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involves a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated
Oppositional Defiant Disorder
passive aggressive behaviors such as stubbornness, procrastination, disobedience, carelessness, negativism, testing of limits, resistance to directions, deliberately ignoring the communication of others and unwillingness to comprimise
Expressed Response Pattern
when the victim of rape expresses feelings of fear, anger and anxiety through behaviors like crying, sobbing, smiling, restlessness and tenseness
Controlled Response Pattern
the response to rape in which feelings are masked or hidden, and calm, composed or subdued affect is seen
Profile of abuser/perpetrator
- saw abuse in family or was abused
- no anger management
- low self esteem
- dual personality
- poor coping skills
- spouse is a "possession"
Profile of a rapist
- mother that's overbearing, seductive and quick to withdraw her love...dominates son
- grew up in abusive home (father abused him)
- ** rapists anger is directed toward the mom for not providing adequate protection from the father's abuse**
Tics that are vocal are called....
echolalia or palilalia
Who are the individuals at risk for intimate partner violence?
Phase I of domestic/interpersonal violence
- Tension building....gets angry with little provocation
- she senses and tries to stay out of his way...her withdraw is seen as rejection and makes him more angry
- minor battering occurs
Phase II of domestic/interpersonal violence
- Most violent phase
- Begins by batterer justifying to himself "teaching her a lesson"
- By the end he doesn't understand how he lost control
- Help is only sought when severe injuries occur or she fears kids safety
- Honeymoon phase...
- Batterer is extremely loving and promises it will never happen again
- He plays on feelings of guilt and she wants to believe him
- Cycle repeats itself
When is the phase of violence when the person needs to leave to make a statement for change and intolerance of abuse?
After the abuse....phase II
Describe the victim of interpersonal violence
- all ages, races, religions, socioeconomic grps
- usually female
- low self esteem
- adhere to feminine sex role stereotypes
- grew up in abusive home
Learning theory for how an abuser was created
- they were abused as kids
- they saw it on TV or in video games and mimic it
Sociocultural theory for how an abuser was created
- aggressive behavior is a product of social structure
- poverty and income are a powerful indicator of homicide and violent crimes
Appropriate questions when assessing a victim of interpersonal violence
- I believe you
- Tell me what you are remembering
- I would feel angry too
- It is a normal response to a terrible experience
- Let me go thru it with you this time
Appropriate attitude when treating a victim of interpersonal violence
We will do everything to keep you safe
If there is a child and parent involved in interpersonal violence....how do you handle it?
Interview them separately
Primary prevention for domestic violence
- parent education
- family life education
- child and elder care
- support groups
- self defense classes
Secondary prevention for domestic violence
- intervene with children who are abused
- hotlines/crisis centers
inappropriate sexual behavior instigated by a perpetrator for purposes of sexual pleasure or economic gain
an act of aggression, not passion. It is identified by the use of force and executed against the person's will
Examples of sexual assault
- date rape
- marital rape
- statutory rape
How do children and adolescent victims feel after the assault(s)
- feel responsible for what happened
- confuse it for love
Long term effects of sexual violence
- feelings of loss of control
- phobias (particularly with those that have to do with sexual interactions)
Why do people abuse others sexually?
most rapists are preoccupied with their own fantasies and their goal is to control and dominate others. This is attributed to their lack of normal interpersonal involvements
Describe cues that signal sexual abuse in kids
- cant walk or sit
- suddenly refuses to change for gym or participate in physical activities
- reports nightmares/bedwetting
- sudden change in appetite
- demonstrates bizarre, sophisticated or unusual sexual knowledge/behavior
Describe cues that signal sexual assault in an adult
- they don't trust anybody
- low self esteem
- poor sense of identity
- absence of pleasure with sexual activity
How do you care for a victim of sexual assault
- provide shelter and assure safety
- head to toe assessment
- attend to injuries
- report to authorities when required
- promote therapy
- provide a list of shelters/safe house
What's a SANE nurse?
- Sexual Assault Nurse Examiner
- RN with advanced training
- provides forensic examination of sexual assault victims
- combined with compassionate care for bio-psychosocial
- deficits in general intellectual functioning and adaptive functioning
- Severity is identified by pts IQ level
What's adaptive functioning
a persons ability to adapt to requirements of activities of daily living and the expectations of his or her age and cultural groups
What causes mental retardation
- alterations in embryonic development
- pregnancy and perinatal factors
- general medical conditions acquired in infancy or childhood
Characteristics of autism
- socially isolative
- little sense of human relations
- indifference to affection
- impaired communication
A person with Conduct Disorder lacks....
What kind of meds treat Tourettes?
Medications that treat ADHD
- CNS Stimulants
- Mood Stabilizers
Side Effects of ADHD meds
- pinched facial expressions
- dark hollows under eyes
- dry mouth
Medication teaching for ADHD meds
- no caffeine or ephedrine
- DONT TAKE ON AN EMPTY STOMACH
If a person is on Dexedrine/Adderall what do they need to know?
Don't eat citrus foods within 1 hr of taking this med
If a person is on Ritalin what do they need to know?
Dont take antihistamines
Goals of nursing care for a person with separation anxiety?
- help the pt maintain anxiety at a manageable level when separated from significant other
- assist with dev. of coping skills
- develop trust and demonstrate the ability to interact appropriately with others
What's silent rape reaction?
rape that isn't reported
What disorders come about after a rape?
- Eating disorder
Things to put in to a safety plan
- Stash $$
- tell neighbor if hear yelling call 911
- remove weapons
- plan an escape plan and place
- hide a bag of clothes etc...
- make copies of legal papers
- memorize shelter numbers and addresses
Questions you would ask an adult when screening for abuse....
- Do you ever feel afraid or threatened by your partner?
- Are you in a relationship where you are treated badly?
- Has your partner ever destroyed anything you care about?
- What happens when you and your partner fight?
- Has your partner ever prevented you from leaving the house?
Questions you would ask a child when screening for abuse...
Moms and dads try to help their children learn how to behave well. What happens when you do something wrong?
How do you support a client during a crisis period following sexual/physical assault?
- Multidisciplinary approach-Dr., Social Worker, CPS
- Empower clients-recognize self worth, strength and abilities
- Family centered education
- Explain cycle of violence and ID associated feelings
IQ score of below 20...
- cognition-no benefit from academic or vocational training
- social-little if any speech development/no social skills
- psychomotor-no fine or gross motor movement, needs constant supervision
IQ score of 20-35
- cognition-unable to benefit from vocational and academic training...benefits from systematic habit training
- social-minimal verbal skills, needs communicated by acting out behaviors
- psychomotor-only able to perform simple tasks under close supervision
IQ score of 35-39
- cognition-academic skills to the 2nd grade, can work in a sheltered workshop
- social-limited speech, difficulty adhering to social convention, difficult peer relationships
- psychomotor-fair development, can work doing unskilled gross motor activities
IQ score of 50-70
- cognition-academic skills to 6th grade, can achieve vocational skills to min. self support
- social-capable of developing social skills, functions well in structured sheltered setting
- psychomotor-not affected, slight coordination problems
Three behaviors common to Autism Spectrum Disorder
- Impaired social interactions
- impaired communication and imaginative activity
- restricted activities and interest
Name some emotional manifestations for individuals with ADHD
- mania....which cant be treated concurrently
Difference between conduct disorder and oppositional defiance disorder
The best thing to prevent secondary gain for disruptive behaviors is to __________ the amount of attention given for negative behavior, and ________ the amount of attention given for positive behaviors.