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Physical Abuse

Definition

Physical abuse is forceful behavior that can result in injury to another person. An abuser uses beatings to control the victim. The abuse rarely occurs just one time.

Risks

What are the causes and risks of the injury?

While there is no specific type of person who is at risk for abuse, certain factors do put some people at greater risk. These risk factors include:
  • being a drug or alcohol abuser or having a partner who is one
  • being a female, especially between the ages of 17 and 34
  • being in the first 5 years of a new marriage or a live-in relationship
  • being in a marriage or relationship in which one person dominates the other
  • being pregnant
  • being socially and emotionally isolated
  • being unemployed
  • living in poverty, living in poor housing conditions, moving often
  • being homeless
Experts know that adolescents who have been abused are at higher risk for other health problems. However, we do not yet know whether the health problems came before the abuse, or if the abuse increased the risk for the health problem. These problems include the following:
  • adolescent pregnancy
  • alcohol use, including binge drinking
  • cocaine abuse
  • risky sexual behaviors, including intercourse before age 15 and multiple partners
  • smoking
  • suicidal attempts or thoughts
  • unhealthy weight management, including eating disorders
  • cohabitation

Prevention

What can be done to prevent the injury?

Education about what physical abuse is and how it can be identified and stopped needs to be increased. Developing trust within organizations and communities is important so that people feel comfortable talking about abuse or potential abuse. Prevention also means taking an active role in promoting social change and making efforts to influence legislative reforms.
The best way to prevent abuse is to teach people how to solve problems without using violence. Teenagers and young adults should be taught that it is never permissible to abuse a partner.
Parents, youth leaders, and education, pastoral or healthcare professionals should provide teens with specific information about dating violence and its associated behaviors. They should be encouraged to discuss any issues or concerns with a parent or other appropriate adult.
Since unhealthy behaviors such as cocaine use are associated with a higher risk for physical abuse, healthcare professionals should address dating violence when treating people with these health issues. Careful screening can help identify at-risk individuals and provide the opportunity to stop the abuse cycle.
Resources are available to abuse victims within their communities. Books and articles about child abuse are readily available. Supporting and promoting training and education on recognizing and addressing physical abuse are other preventive measures.
Friends, neighbors, family members, clergy and healthcare professionals need to ask directly about signs of possible abuse. For instance, if a person has unexplained bruising, ask him or her how it happened. The person may not be willing to describe how it happened, but his or her reaction may provide more information about the situation.
Asking the right questions can sometimes make the victim feel less isolated. Showing concern lets the victim know that there is someone to turn to if he or she needs help.

Diagnosed

How is the injury recognized?

Diagnosis of physical abuse begins with a medical history and physical exam. The healthcare professional may order tests to diagnose specific injuries, such as a bone fracture.

Treatments

What are the treatments for the injury?

First, the victim's physical injuries must be treated by a healthcare professional. Bone fractures may need to be repaired. If there are internal injuries, surgery may be needed.
At the same time, the victim needs to be separated from the abuser. He or she may have to stay with a friend or relative or move to a shelter. Sometimes children need to be placed in foster care.
The ultimate goal in treating a victim of physical abuse is to get the person to reestablish his or her life without the abuser. For many reasons, the victim may not be able or ready to leave the abuser.
Providing the victim with information about ways to get help in the future is very important. If he or she has a plan in place for leaving the abuser, he or she is more likely to be able to get away safely when the next incident occurs.

Side Effects

What are the side effects of the treatments?

Side effects depend on the treatment used. Surgery to repair internal injuries, for example, may be complicated by bleeding, infection, or an allergic reaction to the anesthetic.

After Treatment

What happens after treatment for the injury?

Victims of physical abuse will need counseling to deal with a number of issues, including regaining self-esteem. Support groups can be helpful in this healing process. Long-term effects can include posttraumatic stress disorder.
Long-term effects can include posttraumatic stress disorder. The victim may have the following conditions:
  • anxiety disorders
  • depression
  • feelings of isolation
  • irritability
  • nightmares and flashbacks
  • a tendency to avoid other people
Even if the victim does not suffer from posttraumatic stress disorder, he or she may have other long-term effects, such as:
  • living in poverty
  • poor self-esteem
  • trouble staying in school or keeping a job
Studies show that half of men who abuse their partners also abuse their children. Abused mothers often have trouble holding jobs and are more likely to need welfare benefits. This means that children from abusive homes are at a greater risk of being poor and homeless.

Sources

Journal of Accident and Emergency Medicine 2000;17:138-139

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