Violence and Abuse (9-12 questions)

Violence Defined:
Violence: The intentional use of force or power, threatened or actual, against oneself,
another person, or a group or community, that either results in or has a high likelihood of
resulting in injury, death, psychological harm, maldevelopment or deprivation.
Interpersonal Violence: Violence between 2 people (assault, rape, etc)
Intrapersonal Violence: Violence to oneself (suicide, cutting, etc)
Institutional Violence: Violence that is part of an intuitional design (prisons)
Structural Violence: Violence that is part of a societies make up (?)

Factors associated with risk of being involved in violent situations:

 Sociologic
o low socioeconomic status
o involvement with gangs
o drug dealing
o access to guns
o media exposure to violence
o community exposure to violence
o a change in social/economic conditions*
o access to guns*
 Developmental/Psychologic
o alcohol/drug abuse
o rigid sex role expectations
o peer pressure – adolescents esp
o poor impulse control
o history of mental illness
o increased stress level
o poor self esteem
o manual laborer, unemployed or underemployed
o under 30 years old
 Family
o history or intergenerational abuse
o social isolation
o verbal threats from parents
o increased family stress
o 2 or more kids
o multiple demands on one person*
o access to guns*
 Community
o crowded living situations
o POVERTY!!!
o social isolation
o lack of community resources (ie playgrounds, parks, etc)
o culture
o economic conditions
Types of Societal Violence:
Youth/School Violence
Workplace Violence
Community Violence
Gang Violence
Mass Violence and War
Homicide:
o When committed by strangers it is usually related to drugs
o Most often homicide is committed by a friend, acquaintance or family member
o Within families it is usually proceeded by abuse
o rates are increasing in adolescents
o #1 cause of death for black men and women ages 15-34
o Firearms!
Rape:
o Often unreported
o includes marital and date rape
o majority of rape of women is intimate partner violence
o increase incidence reported in cities between the hours of 8pm-2am, on weekends
and in the summer
o ACT OF VIOLENCE, NOT SEX OR PASSION
o Men are also a victim, more often goes unreported
o common violence in prisons

Types of Domestic Violence:

Emotional and Psychological Abuse
Financial and Economic Abuse
Physical Abuse
Sexual Abuse
Child Abuse and Neglect
Intimate Partner Violence
Elder Abuse and Neglect

DOMESTIC VIOLENCE IS THE SINGLE GREATEST CAUSE OF INJURY TO

WOMEN

Child abuse:
MANDATORY REPORTING REQUIREMENTS
o Sometimes the abuse is inflicted on all of the children in the family but often one
child is singled out
o Children who are considered different or have a disability are at increased risk
o Child abuse is familial and often there is a hx of intergenerational violence
o When dealing with these children the RN should be careful to not talk badly about
the parents, the child still has loyalty to their parents.
o Black children highest risk, Asian children lowest risk
o Often goes unreported
o Low socioeconomic status increases risk
o Physical Abuse:
 o punching, beating, burning, etc
o Child Neglect:
o the failure to provide for the child’s basic needs
o Physical, educational or emotional
o Poor maternal bonding increases risk
o Sexual Abuse:
o most underreported form of child abuse
o includes incest, exhibitionism and commercial exploitation through
prostitution or pornography
o Emotional Abuse:
o cause serious behavioral, cognitive, emotional or mental disorders
o very hard to detect

Intimate Partner Violence:

NO mandatory reporting requirements
o Physical, Sexual & Emotional
o Abusers: jealous, controlling, possessive and emotionally dependant
o 3 Phases
o Tension-building Phase
o Battering Phase
o Apologetic Phase

Elder Abuse:
41 States have MANDATORY REPORTING REQUIREMENTS
o VERY under reported
o Physical, Emotional & Financial
o Neglect*
o Happens across all socioeconomic and educational levels
o Adult children (sandwich generation: a person who is raising children and caring
for their aging parents) are most often the abuser
o Elders who live in facilities, have disabilities or dementia are at increased risk
o Often times the caretaker needs support in order to avoid the frustration that leads
to violence.

Strategies to Reduce Violence:

Primary Prevention:
o Focus on
o prevent cycle of abuse
o nonviolent conflict resolution and anger mgmt
o increasing abilities to deal with stress and eliminate or reduce factors
contributing to stress
o Teach alternative methods of conflict resolution, anger mgmt and coping
strategies in schools or community centers and after school programs
o Organize parenting classes to assist families in developing effective parent-child
and intimate partner relationships by assisting with communication and
anticipatory guidance of expected age appropriate behaviors
Secondary Prevention:
o Focus on
o early identification, diagnosis and treatment of abuse
 o screening those at risk for abuse and of those who are potential abusers
o ensure safety of all involved
o support services: shelters, legal services, etc
o Privacy and confidentiality must be respected*
o Includes provision of a 24/7 support and emergency services for treatment and
temporary shelter
o assess and evaluate any unexplained bruises or injuries of any individual, many
bruises of different stages of healing is a major warning sign*
o screen all pregnant women for signs of abuse (not only are they at increased risk
but also this might be the only time a woman see’s health professionals on a
regular basis)
Tertiary Prevention:
o Focus on
o dealing with the consequences of violence and prevention of reoccurrence
o rehabilitative services
o empowering clients to have the strength to change conditions and gain
control of their situations
o Includes the treatment of adults who were abused as children*
o Establishes parameters for long-term follow-up and supervision, including that of
mental health professionals
o Must develop a trusting relationship and focus on the client