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Abuse Health Article

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Definition

Abuse is defined as any thing that is harmful, injurious, or offensive. Abuse also includes excessive and wrongful misuse of anything. There are several major types of abuse: physical and sexual abuse of a child or an adult, substance abuse, elderly abuse, and emotional abuse.

Description

Physical abuse of a child is the infliction of injury by an other person. The injuries can include punching, kicking, biting, burning, beating, or pulling the victim's hair. The physical abuse inflicted on a child can result in bruises, burns, poisoning, broken bones, and internal hemorrhages. Physical assault against an adult primarily occurs with women, usually in the form of domestic violence. It is estimated that approximately three million children witness domestic violence every year.

Sexual abuse of a child refers to sexual behavior between an adult and child or between two children, one of whom is dominant or significantly older. The sexual behaviors can include touching breasts, genitals, and buttocks; either dressed or undressed. The behavior can also include exhibitionism, cunnilingus, fellatio, or penetration of the vagina or anus with sexual organs or objects.

Pornographic photography is also used in sexual abuse with children. Reported sex offenders are 97% male. Females are more often perpetrators in child-care settings, since children may confuse sexual abuse by a female with normal hygiene care. Sexual abuse by stepfathers is five times more common than with biological fathers. Sexual abuse of daughters by stepfathers or fathers is the most common form of incest.

Sexual abuse can also take the form of rape. The legal definition of rape includes only slight penile penetration in the victim's outer vulva area. Complete erection and ejaculation are not necessary. Rape is the perpetration of an act of sexual intercourse whether:

  • will is overcome by force or fear (from threats or by use of drugs).
  • mental impairment renders the victim incapable of rational judgment.
  • if the victim is below the legal age established for consent.

Substance abuse is an abnormal pattern of substance usage leading to significant distress or impairment. The criteria include one or more of the following occurring within a 12-month period:

  • recurrent substance use resulting in failure to fulfill obligations at home, work, or school.
  • using substance in situations that are physically dangerous (i.e., while driving).
  • recurrent substance-related legal problems.
  • continued usage despite recurrent social and interpersonal problems (i.e., arguments and fights with significant other).

Abuse in the elderly is common and occurs mostly as a result of caretaker burnout, due to the high level of dependency frail, elderly patients usually require. Abuse can be manifested by physical signs, fear, and delaying or not reporting the need for advanced medical care. Elderly patients may also exhibit financial abuse (money or possessions taken away) and abandonment.

Emotional abuse generally continues even after physical assaults have stopped. In most cases it is a personally tailored form of verbal or gesture abuse expressed to illicit a provoked response.

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Author Info: Laith Farid Gulli M.D., Bilal Nasser M.Sc., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Medicine, 2002
 
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