Kk&s Ch.32 Problems Related To Abuse Or Neglect

Front 1

Most common forms of child abuse?

Back 1

neglect, 62 percent; physical abuse, 18 percent; sexual abuse, 10 percent; and emotional abuse, 7 percent

Front 2

Approximately 81 percent of these deaths (2004 Children's Bureau) were children younger than ? years of age

Back 2

4

Front 3

Sexual abuse rate: > in boys or girls?

Back 3

girls

Front 4

perpetrators of abuse: > women or men?

Back 4

women

Front 5

Age group with highest victimization?

Back 5

0 to 3

Front 6

List etiological factors related to child abuse

Back 6

Parental factors: hx of abuse, axis I esp desp, psychosis, PD
Social: low SES, isolation
Child factors: MR, disabled, "difficult", adhd

Front 7

A child who is the object of physical abuse is also known as a ?

Back 7

battered child.

Front 8

The perpetrator of physical abuse is more often the ? than the ?
which parent?

Back 8

The perpetrator of physical abuse is more often the mother than the father

Front 9

The average age of a mother who abuses her children is reportedly about ? years; the father's average age is ? years

Back 9

26
30

Front 10

Abusive parents have inappropriate expectations of their children, with a reversal of dependence needs. Parents treat an abused child as if the child were older than the parents. A parent often turns to the child for reassurance, nurturing, comfort, and protection and expects a loving response. Of such parents, ? percent were severely physically abused by their own mothers or fathers

Back 10

90

Front 11

(gender) usually perpetrate sexual abuse

Back 11

men

Front 12

Men are the perpetrators in about ? percent of cases of sexual abuse of girls and about ? percent of cases of sexual abuse of boys

Back 12

95

80%

Front 13

Physical aggression can cause multiple and ? fractures, especially in a young baby; ? in an infant may result from shaking.

Back 13

spiral
retinal hemorrhages

Front 14

In this abuse scenario, a parent repeatedly inflicts illness on, or causes injury to, a child—by injecting toxins or by inducing the child to ingest drugs or toxins to cause diarrhea, dehydration, or other symptoms—and then eagerly seeks medical attention.

Back 14

Munchausen syndrome by proxy, that is, factitious disorder

Front 15

Most often, (there is or there is no) definitive physical evidence can prove the occurrence of sexual abuse

Back 15

no

Front 16

Physical indicators of sexual abuse include

Back 16

bruises, pain, and itching in the genital region. Genital or rectal bleeding may be a sign of sexual molestation. Recurrent urinary tract infections and vaginal discharges may be related to abuse. Sexually transmitted diseases and difficulty walking and sitting raise suspicions of sexual abuse.

Front 17

When a child begins to disclose information about sexual assaults, retractions and contradictions are:
atypical, typical

Back 17

typical

Front 18

An estimated ?percent of allegations of sexual abuse are false

Back 18

2 to 8

Front 19

Children under the age of ? years are unlikely to produce a verbal memory of past trauma or abuses, but their experience may be reflected in play or fantasies

Back 19

3

Front 20

Sexual abuse and disorders associated?

Back 20

MDD
Impulse control ds
PTSD
DID
BordPD
Subs Abuse

Front 21

? incest is the strongest and most nearly universal taboo and is the rarest form of incest

Back 21

Mother–son

Front 22

Incestuous behavior has been associated with

Back 22

alcohol abuse,
overcrowding,
increased physical proximity, and
rural isolation that prevents adequate extrafamilial contacts

Some communities are more tolerant of incestuous behavior than is the whole of society. Major mental disorders and intellectual deficiencies can contribute to clinical incest.

Front 23

About ? percent of reported cases involve father–daughter incest, but parents often deny the occurrence of sibling incest.

Back 23

75%

Front 24

a history of failure to thrive, malnutrition, poor skin hygiene, irritability, withdrawal
consider?

Back 24

neglect

Front 25

Children who have been ? may show overt failure to thrive at less than 1 year of age. Their physical and emotional development is drastically impaired; they may be physically small and unable to display appropriate social interaction. Hunger, chronic infections, poor hygiene, inappropriate dress, and eventual malnutrition may all be evident. Behaviorally, children who are chronically ? can be indiscriminately affectionate, even with strangers, or socially unresponsive, even in familiar situations.

Back 25

neglect (ed)

Front 26

An extreme form of failure to thrive in children 5 years or older is ?, in which a chronically deprived child does not grow and develop, even when offered adequate amounts of food. Such children have normal proportions, but are exceedingly small for their age.

Back 26

psychosocial dwarfism

Front 27

psychosocial dwarfism and growth hormone?

Back 27

decreased growth hormone

Front 28

Children with this disorder exhibit bizarre eating behaviors and disturbed social relationships. Binge eating, ingestion of garbage or inedible substances, drinking of toilet water, and induced vomiting have been reported

Back 28

psychosocial dwarfism

Front 29

Parents who neglect their children are often ?

Back 29

overwhelmed, depressed, isolated, and impoverished.

Front 30

In cases of failure to thrive, ? screening is indicated

Back 30

endocrinological

Front 31

Xray findings suggesting of phsyical abuse?

