Chapter 12 Videbeck – Abuse & Violence
Abuse the wrongful use and maltreatment of another person. Usually perpetrated by someone
the victim knows. Found across the lifespan, spouses or partners, children or elderly parents.
Disorders associated with abuse and violence: PTSD, dissociative disorders (ch 13),
Long Term problems assoc. with abuse and trauma are substance abuse and depression.
Violent behavior is a National Health Concern.
Domestic Violence remains undisclosed for months or years because victims fear their abusers.
Suffer in silence and feel guilt & shame. Children believe they are at fault and did something to
provoke the abuse. Survivors feel degraded, humiliated and dehumanized.
Characteristics of abused:
Low self- esteem unlovable unacceptable to others contaminated
Ruined depression suicidal behavior marital and sexual difficulties
Problems with others esp. authority figures
*Nurses – All mental health Patients need to feel safe, secure and in control of their body,
maintain personal space, check anxiety level, ask permission before touching.
Family Violence – encompasses spouse battering, neglect and physical, emotional or sexual
abuse of children: elder abuse and marital rape. Family members tolerate abusive, violent
behavior from relatives that they would never accept from strangers
In VIOLENT FAMILIES the HOME is the most dangerous place for victims
BOX 12.1 CHARACTERISTICS OF VIOLENT FAMILIES
SOCIAL ISOLATION
ABUSE OF POWER AND CONTROL
ALCOHOL AND OTHER DRUG ABUSE
INTERGENERATIONAL TRANSMISSION PROCESS
SOCIAL ISOLATION – keep to themselves, do not invite others into the home. Abusers threaten
with more harm if they reveal the secret. Children keep the secret out of FEAR
ABUSE OF POWER AND CONTROL - Abusive family member holds a position of power and
control over the victim. Abuser is only one who makes decisions, spends money or spends time
outside the home. Abuser belittles and blames victim by threats and emotional manipulation. If
abuser perceives victim independence or disobedience, violence usually escalates.
ALCOHOL AND DRUG ABUSE – Alcoholism associated with family violence. Partners who abuse
alcohol are like to abuse their partners. Alcohol diminishes inhibitions and makes violent
behavior more intense and frequent. Alcohol is factor in acquaintance rape or date rape
, The use of Rohypnol (flunitrazepam) “date rape drugs” used to subdue potential victims.
Women think of safety more than men
Intergenerational Transmission Process – shows patterns of violence are perpetuated from one
generation to the next through role modeling and social learning. Family Violence is a learned
behavior pattern.
CULTURAL CONSIDERATIONS - At Risk immigrant women, face legal, social and economic
problems
Comes from culture that accepts domestic violence
Believe she has less access to legal and social services
If not a US citizen may be forced to leave the country
Isolated by cultural dynamics, ( unable to leave husband) or economically ($$)
Language barriers- interfere with ability to call for help, learn of her rights or legal
options and obtain shelter, financial assistance or food.
***UP TO NURSE to obtain interpreter, assist in contacting Dept of Immigration or referral for
legal council.
INTIMATE PARTNER VIOLENCE - the mistreatment of one person by another in the context of
an emotionally intimate relationship.
PSYCHOLOGICAL ABUSE ( EMOTIONAL ABUSE) – name calling, belittling, screaming, yelling,
destroying property and making threats, refusing to speak or ignoring.
PHYSICAL ABUSE – shoving and pushing to severe battering and choking, may involve broken
limbs, ribs, internal bleeding, brain damage, homicide.
SEXUAL ABUSE – biting nipples, pulling hair, slapping and hitting, & rape
Partner violence during PREGNANCY 15-25% partner is jealous, possessive, insecure of the
lessened physical and emotional availability of the preg woman.
Same sex relationships - same rate as heterosexual
SODOMY – anal intercourse- is a crime in 21 states.
Same sex batterer has additional weapon – threat of exposing partners homosexuality to friends
family employer or community.
CLINICAL PICTURE – Abuser believes partner is his property, becomes increasingly violent and
abusive if there are any signs of independence, this makes abuser have strong feelings of
inadequacy and low self-esteem as well as poor problem solving and social skills. Emotionally
immature, needy, jealous, and possessive. Violent behavior is rewarding and builds self esteem
by bullying and physically punishing the family.
Dependency trait of abused wives that stay with husband, cite personal & financial dependency,
unable to function without husband. “ make-it-work” some believe they are to blame. Or Fear
abuser will kill them if they try to leave...75% chance