Exam 1: Neglect/Abuse

Statistics for elder abuse

- 1 in 10 adults over 60 years has experienced elder abuse -60% of perpetrators are members of victims family -increased risk to older adults who are isolated or have cognitive impairments -annual loss of financial exploitation is estimated to be 36.5 billion

Stats for IPV

- 1 in 4 women and 1 in 9 men experience IPV -1.9 million women raped in the past year (2011) -15% of all violent crime

Women Abuse Screening Tool (WAST)

- primarily used in doctor's offices to help determine if a woman is in an abusive relationship. -specifically screens for verbal, emotional, physical, and sexual abuse -8 questions that ask about the level of tension in the relationship, the resolution of arguments, feelings of depression or humiliation, incidents of physical harm, feelings of fear due to partner's actions, and experiences of physical, emotional, and sexual abuse.

Prevalence of AHT

-A leading cause of physical child abuse deaths in children under 5 in the United States. -Babies less than one-year-old are at the greatest risk of injury from AHT. AHT has an estimated incidence of 32 to 38 cases per 100,000 children per year in the first year of life and is fatal in nearly one-quarter of cases2.

Individual risk factors for perpetration of child abuse

-Caregivers with drug or alcohol issues, mental health issues including depression, lack of understanding of children's needs or development -history of being abused or neglected as children, young or single parents or parents with many children, low education or income, high levels of parenting stress or economic stress, use of spanking and other forms of corporal punishment for discipline

Child sexual abuse definition

-Child sexual abuse includes any contact between an adult and a child or an older child and a younger child for the purposes of sexual stimulation of either the child or the adult or older child, and that results in sexual gratification for the older person. This can range from non-touching offenses, such as exhibitionism and child pornography, to fondling, penetration, incest, and child prostitution

Individual risk factors for victimization in child abuse

-Children younger than 4 years of age and children with special needs that may increase caregiver burden (e.g., disabilities, mental health issues, and chronic physical illnesses).

Risk factors on community level for IPV (perpetration)

-Communities with high rates of poverty and limited educational/ economic opportunities -communities with high unemployment rates -communities with high rates of violence and crime

Mandated reporting of elder abuse

-Elder justice act: provides federal guideline for the administration of older adult protection programs

Family risk factors for child abuse

-Families that have household members in jail or prison, families that are isolated from and not connected to other people (extended family, friends, neighbors), families experiencing other types of violence, including relationship violence.

HITS DV screening tools

-Hurt, Insulted, Threatened with Harm and Screamed -This is a short domestic violence screening tool consisting of four questions . It asks how often a partner physically hurts, insults or talks down to, threatens with harm, and screams or curses at the individual. Each item is scored from 1-5. Thus, scores for this inventory range from 4-20. A score greater than 10 signifies individual is at risk

PA state guidelines for elder abuse

-Mandated reporters are determined by the employment setting of the reporter -Facilities (mandated reporters): Skilled nursing facilities, long term care facilities, home health agencies, residential homes -Additional requirements for reports of sexual abuse, serious bodily injury, suspicious death: PDA mandatory Abuse Report

Older Adults Protective Services Act (OAPSA)

-Mandates reporting requirements on suspected abuse -Any employee or administrator of a facility who suspects abuse is mandated to report the abuse -All reports of abuse reported to the local area agency on aging and licensing agencies -IF suspected abuse is sexual abuse or serious physical injury, serious bodily injury or suspicious death law requires additional reporting to the department of aging and local law enforcement

Prevalence/statistics for child abuse/neglect

-More than 600,000 children are victims of abuse and neglect each year -At least 1 in 7 children have experienced child abuse or neglect in the past year. -The actual number of children abused is likely underreported because of the ongoing COVID-19 pandemic in 2021

Behavioral signs of abuse

-Name-calling and put-downs; overt anger; threats; attempts to intimidate by the abuser -restricting victim's movements -restricting victim's access to money -Overt jealousy or possessiveness over the victim -A delay between time of injury and seeking of treatment -The victim's noncompliance with a treatment regimen such as missed medical appts, or an inability to take meds due to lack of access to money -victim's fear of disagreeing with her abuser -The abuser harming other people or animals in the victims life

Mandated reporting of Child abuse

-PA Child protective service law of 1975 -Must report when in direct contact with child, are directly responsible for the child and/or child makes specific disclosure -may also make a general report if suspect child's needs are not being met

consequences of stalking

-PTSD -depressive and somatic symptoms -sleep problems -generally lower well-being victim takes defensive action: -taking time off work/ school -changing jobs/schools -moving away from family/friends

Signs and symptoms of child sexual abuse

-Signs of sexual abuse may include unusual interest in or avoidance of all things of a sexual nature, sleep problems or nightmares, depression or withdrawal from friends or family, seductiveness, statements that their bodies are dirty or damaged, refusal to go to school, delinquency/conduct problems, secretiveness, unusual aggressiveness, extreme fear or anxiety, substance use/abuse, suicidal behavior. Physical signs may include trauma to the genital area or anus including bleeding, bruising, or irritation.

