PH Exam 2 Violence

The intentional use of physical force against oneself that results in, or has a high likelihood of resulting in, injury or death

• Bullying
• Sexual Violence

Exposure, repeatedly and over time, to negative actions on the part of one or more other students

• Direct bullying: overt, physical act
• Indirect bullying: covert, more psychological (ex. threats, isolation)

• Gang presence in school
• Lack of school-related supervision (no hallway or lunchroom monitoring, no security officers)

• White, non-hispanic
• Younger students
• No gender differences
• No diff btwn public and private schools

• Victimization
• Fear, anxiety
• Physical aggressiveness
• Risk-taking behaviors (school shootings)
• Low academic achievement
• Low self-esteem

Sexual assault includes touching any part of a person's body in a sexual way, even through clothes without that person's consent

• Women (men too)
• Younger age- <20 years old
• American indian and Alaskan native
• Persons who engage in high-risk behavior
• Lower socioeconomic level

• Inc rates of STDs
• Inc rates of pregnancies
• Long-term health problems including:
• -chronic pelvic pain
• -premenstrual syndrome
• -GI d/o
• -gynecological and pregnancy complications
• -migranes and other frequent h/a
• -disability preventing work

• Denial
• Shock
• Fear
• Confusion
• Anxiety
• Withdrawal
• Guilt
• Nervousness
• Distrust of others
• PTSD

• Depression
• Attempted suicide
• Alienation
• PTSD
• Unhealthy diet-related behaviors

• Physical
• Sexual
• Psychological
• Economic
• Medical

• Actual action by perpertrator
• Acute: single, inpulsive act (ex. shaken baby syndrome)
• Chronic: child who is chronically battered

• Failure to act, results in harm to person
• Acute: failure to act, when child drowning
• Chronic: forget about child (ex. feeding)

• Abuse: refers to purposely perpetrated physical injury and can range from minor bruises to severe fractures or death (pinching)
• Neglect: refers to failure to protect someone from purposely perpetrated physical injury or failure to provide necessary food, shelter, and supervision

• Abuse: fondling, exposure, rape, sodomy
• Neglect: failure to protect from abuse

• Abuse: behavior that impairs emotional development or self-worth
• Neglect: inattention to emotional needs, failure to provide psychological care

• Abuse: coercion through monetary threat (controlling bank account)
• Neglect: failure to economically provide food

• Abuse: interfering with medical attention or access
• Neglect: failure to secure medical needs or medications

• Death
• Physical problems
• Mental and emotional problems
• Unhealthy behaviors
• Risk for continued cycle of violence
• Economic cost to society

• Intimate partner violence
• Child abuse and neglect
• Elder abuse and neglect

A pattern of assaultive or coercive behavior that is perpetrated by someone who is, or was, in an intimate relationship with the victim for th purpose of achieving compliance or control

• Theory of violence
• As the cycle continues overtime phase 3 is shorter as they feel they have control
• Survivor sees themselves as the cause of the violence
• Most significant sign: isolation

• Tension Building
• Perpetrator makes accusations
• Survior is compliant
• Trying to ease tension
• Walking on egg shells

• Acute Battering
• Actual psychological violence
• Physical pinching, slapping, murder, sexual violence
• Best time for HCP to intervene, post phase 2

• Honeymoon Phase
• Perpetuator is apologetic
• Survivor is guilty for not helping/ throwing overboard

• Do not have resources- isolates from family and friends
• Do not have power
• Have children
• Were abused as children or witnessed violence in the family
• Violence may be infrequent or of lesser severity
• Religious/ cultural reasons
• Fear

An act (abuse) or failure to act (neglect) on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation or imminent risk of serious harm

• Unexplained bruises in various stages of healing
• Unexplained cigarette burns, immersion burns, or rope burns
• Lacerations or abrasions
• Fractures
• Injuries to mouth, lips, gums, eyes or external genitalia

• Wariness of adults
• Apprehension when other children cry
• Constant alertness for danger
• Showing fear of parents
• Fear of going home

• Hunger
• Poor Hygiene
• Inappropriate dress

• Lack of supervision
• Lack of medical/dental care
• Fatigue
• Begging or stealing food
• Early arrival/ late departure from school

• Difficulty walking or sitting
• Torn, stained, or bloody underwear
• Genital pain or itching
• Bruises or bleeding from the genitalia, vagina, or anal area
• STDs

• Drug and alcohol abuse
• Developmental delays
• Teen pregnancy
• Bizarre, sophisticated or unusual sexual behavior
• SI
• Runaway

• Failure to thrive
• Delayed physical development
• Speech d/o
• Developmental delays

• Behavior extremes from passivity to aggression
• Conduct d/o
• Attempted suicide

Any act or omission by a caregiver, guardian or custodian of an elderly person, that results in harm or threatened harm to that person's health or welfare

• Unattended injuries
• Dehydration
• Wt loss
• Lack of medication
• Poor skin hygiene
• Soiled clothes
• Burns
• Signs of confinement

• Fear, w/d, depression
• Agitation
• Missing personal belongings
• Conflicting accounts of events
• Usually economic & medical abuse

• Be aware of at risk populations
• Be able to recognize common S&S as described throughout the presentation
• Realize that effects on health may be due to: direct experience of violence, witnessing violence, living in violent environment

• Saftety
• Empowering response
• Allow survivor to control situation

• Blaming the survivor
• Normalizing victimization
• Violating confidentiality
• Minimizing abuse
• Ignoring safety needs
• Lack of respect

• Supporting the survivor
• Believing/ validating the abuse
• Respecting confidentiality
• Acknowledging the injustice
• Respecting autonomy
• Ensuring safety

• Eliminate/ dec risk of violence
• Dec risk of violence

• Id those affected and at-risk
• Intervene: Priority is to remove the person from the source of the violence
• Tx immediate post-violence sequelae per the specific need

Provide on-going support for survivors

You must report abuse and suspected abuse