Clinical Picture of Abuse and Violence

Abuse and violence can occur in different forms and contexts. Some of the common types of abuse and violence are:

Child abuse: any act or failure to act by a parent or caregiver that results in death, serious physical or emotional harm, sexual abuse, or exploitation of a child under 18 years of age. Child abuse can be physical, sexual, emotional, or neglectful.

Elder abuse: any act or failure to act by a person in a relationship of trust that results in harm or distress to an older person. Elder abuse can be physical, sexual, emotional, financial, or neglectful.

Intimate partner violence (IPV): any physical, sexual, psychological, or economic harm or threat of harm by a current or former partner or spouse. IPV can be physical, sexual, emotional, stalking, or coercive control.

Sexual assault: any unwanted sexual contact or activity without consent or under coercion. Sexual assault can include rape, attempted rape, fondling, groping, oral sex, anal sex, penetration with objects, or exposure to pornography.

Community violence: any intentional act of interpersonal violence that occurs in public or private spaces between individuals who are not related or intimate partners. Community violence can include homicide, assault, robbery, kidnapping, terrorism, hate crimes, gang violence, school violence, workplace violence, or mass shootings.

The causes of abuse and violence are complex and multifactorial. Some of the factors that contribute to abuse and violence are:

• Individual factors: such as age, gender, race/ethnicity, personality traits, mental health status, substance use disorder, history of trauma or abuse, low self-esteem, poor impulse control, anger issues, cognitive impairment, disability.

• Relationship factors: such as family dynamics, marital conflict, power imbalance, poor communication skills, lack of trust or respect, isolation from social support networks.

• Community factors: such as poverty, unemployment, homelessness, crime rates, lack of access to education or health care services or legal protection or social welfare programs or resources for victims/survivors.

• Societal factors: such as cultural norms or values or beliefs or attitudes that condone or justify or tolerate or minimize or deny abuse or violence or discrimination or oppression based on gender or sexuality or race/ethnicity or religion or age or disability.

• The effects of abuse and violence can be devastating and lasting for the victims/survivors, perpetrators, witnesses, and bystanders. Some of the effects of abuse and violence are:

  • Physical effects: such as injuries, bruises, cuts, burns, fractures, internal bleeding, organ damage, sexually transmitted infections (STIs), unwanted pregnancy, chronic pain, headaches, gastrointestinal problems, cardiovascular problems, respiratory problems, immune system dysfunction.

  • Psychological effects: such as post-traumatic stress disorder (PTSD), acute stress disorder (ASD), adjustment disorder (AD), depression, anxiety, panic disorder, phobias, obsessive-compulsive disorder (OCD), dissociative disorders, personality disorders, eating disorders, sleep disorders, substance use disorder, suicidal ideation or behavior.

  • Emotional effects: such as fear, anger, guilt, shame, sadness, grief, loneliness, hopelessness, helplessness, low self-esteem, low self-confidence, low self-worth, distrust, resentment, bitterness.

• Social effects: such as isolation, withdrawal, avoidance, detachment, alienation, rejection, stigma, discrimination, bullying, harassment, violence, abuse, exploitation, homelessness, unemployment, poverty.

• Spiritual effects: such as loss of faith, meaning, purpose, values, morals, ethics, hope.