STAT DV screening tool

-Slapped, Things and Threatened - 3 question screening tool -Have you ever been in a relationship where your partner has pushed or slapped you? -Have you ever been in a relationship where your partner threatened you with violence? -Have you ever been in in a relationship where your partner has thrown, broken or punched things

Barriers to assessment of intimate partner violence

-Stigma/ privacy concerns -Subtle or absent clues -Lack of resources -Discomfort in discussing sexual violence -limited discussion around sex in society

Methods of prevention for AHT

-Understanding the dangers of shaking or hitting a baby's head against something, knowing the risk factors and the triggers for abuse, and finding ways to support parents and caregivers in their community are all ways to prevent AHT. -Other strategies include learning about abusive head trauma, sharing information on typical child development and self-care, helping infants and caregivers build relationships, and connecting with community resources.

Screening tools for Domestic Violence and IPV

-WAST -HITS -STAT

Suspicious death requiring additional reporting

-a death that would arouse suspicion or is questionable

consequences of Intimate Partner violence

-adolescent pregnancy -unintended pregnancy -miscarriage -still birth -intrauterine hemorrhage -nutritional deficiency -abdominal pain/GI issue -Neurological disorders -chronic pain -disability -Anxiety -PTSD -HTN, cancer, cardiovascular diseases

serious physical injury requiring additional reporting

-an injury that causes a person severe pain or significantly impairs a person's physical functioning, either temporarily or permanently

Serious bodily injury requiring additional reporting

-an injury which creates a substantial risk of death or which causes serious permanent disfigurement or protracted loss or impairment of the function of a body member or organ

red flags that indicate physical abuse

-bruises, pressure marks, broken bones, abrasions, burns -unexplained injuries, injuries that don't match description

Overall risk factors for child abuse and neglect

-children younger than 4 or with a disability -caregivers with addiction, mental health challenges -Caregivers with limited understanding of child development -history of violence within the family -communities with high rates of violence and crime -communities with low neighborhood cohesion

Risk factors on community level for IPV - MEN

-communities with high rates of poverty and limited educational and economic income -communities with high unemployment rates -communities with high rates of violence and crime

Risk factors for elder abuse

-current diagnosis of mental illness, current or past abuse of drugs or alcohol, current physical health problem, past experience of disruptive behavior, past experience of traumatic events, high levels of stress among others

Physical signs of abuse

-cuts, bruises, restraint or grip markings, black eyes -unusual pattern of injury; repeated trips to the emergency room -poor hygiene, inappropriate dressing for weather -failure to thrive, poor weight gain malnutrition -lack of care of medical needs; wound care, medication -see fractures, dislocations -see bruising

Appropriate approaches to managing a patient who is a victim of IPV

-diagnosis and ongoing care -assess patient safety -counseling -education -documentation -referrals -follow-up -Trauma-informed perspective -Motivational interviewing

Methods of prevention for stalking

-empowering everyone to understand, recognize and address stalking -mobilizing men and boys as allies in prevention efforts -creating and supporting safe environments within relationships, schools, and communities through programs/ policies that reduce risk and promote healthy relationships -restricting social media posts to friends and not public -checking privacy settings on social networking sites and limiting amt of info supplied -regularly googling oneself to check digital footprint

Neglect signs in a child

-failure to provide adequate food, clothing, shelter, clean living conditions, affection, supervision, education, or dental or medical are

protective factors on relational level for IPV (perpetration)

-high friendship quality -strong social support -stable and positive relationships

highest predictor for becoming a perpetrator of DV

-history of being abused

red flags that indicate emotional abuse

-increased anxiety or agitation -isolation from friends and families -changes in sleep and/or behavior -withdrawal from normal activities

emotional abuse signs in children

-injuring a child's self-esteem or emotional well-being -includes verbal an emotional assault, such as continually belittling or berating a child -as well as isolating, ignoring or rejecting a child

Sexual abuse requiring additional reporting

-intentionally, knowingly or recklessly causing or attempting to cause rape, involuntary deviate sexual intercours, sexual assault, statutory sexual assault, aggravated indecent assault, indecent assault or incest -Sexual harassment requires reporting to the AAA only

