Sequelae of abuse. Health effects of childhood sexual abuse, domestic battering, and rape

Abstract

Violence against women is endemic in the United States. One third to one half of all women will experience one or more types of abuse in their lifetime, most often at the hands of a family member or an intimate or formerly intimate partner. One in 12 women is battered during pregnancy. Abuse survivors are disproportionately frequent users of health care services because of acute and chronic physical, somatic, emotional, and behavioral sequelae of abuse. Health care practitioners are often the first contact abuse survivors have with a potentially helping professional. It is, therefore, essential that health care providers learn to identify and to intervene appropriately with survivors of abuse. This article reviews and compares the health effects of three of the most common types of violence against women: childhood sexual abuse, domestic battering, and rape. Sequelae are divided into six categories: physical/medical, somatic, emotional/ psychological, social/interpersonal, behavioral/sexual, and pregnancy-related effects. The health effects discussed in this article include research findings, as well as effects noted in clinical practice. Recommendations are made for routine screening of all women for past and current abuse, as well as for intervention strategies.

PIP: This paper reviews and compares the health effects of three common types of abuse against women: childhood sexual abuse, domestic battering, and rape. In the US, violence against women has become a serious problem. One half to one third of all women in the country experience abuse in their lifetime that is usually inflicted by a family member, or an intimate or formerly intimate partner. One out of 12 women experienced abuse during pregnancy. Victims of violence frequently seek medical care because of the acute and chronic health problems that result from abuse. Since health care practitioners are often the first contact abuse victims have, it is essential that they learn to assess and intervene appropriately with survivors of abuse. In this discussion, the health effects of abuse were categorized as physical/medical, somatic, emotional/psychological, social/interpersonal, behavioral/sexual, and pregnancy-related. Recommendations are made concerning the routine screening of all women for past or current abuse, as well as for effective intervention strategies.