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An individual misuses, attacks or injures another individual Can be sexual, physical, emotional

The Abuser (Perpetrator)

 Individual who grew up in an abusive family  Research findings indicate that children who observed or

were victims of beatings and violence when young believe that abuse is normal behavior and will reenact these behaviors later as adults  Common characteristics:
Low self concept Immaturity Fear of authority Lack of skills to meet their own emotional needs Belief in harsh physical discipline Poor impulse control Lack parenting or relationship skills Often use alcohol or other substances to cope with stress

The Abused
 Individuals often demonstrate a pattern of learned

helplessness, manifest characteristics of low self esteem and shame, and often experience feelings of increased dependence, isolation, guilt and entrapment

A Crisis
 Precipitating event that sets the abusive behavior into

action  The individual overreacts because he or she is unable to cope with numerous or complex stressors. The person becomes frustrated and anxious and suddenly loses control

Also referred as maltreatment Any recent act or failure to act, resulting in imminent risk of serious physical harm or death, emotional harm, sexual abuse, neglector exploitation of a child under the age of 18 years by a parent, caretaker or other persons.

Bullying is the most common form of abuse children and adolescents experience. Neglect, another form of child abuse, an act of omission and refers to a parent or other's failure to meet dependent s basic needs such as proper food, clothing, shelter, medical care, schooling or attention; provide safe living conditions; provide physical or emotional care; or provide supervision, thus leaving the child unattended or abandoning him or her.

A report of child abuse is made every ten seconds. Almost five children die everyday as a result of child abuse. More than three out of four are under the age of 4. It is estimated that between 60-85% of child fatalities due to maltreatment are not recorded as such on death certificates. 90% of child sexual abuse victims know the perpetrator in some way; 68% are abused by family members. Child abuse occurs at every socioeconomic level, across ethnic and cultural lines, within all religions and at all levels of education. 31% percent of women in prison in the United States were abused as children. Over 60% of people in drug rehabilitation centers report being abused or neglected as a child. About 30% of abused and neglected children will later abuse their own children, continuing the horrible cycle of abuse. About 80% of 21 year old that were abused as children met criteria for at least one psychological disorder. The estimated annual cost of child abuse and neglect in the United States for 2007 is$104 billion. Abused children are 25% more likely to experience teen pregnancy. Abused teens are 3 times less likely to practice safe sex, putting them at greater risk for STDs.

Can occur:
 within the family, where the abusers are parents or parent

substitutes  in institutional setting, such as daycare centers, child-care agencies, schools, welfare, departments, correctional settings and residential centers  in society, which allows children to live in poverty or to be denied the basic necessities of life.  As a result of war

Children who experience trauma that can interrupt their development, trigger serious psychiatric disorders, or predispose them to delinquency and life long crime Anyone under circumstances, such as stress due to illness, marital problems, financial difficulties, or parent-child conflict

Warning Signs
 Denial pregnancy by a mother who has made no plans for the         

birth of the child and refuses to talk about pregnancy Depression during pregnancy Fear of delivery Lack of support from husband or family Undue concern about unborn child s gender and how well it will perform Fear that child will be one of too many children Birth of unwanted child Indifference or a negative attitude toward the child by a parent after delivery Resentment toward the child by a jealous parent Inability to tolerate the child s crying; viewing child as being too demanding

Younger than 6 years, are more vulnerable to abuse than others and may have physical or mental handicap Emotionally disturbed, temperamental, hyperactive or adopted children demonstrate a higher incidence of abuse Congenital anomalies or chronic medical conditions are at risk Children , in attempt to get attention

Physical Abuse
 Infliction n of bodily injury that results from punching,

beating, kicking, biting, burning, shaking, or otherwise harming a child.

Physical indicators
Bruises Burns Lacerations, abrasions, welts, scars Missing or loosened teeth Skeletal injuries (fractured bones, epiphyseal separation or stiff, swollen, enlarged joints, head injuries)  Internal injuries

 Behavioral and Environmental Indicators

Fear of parents and fear physical contact with adults Extremes in behavior such as passivity pr aggressiveness or crying very often or very seldom Sudden onset of regressive behavior such as thumb sucking, enuresis, or encopresis Truancy from school or tardiness Fatigue causing child to sleep in class Inappropriate dress to hide burns, bruises or other marks of abuse Inappropriate dress, resulting in frostbite or illness due to exposure to inclement weather Excessive compliance to avoid confrontation Sporadic temper tantrums Violence toward other children or animals Demanding behavior

