Physical Abuse

Overview, Causes, & Risk Factors

Physical abuse is forceful behavior that can result in injury to another person. An abuser uses beatings to control the victim. The abuse rarely occurs just one time. Physical abuse may be accompanied by emotional abuse. A recent study of girls in 9th through 12th grade found that one out of five girls were physically and/or sexually abused by a dating partner.

A victim of physical abuse might be:

assaulted with a weapon

bitten

burned, often with a cigarette

choked

kicked

pushed or thrown

slapped, hit, or punched

tied down

A victim may also suffer from being shaken. When a person is severely shaken, the injury can cause clots and swelling in the brain. This is much like shaken baby syndrome. Men, women, and children can all be victims of physical abuse. Victims can be any age and from any ethnic, religious, or economic group.

What are the causes and risks of the injury?

While there is no specific type of person who is at risk for abuse, certain factors do put some people at greater risk. These risk factors include:

being a drug or alcohol abuser or having a partner who is one

being a female, especially between the ages of 17 and 34

being in the first 5 years of a new marriage or a live-in relationship

being in a marriage or relationship in which one person is more dominant than the other

being pregnant

being socially and emotionally isolated

being unemployed

living in poverty, living in poor housing conditions, moving often

Experts know that adolescents who have been abused are at higher risk for other health problems. However, we do not yet know whether the health problems came before the abuse, or if the abuse increased the risk for the health problem. These problems include the following:

adolescent pregnancy

alcohol use, including binge drinking

cocaine abuse

risky sexual behaviors, including intercourse before age 15 and multiple partners

smoking

suicidal attempts or thoughts

unhealthy weight management, including eating disorders

Symptoms & Signs

What are the signs and symptoms of the injury?

Most injuries occur to the neck, head, chest, breast, lower back, and belly. Victims who are pregnant are often beaten in the breast and abdomen. Even though they may be severely hurt, victims often do not seek medical help right away.

A person may have been physically abused if he or she has:

broken bones

broken or missing teeth

bruises, scrapes, and cuts anywhere on the body

injuries on different parts of the body, in different stages of healing

rope burns or burns from something hot, such as a cigarette

a sprained finger, arm, or leg

Diagnosis & Tests

How is the injury recognized?

Diagnosis of physical abuse begins with a medical history and physical exam. The healthcare provider may order tests to diagnose specific injuries, such as a bone fracture.

Prevention & Expectations

What can be done to prevent the injury?

Society needs to be educated about what physical abuse is and how it can be identified and stopped. Developing trust within organizations and communities is important so that people feel comfortable talking about abuse or potential abuse. Prevention also means taking an active role in promoting social change and making efforts to influence legislative reforms.

The best way to prevent abuse is to teach people how to solve problems without using violence. Teenagers and young adults should be taught that it's never OK to abuse a partner. Parents and healthcare providers should provide teens with information and statistics about dating violence. The teens should be given specific information about behaviors that are part of dating violence. They should be encouraged to discuss any issues or concerns with a parent or other appropriate adult.

Since health concerns such as cocaine use are associated with a higher risk for physical abuse, healthcare providers should address dating violence when treating people with these health concerns. Careful screening can help identify at-risk individuals and provide the opportunity to stop the abuse cycle.

Resources are available to abuse victims within their communities. Books and articles about child abuse are readily available. Supporting and promoting training and education on recognizing and addressing physical abuse are other preventive measures.

Friends, neighbors, family members, and healthcare providers need to ask directly about signs of possible abuse. For instance, if a person has unexplained bruising, ask him or her how it happened. The person may not say how it happened, but his or her reaction may provide more information about the situation. Asking the right questions can sometimes make the victim feel less isolated. Showing concern lets the victim know that there is someone to turn to if he or she needs help.

Treatment & Monitoring

What are the treatments for the injury?

First, the victim's physical injuries must be treated by a healthcare provider. Bone fractures may need to be repaired. If there are internal injuries, surgery may be needed. Next, if possible, the victim needs to separate himself or herself from the abuser. He or she may have to stay with a friend or relative or move to a shelter. Sometimes children need to be placed in foster care.

The ultimate goal in treating a victim of physical abuse is to get the person to reestablish his or her life without the abuser. For many reasons, the victim may not be able or ready to leave the abuser. Providing the victim with information about ways to get help in the future is very important. If he or she has a plan in place for leaving the abuser, maybe the next time he or she is abused, he or she will be able to get away safely.

What are the side effects of the treatments?

Side effects depend on the treatment used. Surgery to repair internal injuries, for example, may cause bleeding, infection, or allergic reaction to anesthesia.

What happens after treatment for the injury?

Victims of physical abuse will need counseling. They may need help to regain their self-esteem. Support groups can be helpful in this healing process.

Long-term effects can include posttraumatic stress disorder. The victim may have the following conditions:

acute situational anxiety

generalized anxiety disorder

panic disorder

post-traumatic stress disorder

phobias

obsessive compulsive disorders

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depression

feelings of isolation

irritability

nightmares and flashbacks

a tendency to avoid other people

Even if the victim doesn't suffer from posttraumatic stress disorder, he or she may have other long-term effects, such as:

living in poverty

poor self-esteem

trouble staying in school or keeping a job

Studies show that half of men who abuse their partners also abuse their children. Abused mothers often have trouble holding jobs. They also are more likely to need welfare. This means that children from abusive homes are at a greater risk of being poor and homeless.