with child abuse. The following are some common symptoms of physical abuse in children:
The following risk factors in the social environment may lead to child abuse (Boos, 2018): ● Unplanned pregnancy ● Poverty ● Acute or chronic stressors in the home environment (such as job loss) ● Parents with low education levels ● Parents with a negative view of their child’s normal developmental behaviors
● Substance abuse in the home ● Caregiver with a history of abuse ● Animal cruelty ● Psychiatric illness in the caregiver
● Learning disabilities ● Conduct disorders ● Bruises of various ages ● Human bites ● Missing or fractured teeth ● Cigarette burns or hot water scalding ● Fractures ● Head trauma
Clinicians should always assess for the potential or actual presence of child abuse and report any suspicions to the local authorities per the guidance of state laws.
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