Abuse: Physical And Sexual

Introduction

• Description: Abuse is a pattern of physical or emotional trauma that occurs in a continuing relationship (see Chapter 35 , Domestic Violence [Intimate Partner Violence]). Although the definition of abuse requires only one episode of abuse, a pattern of escalating violence is more typical. (In at least one-fourth of cases, there have been three or more episodes of violence in the 6 months preceding the report of abuse.) In the United States, women are at a greater risk of injury or death at the hands of a domestic partner than from an unrelated attacker. Sexual abuse is a specific form of physical abuse that is related to trauma of a sexual nature or a pattern of coercive sexual activities. Sexual abuse includes but is not limited to, disrobing, exposure, photography or posing, oral–genital contact, insertion of foreign bodies, and vaginal or rectal intercourse.

• Prevalence: More than 1.5 million cases of domestic violence annually occur. It is estimated that between 5% and 25% of women who are treated for injuries in emergency rooms receive these injuries as a result of domestic violence. Of adults, 20%–40% report abuse or sexual victimization before the age of 18 years and 10%–25% of wives report one or more episodes of sexual abuse. Over 43 million women have experienced psychologic aggression by an intimate partner in their lifetime.

• Predominant Age: Any, most common teens to 30s.

• Genetics: Women are the primary victims of domestic violence, accounting for almost 95% of incidents.

Etiology And Pathogenesis

• Causes: Multiple factors. Alcohol or drugs are often involved, although they are not causative factors.

• Risk Factors: Such abuse occurs at a slightly higher rate among those of lower educational or socioeconomic status.

Signs And Symptoms