Obstacles to leaving an abusive relationship

-isolation from support system -fear of retaliation -assaults following previous attempts to leave -threats towards children, pets -economic reliance -cultural, religious pressure -fear related to immigration status, homophobia, transphobia, racism -Lack of resources -Homelessness

Risk factors for perpetration of IPV

-low income or academic achievement -aggressive/ delinquent behavior -Heavy alcohol/drug use -lack of nonviolent problem-solving skills -poor impulse control -hx of being abused -belief in strict gender roles/ hostility toward women

Risk factors on individual level for IPV - MEN

-low self-esteem -low education/income -young age -aggressive or delinquent behavior as a youth -heavy alcohol/drug use -depression/suicide attempts -anger/hostility -lack of nonviolent social problem-solving skills -antisocial personality traits and conduct problems -history of being physically abusive -emotional dependence/insecurity -economic stress -traits associated with borderline personality disorder -Sexual entitlement -Involvement in violence outside of home -beliefs in family honor and sexual purity

Risk factors on the individual level for IPV (perpetration)

-low self-esteem -low education/income -young age -aggressive or delinquent behavior as a youth -heavy alcohol/drug use -depression/suicide attempts -anger/hostility -lack of nonviolent social problem-solving skills -emotional dependence/insecurity -economic stress -traits associated with borderline personality disorder

Consequences on those affected by teen dating violence

-more likely to experience depression and anxiety symptoms -engage in unhealthy behaviors like using tobacco, drugs, and alcohol -more likely to exhibit antisocial behaviors like lying, theft, bullying, or hitting

protective factors on community level for IPV (perpetration)

-neighborhood collective efficacy -resident involvement -coordinated resources and services -access to medical and mental health services

prevalence of child sexual abuse

-one in four girls and one in 13 boys will experience sexual abuse by the time they reach 18. However, it's believed that only 30% of child sexual abuse victims report the abuse as children.

red flags for neglect

-personal hygiene -unpaid bills -infestation -bed sores

5 types of elder abuse

-physical abuse -emotional abuse -neglect -sexual abuse -financial abuse

Consequences of child sexual abuse

-physical health consequences include: sexually transmitted infections (STIs) and physical injuries -Psychological consequences can include disorders such as: depression, anxiety and PTSD -It can also have long-term impacts on physical health, with people being more likely to report pain, gastrointestinal symptoms and obesity

Consequences of elder abuse

-physical injuries that can be disabling, complications of untreated or mismanaged health conditions that can be life-threatening, depression and anxiety, fear or lack of trust in other people, and stress. Research also suggests that older people who have been abused tend to die earlier than those who have not been abused, even in the absence of chronic conditions or life-threatening disease.

What are the different types of DV/IPV

-physical violence -sexual violence -emotional abuse -psychological abuse

4 types of violence behaviors in teen dating

-physical violence -sexual violence -psychological aggression -stalking

Risk factors on relational level for IPV (perpetration)

-relationship conflicts including jealousy, possessiveness, tension, divorce or separations Dominance/control of the relationship by one partner over the other Families experiencing economic stress Unhealthy family relationships/ interactions

Risk factors on relational level for IPV - MEN

-relationship conflicts including jealousy, possessiveness, tension, divorce, or separations -dominance and control of relationship by one partner over the other -families experiencing economic stress -unhealthy family relationships/ interactions -association with antisocial and aggressive peers -parent with less than a high-school education -witnessing violence between parents as a child

Sexual abuse signs in children

-sexual behavior or knowledge that's appropriate for the child's age

Abusive Head Trauma (AHT)

-shaken baby syndrome -A preventable and severe form of physical child abuse that results in an injury to the brain of a child. -It often happens when a parent or caregiver becomes angry or frustrated because of a child's crying. It is caused by violent shaking and/or with blunt impact.

Less obvious signs of abuse

-social isolation or withdrawal -vague medical complaints such as chronic headaches, fatigue or stomach pain -pelvic pain; vaginal/urinary tract infections -Unwanted pregnancy, lack of prenatal care -Sexual problems -depression -anxiety, including panic attacks and PTSD

red flags for financial exploitation

-sudden changes in spending patterns, will, financial documents -fraudulent signatures -unpaid bills

Risk factors on societal level for IPV - MEN

-traditional gender norms/ gender inequality -cultural norms that support aggression toward others -social norms that support male superiority and sexual entitlement

Risk factors on the societal level for IPV (perpetration)

-traditional gender norms/ inequality -cultural norms that support aggression toward others

red flags that indicate sexual abuse

-unexplained STIs -vaginal or anal bleeding -bruises around genital region -changes in demeanor -Sexual behavior/ knowledge beyond age, pregnancy/STI, blood in underwear, sexual contact with other children

