domestic violence

Question 1

What is intimate partner violence

Answer 1

Assaultive behavior that functions to dominate, control or punish another in an intimate, supposedly peer, relationship

Question 2

4 types of intimate partner violence

Answer 2

physical, sexual, property/pet destruction, psychogical battering/terrorism

Question 3

Intimate partner violence incidence and prevalence

Answer 3

physical violence past year- 25%, injury in past year 15%

lifetime39%
lifetime injury-25%

Forced sex- 9% f, 2.2 % M

17% F, 8% men in non rape sex violence

Question 4

Men in heterosexual relationships are less victims of severe Interpartner violence

Answer 4

men are most at risk for violence by- male friends, male acquaintances, male strangers

Question 5

Female vs Male intentional injury

Answer 5

Violence against women- primarily IPV- 64% of women who reported rape, physical assault, and or stalking since age 18 were victimized by a current or former partner (husband, cohabiting partner, boyfriend or dat)

Violence against against men- Primarily non-IPV: 84% of men who reported rape and/or physical assault since age 18 were by non partner, only 16% of men who reported rape and/or physical assault were assaulted by a current/former partner

Question 6

homosexual relationships

Answer 6

gay men and women experience partner violence at a rate comprable to women in heterosexual relationships

Question 7

is there a cycle of violence

Answer 7

transgenerational, cycle of violence within the relationship

Question 8

Societal dynamics

Answer 8

institutional/structural sexism
Legislative factors
Law enforcement/criminal justice/ family law
Social services
Medicine

Question 9

impact

Answer 9

women had more face, head and neck,

bruises in face head and neck

will lead to PTSD, depression, suicidality, functional disorder, anxiety, alcohol abuse

Question 10

PTSD and IPV

Answer 10

Compared to people with PTSD caused by non interpersonal trauma, victims of IPV experience more:
Intrusive re-experiencing, avoidance of reminders , hypervigilance, startle responses, detachement from others, restricted affect

Question 11

Disguised presentations of IPV

Answer 11

As a mental health problem- Depression, anxiety, alcohol/drug abuse

as a relationship problem- Sexual dysfunction, partner as identified patient

AS a child related problem- suspected child abues, child behavior problem

As multiple, stress related physical complaints

Question 12

impact on children living with IPV

Answer 12

in violent families with children, 85% directly witnessed assault

80-90% of kids in violent families indicate they have witnessed violence

Question 13

adverse childhood events

Answer 13

Child abuse- Physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect

Family dysfunction- intimate partner violence, mental illness, substance abuse, imprisonment, marital discord

Smoking alcoholism ets, IHD, COPD, stroke, idiopathic myocarditis

Question 14

Trama exposure PTSD, cardiovascular events in women

Answer 14

4+ ptsd symptoms predicts CVD risk, trauma exposure w/o PTSD predicts CVD risk

After controlling for health behaviors and medical risk factors

Question 15

Physiological pathways

Answer 15

chronic stress disrupts the normal neurochemical mechanisms of coping and stress responding

catecholamine, hpa axis, and immune response, trauma dysregulates these physiologic processes, increase in proinflammatory cytokines, creates wear on the system, increases vulnerability to disease

Question 16

IPV and sleep

Answer 16

negative effects of sleep disruptions:
immune function, metabolic changes, chronic HPA axis activation

Sleep deprived persons have more- inflammation, greater functional disability, decrease quality of life

Question 17

barriers to identifying IPV

Answer 17

patient barriers to diagnosing and treating partner violence

Lack of trust, safety jeopordized, financial support jeopordized, financial support jeopardized, shame and humiliation, sense of futility, low self esteem

Question 18

barriers health professionals face diagnosing and treating partner violecnye

Answer 18

Lack of knowledge, lack of clinical skills and training, fear of offending the patient, too close for comfort, pandoras box: powerlessness and loss of control