Child Neglect
 Failure to provide for a

child s basic physical, medical or educational needs

 Physical Indicators:
Weight loss resulting from inadequate nutrition Dental caries caused by lack of appropriate nutrition or dental care Symptoms of an undiagnosed medical condition such as anemia or pneumonia Child may look unkempt and lack adequate clothing

 Behavioral and Environmental Indicators:

Failure to thrive Learning difficulties caused by poor attention span, inability to concentrate, or autism Use of drugs or alcohol Delinquency Sexual misconduct

Emotional Abuse
Verbal assaults or threats that provoke fear; poor communication that may send double meanings; ad blaming, confusing or demeaning messages
Children may be told to be unwanted, unloved, or unworthy of care. The child may become a scapegoat of the family

Emotional Neglect
Parents or other adults responsible for the child fail to provide an emotional climate that fosters feelings of love, belonging, recognition and enhanced self-esteem.
Ignoring of child, providing minimal human contact and failing to provide opportunities to foster growth and development

May develop serious behavioral, cognitive, emotional or mental disorders

 Behavioral and Environmental Indicators: Low self-concept as he or she hears negative comments Stuttering Enuresis or encopresis Delinquency or truancy or other disciplinary problems Hypochondriasis Autism or failure to thrive Overeating Childhood depression Suicide attempts

Child Sexual Abuse

 Sexual abuse of a child includes:
Fondling or a child s genitals Intercourse Incest sexual intercourse or behaviors between family members Rape - actual penetration of an orifice of a child s body during sexual activity Sodomy - any contact between the genitals of one person, and the mouth or anus of another Exhibitionism - mental disorder characterized by a compulsion to display one's genitals to an unsuspecting stranger Commercial exploitation through prostitution or the production of pornographic materials

High Risk for sexual abuse:

3 years of age or younger Suffer from a developmental delay Live in a home where substance abuse occurs Have adolescent parents or a single parent Are in foster care Primary caretakers who were sexually abused themselves  Primary caretakers who are mentally ill or who have a developmental delay

Episodes of Childhood sexual abuse:

 Acute episodes
Sexual abuse occurred within previous 72 hours of examination by clinician Evidence of moderate-to-severe injury such as vaginal bleeding or genital lacerations

 Sub acute episodes

Sexual abuse occurred more than 72 hours before an examination by a clinician Symptoms like minor abrasions or dysuria

 Non acute episodes

Sexual abuse more than 72 hours before clinicians examination No significant injuries or symptoms

 Physical Indicators:
Itching, pain, bruises or bleeding in the external genitalia, vagina or anal area Edema of the cervix, vulva or perineum Torn, stained or bloody undergarments Stretched hymen at a very young age Presence of semen oral sexually transmitted disease Pregnancy in an older child Bladder infections

 Behavioral Indications:
Fear of being touched Difficulty of walking or sitting Reluctance to participate in recreational or physical activities Poor peer relationships Delinquency, truancy, acting-out or running away Preoccupation with sexual organs of self or others Sexual promiscuity or prostitution Change in sleeping patterns; nightmare; or sudden fear of falling asleep Bed wetting or thumb sucking (inappropriate to age) Use of drugs and alcohol

Child Abduction
 A person is taken or detained

against his or her will  82 % of abductions are committed by family frequently to children under the age of 6 years. Non-family or acquaintance abductions accounts for 18 % of reported cases of female and teen-aged victims

Referred to as intimate partner violence or family violence Designed to manipulate, control, dominate the partner to achieve compliance and dependence Includes repeated battering and injury, psychological abuse, sexual assault, progressive social isolation, stalking, deprivation, and intimidation Usually occurs as a result of the inability to cope with an increase in daily stressors

Groups at Risk:
 Women who are emotionally    

involved with the batterer Children (silent victims) Elder partners Men Same sex couples
Men living with make intimate partners

Individuals with neurologic impairments, agitated depression, antisocial or borderline behavior or who abuse drugs and alcohol Lack of nurturing and mothering during childhood Poor socioeconomic conditions Specific behaviors learned during various developmental stages become part of a person s interactions with spouse or family. Domestic violence may increase after death of a significant family member, loss of a job, a geographic move, the onset of physical or mental illness, a developmental change or a family change such as pregnancy or birth of a child

Intimidation Threats Sexual abuse Isolation Emotional abuse Use of children Male Privilege Economic abuse

Tension-Building Phase
 Disagreements occur within couple as battered

person withdraws rather than making any attempts to display anger verbally or non verbally. The batterer becomes possessive, jealous, and fearful, sensing the battered partner s anger. Emotional distancing occurs. The batterer rationalizes the batterer person s non assertiveness as acceptance and permission to vent tensions. Minor physically abusive incidents may cause the battered person to cope with abuse by somatizing, batterer attempts to reduce tension by taking drugs or drinking alcohol.

