Abuse, grief and suicide

Child Abuse

The physical, sexual or emotional maltreatment or neglect of a child or children
Classification:
- Neglect
- Physical Abuse
- Psychological or Emotional Abuse
- Sexual Abuse: Several studies have shown that in North America Studies that as many as 25% of women and 12% of men have experienced sexual abuse as a child!!! Here is a link to one of papers.
Prevention is of highest priority
Cultural practices
- Child labor
- Child trafficking
- Female genital mutilation
- Child marriage

Shaken baby syndrome
Impaired brain development
Unexplained injuries
Abused children may show signs of: anxiety, PTSD, depression, failure to thrive, substance abuse, suicidal tendencies, paranoia etc.

Abuse of people who are older, frail, and vulnerable and cannot help themselves and depend on others to meet their most basic needs
Approximately four percent of elders experience moderate to severe abuse each year
Types of Elder Abuse
- Physical Abuse
  - Inflicting physical pain or injury on a senior
  - Slapping, bruising, or restraining by physical or chemical means
- Sexual Abuse
- Neglect
- Financial or Material Exploitation
- Emotional Abuse
- Abandonment

A pattern of behavior which involves violence or other abuse by one person against another in a domestic context, such as in marriage or cohabitation.
Link to a study on Intimate partner violence and the rates of violence perpetrated by gender.
Forms:
- Physical
- Emotional
- Verbal
- Economic
- Sexual abuse

Complete physical and medical assessment
- Episodes of physical assault characterize abusive relationships
Domestic Violence Screening Test
- used primarily in doctors offices and asks respondents how often their partner physically Hurt, Insulted, Threatened with harm, and Screamed at them
Neuroimaging studies –
- X-ray
- MRI Scan
- CT Scan

Natural response to loss
Types of Grief Reactions:
- Anticipatory grief
  - occurs in anticipation of an impending loss
- Common grief
  - Marked by a gradual movement toward an acceptance of the loss and managing to continue basic daily activities
Grieving Process
- Shock and Denial
  - Initial reaction to loss
  - Normally lasts two or three months
- Intense Concern
  - Manifests by being unable to think of anything else
  - May last from six months to a year
- Despair and Depression
  - The long period of grief
  - Involves a wide range of feelings, thoughts, and behaviors
- Recovery
  - Shows a new interest in daily activities and begins to function normally day to day

Physical Symptoms:
- Shortness of breath
- Palpitations
- Severe headache and dizziness
- Chest heaviness
- Stomach discomfort
- Numbness
- Easy fatigability
- Frequent sighing
- Weight loss / loss of appetite
- Sense of emptiness and heaviness
- Loss of sexual desire or hyper-sexuality
- Sleep problems
Behavioural Changes:
- Restlessness, inability to sit still
- Usually absentminded and forgets easily
- Inability to intake and maintain organization
- Isolation and withdrawal from society
- Inability to concentrate
- Performing too many activities to keep from thinking
Psychological Symptoms:
- Preoccupation with thoughts of the deceased
- Auditory or visual hallucinations

Counselling
- For those with normal grief reactions and help them work through the tasks of grieving
Grief therapy
- Used with people who have more serious grief reactions

Phases of Suicide
- Severe disappointment
  - Where standards were set and the circumstances fall far below from expectations
- Self-blame
  - Blaming one’s self for all of the disappointment in life.
  - “Demonize” self
- Self-absorption
  - Becoming obsessed with one’s own inability to measure up to the standards set up
  - Inward turn, shutting off from the world
- Depression and anxiety
  - “negative affect,”
- Cognitive deconstruction
  - Involves an “escape from meaningful thought,”
  - Thinking about the big questions going into an “emotional death”
- Disinhibition
  - Leaping over the last psychological hurdles that stand between the person and suicide
Prevalence: 40,000 Americans every year
Many who attempt suicide never seek professional care
Over half of all suicides are completed with a firearm
Risk Factors
- Mental disorder
- Substance abuse
- Problem gambling
- Medical conditions triggering depression
Male > Female

Emergency Treatment
Psychotherapy
Medications
- Antidepressants
- Antipsychotic medications
- Anti-anxiety medications
Addiction treatment

Keep a studying Journal.

Record daily progress. This helps you to look back and see what you have accomplished. The journal becomes a tool to keep test anxiety at bay.
Mark down where you left off and where you should pick up at th next study session. This saves valuable time when you first sit down to get started the next time you study.

What % of woman in North America will have experienced sexual abuse by adulthood.
- 25%
Define hyphema
- Blood in the anterior chamber of the eye.
A patient who has lost her husband 6 months ago believes she can hear his voice in the their home. Is this normal?
- Yes, auditory hallucinations can be a normal part of the grieving period.