domestic abuse


abuse

 [ah-būs´] misuse, maltreatment, or excessive use.child abuse see child abuse.domestic abuse abuse of a person by another person with whom the victim is living, has lived, or with whom a significant relationship exists. The abuse may take the form of verbal abuse, sexual abuse, physical battering, or psychological (emotional) unavailability. Abuse is a learned behavior and has an escalating cycle; abusive behavior cuts across all racial, ethnic, educational, and socioeconomic boundaries.drug abuse see drug abuse.elder abuse maltreatment of an older adult, ranging from passive neglect of needs to overt mental, physical, or sexual assault.physical abuse any act resulting in a nonaccidental physical injury, including not only intentional assault but also the results of unreasonable punishment.psychoactive substance abuse substance abuse.sexual abuse any act of a sexual nature performed in a criminal manner, as with a child or with a nonconsenting adult, including rape, incest, oral copulation, and penetration of genital or anal opening with a foreign object. The term also includes lewd or lascivious acts with a child; any sexual act that could be expected to trouble or offend another person when done by someone motivated by sexual interest; acts related to sexual exploitation, such as those related to pornography, prostitution involving minors, or coercion of minors to perform obscene acts.substance abuse a substance use disorder characterized by the use of a mood or behavior-altering substance in a maladaptive pattern resulting in significant impairment or distress, such as failure to fulfill social or occupational obligations or recurrent use in situations in which it is physically dangerous to do so or which end in legal problems, but without fulfilling the criteria for dependence" >substance dependence. Specific disorders are named for their etiology, such as alcohol abuse and anabolic steroid abuse. DSM-IV includes specific abuse disorders for alcohol, amphetamines or similar substances, cannabis, cocaine, hallucinogens, inhalants, opioids, PCP or similar substances, and sedatives, hypnotics, or anxiolytics. See also drug abuse.

domestic abuse

Abuse of people in a domestic setting. Such abuse includes physical violence (such as striking or raping a family member), passive abuse (such as withholding access to health care), psychological or emotional abuse (such as intimidation, or threatening physical harm or abandonment), and economic abuse by imposing financial dependency. Domestic abuse is common: more than two million Americans are abused or assaulted each year.

Patient care

Domestic violence should be considered in any patient who presents with unexplained bruises, lacerations, burns, fractures, or multiple injuries in various stages of healing, esp. in areas normally covered by clothing; delays seeking treatment for an injury; has a partner who is reluctant to leave the patient alone or is uncooperative or domineering; indicates that he or she has a psychiatric history or drug or alcohol problems; presents with injuries inconsistent with the “accident” reported; expresses fear about returning home or for the safety of children in the home; or talks about harming himself or herself. Professional health care providers should screen such patients privately to ensure confidentiality and patient safety. “Do you feel safe at home?” may elicit a history of abuse. A sympathetic and nonjudgmental manner helps victims communicate. Scrupulous documentation of evidence of abuse is critical. Reporting is mandatory in many states.

See also: abuse