Disordered Eating - National Service Project
** All screening/assessment tools are designed to help determine if individuals should see a mental health professional for proper diagnosis and treatment. They are in no way to replace the diagnosis and treatment of mental health professional.**

Risk Factors for Domestic Violence

A number of studies have looked into identifying women most at risk for domestic violence. The most common feature is an imbalance of power and control. However, neither women who experience domestic violence nor the partners who abuse them fall into distinct categories. They can be of any age, ethnicity, income level, or level of education. Following are examples of situations that are common among women who experience domestic violence. It is important to understand that any woman can be abused.

• Women at risk
• Planning to leave or has recently left an abusive relationship
• Previously in an abusive relationship
• Poverty or poor living situations
• Unemployed
• Physical or mental disability
• Recently separated or divorced
• Isolated socially from family and friends
• Abused as a child
• Pregnancy, especially if unplanned
• Younger than 30 years
• Stalked by partner

Although the abusers also share some common characteristics, it is important to note that abusers choose violence to get what they want in a relationship. Risk factors may point to an increased likelihood of violence in a relationship, but the person is not destined to become violent because of the presence of certain risk factors. Nor is the violence justifiable because it happened while the abuser was in a blind rage that he was powerless to control. The following factors may indicate an increased likelihood that a person may choose violence:

• Abuser risk factors
• Abuses alcohol or drugs
• Witnessed abuse as a child
• Abused former partners
• Unemployed or underemployed
• Abuses pets

Signs & Symptoms of Domestic Violence:

• Psychological signs and symptoms
• Recognizing the signs and symptoms of domestic violence begins by observing the behavior of both the abuser and the person being abused. The abuser may appear overly controlling or coercive, attempting to answer all questions for the woman or isolating her from others. This type of behavior may occur in the context of a visit to the doctor where the abuser refuses to let the woman out of his sight and attempts to answer all questions for her. You may even note emotional abuse actually taking place. In stark contrast, the woman may appear quiet and passive. She may show outward signs of depression such as crying and poor eye contact.
• Other psychological signs of domestic violence range from anxiety, depression, and chronic fatigue to suicidal tendencies and the battered woman syndrome—a syndrome similar to the posttraumatic stress disorder seen in people threatened with death or serious injury in extremely stressful situations (such as war).
• Substance abuse is also more common in the woman experiencing domestic violence than in the general adult female population. The abuse of alcohol, prescription drugs, and illicit drugs may happen as a result of the violent relationship rather than being the cause of the violence.

• Physical signs and symptoms
• Domestic violence assault may lead to specific injury types and distributions.
• These injury types and patterns may result from things other than domestic violence but should raise suspicion of abuse when present.
• Injury types seen more commonly in domestic violence injuries than in injuries caused by other means are these:
• Tympanic membrane (eardrum) rupture
• Rectal or genital injury
• Facial scrapes, bruises, cuts, or fractures
• Neck scrape or bruise
• Abdominal cuts or bruises
• Tooth loose or broken
• Head scrape or bruise
• Body scrape or bruise
• Arm scrape or bruise

• Physical signs and symptoms of domestic violence that result from traumatic injury may seem similar to injuries resulting from other causes. But some injury types and locations may increase the suspicion of assaultive violence. The distribution of injuries on the body that typically occurs in the domestic violence assault may follow certain patterns. Some frequently seen patterns of injury are as follows:

• Centrally located injuries
• Injury distribution is in a bathing suit pattern, primarily involving the breasts, body, buttocks, and genitals.
• These areas are usually covered by clothing, concealing obvious signs of injury.
• Another central location is the head and neck, which is the site of up to 50% of abusive injuries. \

• Characteristic domestic violence injuries
• Cigarette burns
• Bite marks
• Rope burns
• Bruises
• Welts with the outline of a recognizable weapon (such as a belt buckle)

• Bilateral injuries: Injuries involving both sides of the body, usually the arms and legs
• Defensive posture injuries: These injuries are to the parts of the body used by the woman to fend off an attack.
• The small finger side of the forearm or the palms when used to block blows to the head and chest
• The bottoms of the feet when used to kick away an assailant
• The back, legs, buttocks, and back of the head when the woman is crouched on the floor

• Injuries inconsistent with the explanation given
• The injury type or severity does not fit with the reported cause.
• The mechanism of injury reported would not produce the signs of injury found on physical examination.

• Injuries in various stages of healing
• Signs of both recent and old injuries may represent a history of ongoing abuse.
• Delay in seeking medical attention for injuries may indicate either the woman's reluctance to involve doctors or her inability to leave home to seek needed care.

• Noninjury physical signs and symptoms
• Women experiencing ongoing abuse and stress in their lives may develop medical complaints as a direct or indirect result.
• Often, the woman experiencing domestic violence goes to the emergency department or clinic on multiple occasions with no physical examination findings to account for her symptoms.
• Some typical medical complaints
• Headache
• Neck pain
• Chest pain
• Heart palpitations
• Choking sensations
• Numbness and tingling
• Painful sexual intercourse
• Pelvic pain
• Urinary tract infection
• Vaginitis