Domestic Violence - Hamberger Flashcards
What is intimate partner violence?
What are the four ways in which it can manifest?
Assaultive behaviors that function to dominate, control or punish a partner in what is supposedly an equal relationship
Physical violence
Sexual violence
property/pet destruction
Psychological battering
Who is a woman most likely to be raped by?
What percentage of women will be sexually assaulted in their lifetime?
Someone they are in love with (46%)
22% of all women, 16.9% by a partner
What are differences between violence against men and violence against women?
The perpetrator
Women are more likely to be attacked by a partner (64%); men are more likely to be attacked by a stranger (84%)
Co-morbidities
Women are more likely to experience physical injury, psychological injury than men
Which gender mostly attacks men?
How does sexual preference affect intimate partner violence?
Men are typically attacked by other men
Homosexual couples experience equal rates of intimate partner violence; bisexual individuals experience higher rates.
Women in violent relationships are more likely to have hospitalizations than women who are not. True or False?
Facial and head injuries are more characteristic of abuse than of car crashes or falls. True or False?
Women in abusive relationships are more likely to have psychological problems, including depression. True or False?
True
True
True
What are common presentations of intimate partner violence?
Depression
Anxiety
Alcohol/Drug abuse
Sexual dysfunction
Child behavioral problem
High blood pressure
How can intimate partner violence affect health?
Increased risk of chronic disease, especially if witnessed as a child.
Sleep disruption
Increased sickness
Depression
What problems can be barriers to treatment for partner violence?
Patient:
Lack of trust in provider
Safety jeopardized
Financial support jeopardized
Shame
Resignation/sense of futility
Provider:
Lack of knowledge
Fear of offending patient
lack of training
How should IPV screening be approached?
What questions should be asked?
Approach it as ‘prevention and safety,’ Think of it as asking about sexual preference, can be invasive, but important information!
Have you been hit, kicked, etc by someone in the past year? If so by whom?
Do you feel safe in your current relationship?
Is a partner from a previous relationship making you feel unsafe?
If screening for IPV is positive, how should interviewing proceed?
What makes an interview question effective?
Start with open ended questions and move to specific behaviors.
Asks about specific behaviors
Avoids charged terms like ‘abuse’ ‘violence’
Asks about responses to violence
Avoids asking ‘why it happened’
What is the medically appropriate response to intimate partner violence?
SOS DOC
Support
Options
Safety
DOCument
When documenting, use rulers, take pictures, and include victim’s face
What are common pitfalls doctors face when treating patients with IPV?
Frustration at patient
- denial
- revolving door syndrome
- magnitude of the problem
Denial of service
- too helpless
- not my area
- opening pandora’s box
