3 minute read
Diagnosing Domestic Violence and Intimate Partner Violence
Tamra Werner, MM
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Discussing Domestic Violence (DV) and Intimate Partner Violence (IPV) is not an easy conversation to have with your patients, but it is an important one. Nearly 20 people per minute are physically abused by an intimate partner in the United States. During one year, this equates to more than 10 million women and men. Properly trained healthcare professionals can guide patients to vital domestic violence resources and uncover emotional and physical health-related symptoms.
Intimate partner violence is a pattern of purposeful coercive behaviors that may include physical injury, psychological abuse, sexual assault, progressive social isolation, stalking, deprivation, intimidation, and threats. The goal of the perpetrator is to gain control of their partner. One in three people experience some form of IPV in their lifetime. Women report more sexual abuse, violence, stalking and severe violence than men. One in four women, one in ten men, and one in two people in the LGBTQ+ community report ongoing psychological and physiological symptoms from the abuse or violence they experience.
Screening for DV/IPV can be performed during the patient’s appointment or through questionnaires. Asking patients vital questions gives healthcare professionals insight into their physical and emotional needs and possible causes of healthrelated issues. The Woman Abuse Screening Tool (WAST) allows patients to self-report through a series of probing questions.
Questions can include:
• In general, how would you describe your relationship? No tension, some tension, a lot of tension? • How do you and your partner work out arguments? With no difficulty, some difficulty, or great difficulty? • Do arguments ever result in you feeling down or bad about yourself? • Do arguments ever result in hitting, kicking, or pushing? • Do you ever feel frightened about what your partner says or does? • Does your partner ever abuse you physically? • Does your partner ever abuse you emotionally? • Does your partner ever abuse you sexually?
When a patient discloses DV/IPV abuse, clinicians should not doubt their stories; instead, they should validate their disclosure and feelings. Patients need to know they are not alone and there are resources available to help them. The National Domestic Violence Hotline: 800.799.SAFE (7233) is a 24/7 service for survivors to receive advice for a safety plan and directing them to resources in their area.
Trauma and stress can manifest in the body that leads to a host of ailments. Clinical examination considering the patient’s input may unveil the origin of the patient’s symptoms allowing clinicians accurate diagnosis and appropriate treatment. DV/IPV can affect patients in the following areas:
Social/Emotional
• Low self-esteem • Self-harm or thoughts of suicide or homicide • Feelings of guilt or shame • Depressed mood or anxiety • Makes critical or self-deprecating comments • Partner manages patient’s time and money • Patient is isolated from social network support
Gynecological
• Delay in diagnosing gynecologic malignancy • Dyspareunia • Elective abortion • Pelvic pain • Sexually transmitted infections • Unintended pregnancy • Unsafe sexual behaviors
Reproductive
• Fetal injury
• Fetal loss • Low birth weight in infants • Preterm birth
Pulmonary
• Asthma
Neurologic
• Chronic migraines
Psychiatric
• Anxiety • Depression • Low self-esteem • Phobias • Posttraumatic stress disorder • Sleep disturbance • Substance abuse • Suicide
Endocrine Issues
• Chronic abdominal pain • Gastrointestinal effects • Irritable bowel syndrome • Type 2 diabetes mellitus
Musculoskeletal
• Chronic pain • Fibromyalgia
Professionals and survivors can seek counseling and educational support from RESOLVE of Greater Rochester, Inc. RESOLVE provides therapists, organizations, and other professionals the resources and tools to help domestic and intimate partner violence survivors overcome physical, emotional, psychological, and financial hurdles. RESOLVE’s Survivor Transition Program (STP) facilitates survivors to chart their course forward. More than crisis intervention, RESOLVE promotes healing and encourages each survivor to reclaim their wholeness then step forward as an empowered version of themselves to thrive in new life.
If you would like to learn more about RESOLVE’s services or schedule a training session, please visit our website at https://resolve-roc.org/ or call 585-425-1580.
Tamra Werner serves on the Board of Directors for RESOLVE. She works at Rochester Institute of Technology as the Associate Director of Planned Giving and has published two children’s books. Ms. Werner earned her Micro Masters in Design Thinking and will graduate in May with her MS in Higher Education and Communication Leadership.
