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Behavioral Med

Domestic Abuse and Suicide

Describe teh scope of domestic violence in our society 2 to 12 million families; mostly wife abuse
risk facors for domestic violence most common with substance abuse, especially alcohol and crack; occurs in all racial, religoious and socioeconomic groups
Explain the cycle of violence (3) tension building phase; violent phase; honeymoon phase
explain teh barriers to women getting out of DV situations psychological variables: past history of abuse, low self-esteem, to "save" the disturbed man; finances, shelter, children, fear, threats of retaliation, isolation, lack of family and social support, embarrassment, shame, stigma, lack of faith in system
Physician responses to DV situations openings; asking hard questions; non-judgmental; safety planning; know that it takes time; no mandate to report it
3 kinds of domestic abuse spousal abuse, elder abuse, child abuse
Munchausen's Syndrome mother constantly takes child for medical treatment; sometimes by making the children sick or making them look sick; mother is gratified by the clinic visit and attention
What are forms of Child sexual abuse intercourse, inappropriate touch, forcing teh child to watch pornography, takin gponron pictures, sexually explicit conversations, adult having animals lick children
What is child-child sexual experimentation that needs intervention? oral activity; one much older than the other, if one is mentally challenged, forceful behavior
How do children disclose abuse? in stages similar to death/dying stages; begin tentitavely at first, and reveal once they feel comfortable; many recant their stories after revealing abuse
risk factors for child abuse parents who were abused or were overly punished; premature children; MR; physically disabled; excessive criers; "difficult child" ADHD; views as different, slow, bad, selfish or hard to discipline
ARe most child abuse cases reported? no
what happens to most reported child abuse cases? unsubstantiated adn dropped
What sex are most child abuse victims? women
Who are usually the perpertrators of child abuse? fathers
What are the parent risk factors for child abuse? PHYSICAL ABUSE: more often mother than fathers; one parent isusually the active batterer and the other passively accepts the situation; poor, socially isolated; regularly living in the home; inappropriate expectations of their children
what is most common form of incest? father-daughter
what are teh behavioral indicator of child sexual abuse detailed knowledge of sexual acts, sexualized play, sexual acts with peers
what do you do if child abuse is suspected REPORT IT
How should you interview if you suspect abuse? careful adn not ask overly in-depth questions; are you hurting anywhere in your private places today?
When sexual abuse is suspected... how sensitive is physical exam? only 10%!!!! 90% of sexual abuse exam should be history!
Does HIPAA apply with child abuse? NO
How do you analyze veracity of child's presentation? speaks in a manner consistent; does not sound rehearsed; does not use adult-like phrasing; emotional distress, relucance to reveal; precocious sexual behavioral and knowledge
What makes up the Multi-disciplinary Investigative Team? Police, Prosecuting attorney; child advocacy center; CPS;special advocates; medical professionals
Age of censent in WV 16 but must be 4 years age difference or less
common examples of injuries seen in child abuse bruises or marks that are symmetrical; injury to both sides of face, back or buttocks; bruise with shape of the instrument used; cigarette burns; multiple fractures
what kind of fractures in infants are most often from abuse? fractures in non-ambulatory infoants
what is the second most common cuase of child abuse fatality? abdominal injuries
what is the cause of most failure to thrive cases? psychosocial causes (often from neglect)
imperturbability ability to maintain extreme calm and steadiness
equanimity ability to handle stressful situations with an undisturbed, even temper
birth to 4 weeks hand to mouth; grasping reflex; visual tracking
4 weeks tonic neck reflex positions predominate; follows moving objects to the midline. visual fixation
16 weeks follows a slowly moving object well; spontaneous social smile
28 weeks one hand approach and grasp of toy; takes foot to mouth; starts to imitate mothers sounds
40 weeks separation anxiety manifest when taken from mother; feeds self cracker and holds own bottle
52 weeks walks with one hand held; stnds alone briefly
15 months toddles; creeps up stairs; points or vocalizes wants
18 months coordinated walking; seldom falls; walks up stairs with one hand held
2 years runs well; no falling; goes up and down stairs alone
3 years rides tricycle; unbuttons buttons; feeds self well; understands taking turns
4 years washes and dries own face; burshes teeth; associative or joint play
5 years counts 10 objects; dresses and undresses self; plays competitive exercise games
6 years rides two-wheel bike; prints name; ties shoelaces
ADHD usually have other misbehaving kind of problems... maybe acting out to get under your skin
what is the order between median, mode and mean? mean, median, mode
what is the mode on a chart? top of teh "hill"; value tha tis most representing in the population
Created by: tjamrose