Back 31

Metaphyseal fragmentation is caused by twisting or pulling of the afflicted extremity. Squaring of the long bones secondary to the new bone formation may be seen on the metaphyseal fragments.

Periosteal hemorrhages are frequently noted because the periosteum of infants is not securely attached to the underlying bone. Periosteal calcification follows this hemorrhaging and begins to become apparent 5 to 7 days after the inflicted trauma. A layer of calcification around the shaft of the bone should cause suspicion of inflicted abuse.

Epiphyseal separations and periosteal shearing usually result from traction and torsion of the affected extremity.

Front 32

Tx of child abuse

Back 32

1. ensure safety (call child protection/police)
2. comprehensive assessment
parenting assessment

Front 33

How improve parental fxning?

Back 33

1) eliminate or diminish the social or environmental stresses;
(2) lessen the adverse psychological effects of social factors on the parents; (
3) reduce the demands on the mother to a level within her capacity through day care placement of the child or provision of a housekeeper or baby-sitter;
(4) provide emotional support, encouragement, sympathy, stimulation, instruction in maternal care, and aid in learning to plan for, assess, and meet the needs of the infant (supportive casework); and
(5) resolve or diminish the parents' inner psychic conflicts (psychotherapy). Some clinics provide group counseling for nonoffending parents.

Front 34

Tx of incest

Back 34

The first step in the treatment of incestuous behavior is its disclosure. Once a breakthrough of family members' denial, collusion, and fear has been achieved, incest is unlikely to recur. When the participants have severe psychopathology, treatment must be directed toward the underlying illness. Family therapy is useful to reestablish the group as a functioning unit and to develop healthier role definitions for each member. While the participants are learning to develop internal restraints and appropriate ways to gratify their needs, the external control provided by therapy helps prevent further incestuous behavior. At times, legal agencies must help enforce external controls.

Front 35

Tx of suspect child abuse and neglect

Back 35

In cases of suspected child abuse and neglect, physicians should diagnose the suspected maltreatment; secure the child's safety by admitting the child to a hospital or arranging out-of-home placement; report the case to the appropriate social service department, child protection unit, or central registry; make an assessment with the help of a history, a physical examination, a skeletal survey, and photographs; request a social worker's report and appropriate surgical and medical consultations; confer with members of a child abuse committee within 72 hours; arrange a program of care for the child and the parents; and arrange for social service follow-up.

Front 36

busive men are likely to have come from violent homes where they witnessed wife beating or were abused themselves as children. The act itself is reinforcing; once a man has beaten his wife, he is likely to do so again. Abusive husbands tend to be?

Back 36

immature,
dependent, and
nonassertive and to suffer from strong feelings of
inadequacy.

The husbands' aggression is bullying behavior designed to humiliate their wives and to build up their own low self-esteem.

Front 37

Dynamics of spousal abuse?

Back 37

The dynamics include identification with an aggressor (father, boss),
testing behavior (Will she stay with me, no matter how I treat her?),

distorted desires to express manhood, and
dehumanization of women.

Front 38

About ? percent of battered wives grew up in violent homes, and their most common trait is ?

Back 38

50%
dependence

Front 39

The Surgeon General's office has identified ? as a high-risk period for battering

Back 39

pregnancy

Front 40

Women face risks when they leave an abusive husband; they have a ? percent greater chance of being killed by their batterers than women who stay.

Back 40

75%

Front 41

Rape is the forceful coercion of an unwilling victim to engage in a sexual act, usually sexual intercourse, although anal intercourse and fellatio can also be acts of rape. Using this definition, one survey found that one of ? women and 1 of ? men have experienced an attempted or completed rape as a child or as an adult in the United States.

Back 41

6

33

Front 42

The male rapist can be categorized into separate groups:

Back 42

1)sexual sadists, who are aroused by the pain of their victims;
2) exploitive predators, who use their victims as objects for their gratification in an impulsive way;
3)inadequate men, who believe that no woman would voluntarily sleep with them and who are obsessed with fantasies about sex; and
4) men for whom rape is a displaced expression of anger and rage

Front 43

An estimated? of ten rapes are reported

Back 43

four to five
highly underreported
(about half)

Front 44

highest age risk for rape?

Back 44

women ages 16 to 24 are at highest risk

Front 45

Most rapes are planned or spontaneous?

Back 45

premeditated

Front 46

Most rape by known or unknown person

Back 46

about half are committed by strangers and half by men known, to varying degrees, by the victims.

Front 47

In one study, ? percent of male students said that they would commit rape if they thought they could get away with it, and ? percent stated that they had committed rape

Back 47

In one study, 38 percent of male students said that they would commit rape if they thought they could get away with it, and 11 percent stated that they had committed rape

Front 48

Homosexual rape is much more frequent among (sex) than among (sex)

Back 48

men >women

Front 49

Most stalkers are ? (sex)

Back 49

men

Front 50

Are women or men more likely to violently attack their stalking victims?

Back 50

women who stalk are just as likely as men to attack their victims violently.

Front 51

Sexual harassment refers to sexual advances, requests for sexual favors, or verbal or physical conduct of a sexual nature—all of which are unwelcomed by the victim. In more than ? percent of cases the perpetrator is a man and the victim, a woman

Back 51

95%