ABUSE & PTSD Flashcards
Abuse
“The wrongful use and maltreatment of another person.”
- Abuse affects all populations equally. It occurs among all races, religions, economic classes, ages, and educational backgrounds.
- The phenomenon is cyclical in that many abusers were themselves victims of abuse as children.
Abuse: Predisposing Factors (6)
- Biological:
a. Neurophysiological influence:
Frontal lobe dysfunction- responsible for complex social behavior
b. Biochemical:
Low dopamine, fluctuating serotonin level
c. Disorders of the Brain:
Brain tumors, particularly in the areas of the limbic system and the temporal lobes; trauma to the brain resulting in cerebral changes, encephalitis and temporal lobe epilepsy, have all been implicated. - Psychological:
a. Psychodynamic Theory:
Aggression and violence supply power and prestige that boosts the self-image of the abuser and validates a significance to his/her life that is lacking. Ego is immature; id is dominant and superego is weak.
b. Learning Theory:
Modeling; individuals abused as children or witnessed domestic violence are more likely to behave in an abusive manner as adults (Hornor, 2005) - Sociocultural:
a. Societal Influences- DOPE
Clinical Picture of An Abuser:
- The abuser treats the spouse/partner as a “property,” becoming violent and aggressive upon manifestation of independence.
- Has strong feelings of inadequacy, low self-esteem and poor problem-solving skills
- Emotionally immature, irrationally jealous, needy and possessive
Why are they abusive?
“By bullying and physically punishing the family, the abuser often experiences a sense of power and control; therefore, the violent behavior often is rewarding and boosts self-esteem.”
Clinical Picture of An Abused:
- Often with a trait of dependency (personal/financial)
- Perceives oneself as unable to function without spouse/partner despite
personal talents and abilities - Suffers low self-esteem; defines success as a person by ability to remain
loyal to marriage/partnership and “make it work.” - Internalizes criticism; mistakenly believes they are to blame.
- Fears their abuser will kill them if they try to leave.
- Learned Helplessness: As abuse continues, ability to see options
available to make decisions concerning life (& children) becomes limited.
65% of women murdered by spouses/boyfriends were attempting to leave or had left the relationship
Spouse/Partner Abuse
Treatment/Intervention:
- Restraining Order (Protection Order); limited, abuser may decide to violate the order and severely injure/kill the spouse/partner before the police can intervene.
- Relief shelters; often crowded and only provides temporary reprieve.
- Individual Counseling, Group Therapy, Self-Help Groups
Child Abuse
Forms (4)
“The worst sin is the mutilation of a child’s spirit.”
a. Physical-severe corporal/unjustifiable punishment
b. Sexual-incest, sodomy, rape (by person or object),
oro-genital contact, molestation, exploitation
c. Neglect-malicious or ignorant withholding of physical,
emotional, or educational necessities
d. Psychological-verbal assaults, constant family
discord, withholding of affection
Child Abuse
Assessment at School:
- Frequently absent from school
- Begs for money/steals food
- Consistently dirty, lacks sufficient clothing
- Appears indifferent, apathetic or depressed
- Has difficulty walking or sitting
- Suddenly refuses to change for gym or to participate to physical activities
- Child preferring a healthcare worker/teacher over own parent
Child Abuse
Treatment/Intervention:
- PRIORITY: ENSURE CHILD’S SAFETY & WELL-BEING
- Thorough psychiatric evaluation; multidisciplinary
- IDEAL THERAPY FOR YOUNG CHILD: PLAY THERAPY & ART THERAPY
- Family Therapy: if child is feasible to be returned; psychiatric/substance abuse treatment for parents
- Short/Long-Term Foster Care: if reunion to family is no longer possible
Elder Abuse
Treatment/Intervention:
- Relieve caregivers’ stress
- If neglect is intentional for self-gain-removal of carer/elderly
- CBT/ One-on-One Therapy
Rape
Forms:
(3)
a. Acquaintance/Date
b. Marital
c. Statutory
Profile of a Victimizer of Rape
- Growed up in abusive homes
- Even when the parental brutality is by the father, the anger may be directed toward the mother who did not protect her child from physical assault
- Rapist displaces this anger on the rape victim because he cannot directly express it toward other men
Rape Assessment:
- If possible, assessment should occur before the woman has showered, brushed teeth, douched, changed clothes or had anything to drink.
- Drinking fluids can be allowed immediately after confirmation that oral sex did not occur.
- Ask questions gently and sensitively
- Prepare rape kits and adhere to institutional rape protocols
- Doctor: primarily responsible to physical assessment
Rape
Treatment/Intervention: (6)
- Giving as much control back to the victim as possible is important.
- It is the victim’s decision about whether or not to file charges and testify against the perpetrator.
- The victim must sign consent forms before any photographs or hair and nail samples are taken for future evidence.
- Prepare prophylaxis for STDs and prepare for HIV Testing
- Ethinyl estradiol and norgestrel (Ovral) can be offered to prevent pregnancy
- Therapy goal: returning the victims’ sense of control
Posttraumatic Stress Disorder
- Three clusters of symptoms are present: reliving the event; avoiding reminders of the event; and being on guard, or hyperarousal.
- Persistently re-experiences the trauma through memories, dreams, flashbacks, or reactions to external cues about the event and, therefore, avoids stimuli associated with the trauma.
- In PTSD, the symptoms occur 3 months or more after the trauma, which distinguishes PTSD from acute stress disorder.
