Abuse Health Article

Medical and psychiatric

In addition to requiring immediate treatment for physical injuries, abused children and adults often need long-term psychotherapy in order to recover from specific mental disorders and to learn new ways of dealing with distorted thoughts and feelings. This approach to therapy is known as cognitive restructuring. Specific mental disorders that have been linked to childhood abuse include major depression, bulimia nervosa, social phobia, Munchausen syndrome by proxy, generalized anxiety disorder, post-traumatic stress disorder, borderline personality disorder, dissociative amnesia, and dissociative identity disorder. Abused adults may develop post-traumatic stress disorder, major depression, or substance abuse disorders. At present, researchers are focusing on genetic factors as a partial explanation of the fact that some people appear to react more intensely than others to being abused.

Legal considerations

Medical professionals and, increasingly, religious professionals as well, are required by law to report child abuse to law enforcement officials, usually a child protection agency. Physicians are granted immunity from lawsuits for making such reports.

Adults in abusive situations may encounter a variety of responses from law enforcement or the criminal justice system. In general, cases of spouse abuse, stalking, and sexual abuse by professionals are taken more seriously than they were two or three decades ago. Many communities now require police officers to arrest the aggressor in domestic violence situations, and a growing number of small towns as well as cities have shelters for family members fleeing violent households. All major medical, educational, and legal professional societies, as well as mainstream religious bodies, have adopted strict codes of ethics, and have procedures in place for reporting cases of abuse by their members. Abuse in the workplace, however, is still a relatively new area of concern, and people affected by it have relatively few legal protections or resources as of 2002.

Prevention

Prevention of abuse requires long-term social changes in attitudes toward violence, gender roles, and the relationship of the family to other institutions. Research in the structure and function of the brain may help to develop more effective treatments for the aftereffects of abuse and possibly new appoaches to help break the intergenerational cycle of abuse. At present, preventive measures include protective removal of children or elders from abusive households; legal penalties for abusive spouses and professionals; and educating the public about the nature and causes of abuse.

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