Acute Battering Phase

 Batterer loses control of behavior because of blind

rage. Battered person also loses control and is unable to stop the physical abusiveness experienced. Both persons are in state of shock immediately. Batterer is unable to recall his or her behaviors; battered person depersonalizes during abusive incident and is unable to recall in detail what occurred.

Loving Phase
 As both calm down, the batterer may exhibit

feelings of remorse, beg forgiveness, promise not to abuse in the future, and state that he or she cannot live without the battered partner. During this phase, the abused person believes the batterer s promises and forgives the batterer because the partner feels less helpless. The batterer interprets such behavior as an act of love and acceptance by battered partner

Lack of resources Lack of Institutional Responses Traditional Ideology

Also referred as sexual assault

Sexual harassment  Unwelcomed advance or conduct on the job that creates an intimidating or offensive working environment Stalking  Pattern of unwanted communication, such as harassing or menacing behavior, coupled with a threat to do harm Sexual coercion  One person dominates another by force or compels the other to performs sexual act

Traditional referred to as forced vaginal penetration of a woman by a male assailant Legal term for male rape is sodomy or sexual assault by an intimate partner

Essential Elements for Rape

 Use of force, threat, intimidation or duress  Vaginal, oral or anal penetration  Non consent by victim

Rape Statues
 Attempted rape
assault In which oral vaginal or anal penetration is intended but does not occur

 Statutory rape
act of sexual intercourse or sexual assault on an individual younger than the age of consent (16 years)

Men who commit rape are usually from singleparent homes, younger than 25 years, and often married. High risk of Rape

 Single females between ages 11 and 25 years  From low socioeconomic background  Lesbians and homosexual male at risk by their

intimate partners  Individuals with mild developmental delays usually want to be accepted and to fit in with normal society. Exhibits some degrees of impulsivity or gregariousness

 Anger rape
Means f expressing anger, hatred and contempt toward the victim Exhibits brutality by beating, kicking and choking

 Power rape
Committed by persons with low self-esteem and a history of poor relationships with women and is done to prove manhood and strength Intimidation, physical force or threats may occur

 Sadistic rape
Persons feels to inflict pain and torment on his victim to achieve sexual satisfaction Rapist misinterprets victim s emotional anguish as excitation rather than a refusal of his advances

 Impulsive or opportunistic rape

Conjunction with another antisocial act such as robbery An antisocial takes what he want whenever he desires it; rape therefore becomes a form of stealing.

 Blitz rape
Unexpected surprise attack occurs in absence of prior interactions with victim

 Confidence rape
Offender and victim have had a prior interaction

 Marked victim rape

Offender assaults a woman he has been acquainted with in some way

Vulnerable victim s inability to give consent

 Date rape
Exploitation of an individual s friendliness or behavior during a date

Rape trauma syndrome

 Acute phase victim is disrupted by crisis

and displays emotional reactions of anger, guilt, embarrassment, humiliation, denial, shock, disbelief, or fear of death  Reorganization changing of daily life patterns, experience recurring dreams and nightmares, seek support from friends and family, initiate or refusing counseling or develop irrational fears(phobias):
fear of being indoors if rape occurred at home fear of being outdoors fear of crowds fear of being alone fear of people around the victim while the person engages in daily activities fear of sexual activity

Silent rape syndrome

 Victim fails to close information about rape to

anyone, is unable to resolve feelings about sexual assault, experiences anxiety and may develop a sudden phobic reaction  Behavior changes may include depression, suicidal behavior, somatization and acting out

Major types of Elder Abuse

 Physical abuse Direct beating, slapping, kicking or shaking; overmedication  Sexual abuse Sexual assault of physically or cognitively impaired elder  Emotional or psychological abuse Verbal assaults or threats  Abandonment (neglect) Leaving elderly unsupervised; Allowing elderly to live in unsanitary conditions  Financial or material exploitation Misuse of money or property by children or legal guardian; Stealing social security checks, credit cards, etc.  Self-neglect Elder threatens own health through failure to take medication or to eat inadequate amounts of food

Dependency on adult children or caretaker Financial dependency Personality conflicts with adult children or caretaker Societal attitudes toward aging Frustration on the part of the adult children or caretaker

Barriers to self-reporting of abuse by elderly victims


Cognitive impairment Inability to communicate clearly or accurately Fear of rejection Low self-esteem Loyalty to caretakers Lack of contact with helping persons Reluctance to report due to fear of retaliation by abuser