Master the board step 3

Psychiatry
Psychosocial Problems
Types of Abuse
Class
Child Abuse
Adult Maltreatment/
Elder Abuse
Spousal Abuse
Definition of
abuse
• Physical is the most common
(look for bruises, burns,
lacerations, broken bones,
shaken baby syndrome—do
eye exam)
• Neglect
• Sexual exploitation (STDs)
• Mental cruelty
• Neglect is the most
common (50% of all
reported cases)
• Physical
• Psychological
• Financial
• Physical is the most
common—it is the
number one cause of
injury to American
women
• Psychological
• Financial
Physician’s role
in care
1. Mandatory reporting up to
age 18. You must report all
suspected cases.
2. Protect the child (separate from
parents) and consider admission
to hospital.
1. You must report all
suspected cases.
2. Protect patient from
abuser and consider
admission to hospital.
1. Reporting is not
indicated.
2. Provide information
about local shelters and
counseling.
Those at risk
• Younger than 1 year
• Stepchildren
• Premature children
• Very active children
• “Defective” children
• Caretaker is the most
likely source of abuse;
spouses are often
caretakers
• More frequent in families
with drug abuse,
especially alcoholism
• Victim often grew up in
a violent home (about
50%)
• Married at a young age
• Dependent personalities
• Pregnant, last trimester
(highest risk)
Exam points
• Be careful not to mistake benign
cultural practices, such as
“coining” or “moxibustion,” for
child abuse.
• Treat female circumcision as
abuse.
• Mandatory reporting
to Adult Protective
Services
519