Physical abuse signs in children

-unexplained injuries such as bruises, fractures or burns

stalking behaviors

-unwanted following and watching of the victim -unwanted approaching or showing up in places such as victim's home, workplace or school -unwanted use of global positioning system (GPS) technology to monitor or track the victim's location

how to make a report for child abuse

-via telephone (MUST also include CY-47 report) or online

Potential Long-term health effects of AHT

-vision problems, -developmental delays -physical disabilities -hearing loss

Prevalence of violence in adolescence (Teen dating)

1 in 11 female teens 1 in 15 male high school males have experienced physical dating violence in the last year

how many homicide victims are killed by an intimate partner

1 in 5

4 types of child abuse/neglect

1. physical abuse 2. sexual abuse 3. emotional abuse 4. neglect

on average how many phone calls a day are placed to domestic violence hotlines

20,000 calls

individuals who experience stalking are how many times more likely to be murdered

200 times more likely

what percentage of stalking victims contemplate suicide

25%

what fraction/percentage of stalking victims know their stalker

3/4 or 75%

The presence of a gun in domestic violence situations increases risk of homicide by what percent

500%

Emotional abuse in children

Also considered psychological or verbal abuse, emotional abuse is persistent non-physical abuse that makes a child believe they are unwanted, unloved, worthless or only valuable in meeting their perpetrator's needs. Words and actions are used to manipulate or control a child causing emotional harm that may result in low self-esteem, hostility, anxiety depression or delinquency

Stalking

An unwanted and/or repeated surveillance by an individual or group toward another person

Community risk factors for child abuse

Communities with: -high rates of violence and crime, -high rates of poverty and limited educational and economic opportunities, -high unemployment rates, -easy access to drugs and alcohol

What was developed by the CDC to help prevent teen dating violence

Dating Matters®: Strategies to Promote Healthy Teen Relationships to stop teen dating violence before it starts. -It focuses on teaching 11-14-year-olds healthy relationships skills and includes sections for kids, parents, schools, and neighborhoods.

Risk factors for AHT

Known risk factors for AHT include male gender, age under 1 year, male caregiver (father, stepfather, or male partner of mother), nonparental caregiver, young or unmarried mother, prenatal care initiated after the first trimester, parents with low socioeconomic status, parent in the military, presence of extended family in the home, and infant crying.

Neglect in children

Neglect is the failure to give children the necessary care they need. It can be as harmful as physical abuse and is more common. It includes failing to provide food, clothing, shelter medical care education or supervision.

Physical abuse in a child

Physical abuse is an injury resulting from physical aggression. Even if the injury was not intended, the act is considered physical abuse The injury from physical child abuse may be the result of beating, slapping, hitting, pushing, shaking, kicking, throwing, pinching, biting, choking, hair-pulling, burning with cigarettes, scalding water, or other hot objects

Sexual abuse in children

Sexual abuse of a child is any sexual act between an adult and a child, including penetration, intercourse, incest, rape, oral sex, and sodomy56. Other examples include fondling - touching or kissing a child's genitals, making a child fondle an adult's genitals

Who is at highest risk for IPV

Women ages 18-24

Passive neglect

a caregiver fails to provide adequate food, shelter, clothing, medical care due to an inadequacy of time, capacity or resources

willful neglect

an individual charged with caring for the older adults does not provide the necessities by conscious choice

definition of child abuse and neglect

at minimum: "Any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation"; or "An act or failure to act which presents an imminent risk of serious harm.

Intimate Partner Violence (IPV)

behavior within an intimate relationship that causes physical, sexual, or psychological harm, including acts of physical aggression, sexual coercion, psychological abuse, and controlling behaviors

over half of all female homicide victims in the U.S are killed by

current or former male intimate partners

Protective factors to reduce risk of perpetrating/experiencing abuse and neglect

emotional intelligence at the individual level and having social support at the relationship level.

sexual violence

includes forcing an intimate partner to participate in a sex act without their explicit consent also any sexual contact between an adult and a partner who is below the age of 18

Physical violence

involved hurting or attempting to hurt someone by punching, kicking, slapping, hitting,biting, pinching, burning, strangling, grabbing, choking, or shoving them

emotional abuse

involved undermining the person's self-worth by criticizing them constantly, gaslighting them, calling them names, isolating from their family and friends, monitoring their activities, and trying to prevent them from working or doing things they enjoy

psychological abuse

involves terrorizing the person, playing mind games with them, or threatening to harm them or their loved ones

number of men and women stalked in their lifetime

women: 19.3 million (1 in 3 women) men: 5.1 million (1 in 6 men)