This Document Contains Chapters 1 to 3 Chapter 1 Characteristics and Consequences of Family Violence TEACHING POINTS • The study of family violence as a discipline is still in its infancy. In U.S. society, numerous myths and misconceptions surround this problem are present when examining family violence issues and prevention techniques. • It is difficult to define what constitutes family violence. • There are inherent problems in attempting to measure the extent of family violence. • The study of family violence is still in its infancy. • There are numerous myths and misconceptions surround family violence. • The concept of family violence is a wide-ranging concept that must remain flexible to adaption as we learn more about its scope and impact. • The term serious injury may involve physical or emotional harm or a violation of another family member’s rights and freedom of choice. • Intervention strategies vary widely in dealing with family violence. • The most commonly relied on data on the extent of family violence are reports by local law enforcement agencies, the American Humane Society, the Uniform Crime Reports, and the National Crime Victimization Surveys. • Since adoption of the mandatory reporting laws for child abuse, and in some states mandatory arrest of those accused of spousal abuse, local agencies have been able to provide researchers with a wealth of information regarding family violence. • The Violence against Women Act provides a fundamental change in the criminal justice system’s gathering of information on violent crimes committed against women. • The Uniform Crime Reports (UCR) program is a nationwide statistical compilation involving more than 1,600 cities, counties, and state law enforcement agencies that voluntarily report data on reported crimes. • The psychiatric model tries to understand family violence by analyzing the offender’s personality traits and mental status. • The psychopathology theory is grounded on the concept that certain individuals suffer from mental illness, personality disorders, and other dysfunctions that cause them to engage in aggressive acts within the family. • The substance abuse theory accepts the proposition that drugs or alcohol cause or contributes to family violence. • The social–psychological model analyzes external environmental factors that affect the family unit. Factors such as stress, family structure, the intergenerational transmission of violence, and family interactions are all considered as primary causes of family violence. • The social learning theory assumes that the type of behavior most frequently rein-forced by others is the one most often exhibited by the individual. • The exchange theory is based on the premise that persons act according to a system of rewards or punishments. • The frustration–aggression theory is based on the premise that human beings display aggression toward objects that impede their achievement of certain goals. • The ecological theory is based on an analysis of the organism and the environment, the interacting systems in which family development occurs, and the environment in which the family resides. • The sociobiology or evolutionary theory is based on the concept that parents display aggressive acts toward children who are not their own or do not have the potential to reproduce. • The sociocultural model of family violence focuses on the roles of men and women in our society as well as on the cultural attitudes toward women and the acceptance of violence as a cause of family violence. • The patriarchy theory views society as dominated by males, with women in subordinate positions, treated by men as possessions and things. • The general systems theory views the maintenance of violence as a result of the social system in which families live. • This social conflict theory analyzes large-scale conflicts, marriages, and the communication process. • The resource theory is based on the proposition that the one who controls resources, such as money, property, or prestige, is in the dominant position in a relationship. • The intergenerational transmission of violence theory was formerly known as the cycle of violence theory. • One of the most obvious consequences of family violence is the physical injuries suffered by victims. These injuries are easy to observe and treat. • There are four general classifications of physical injuries inflicted on victims of family violence: immediate injuries that heal leaving no trace, injuries that leave visible scars, unknown long-term physical injuries, and long-term catastrophic injuries. • The types of physical injuries suffered by victims of family violence can cover the entire spectrum of illness, from simple bruises to deadly gunshot wounds to the head. • Acute stress disorder (ASD) is acute stress that is experienced in the immediate aftermath of a traumatic event. • Posttraumatic stress disorder is defined as the development of characteristic symptoms following a psychologically distressing event that is outside the range of usual human experience. • Victims of family violence may suffer a wide variety of mental disorders as a result of their victimization. TEST BANK FOR CHAPTER 1 Multiple Choice Questions 1. Family violence is defined as a. the physical injury inflicted upon a wife by her husband. b. any act or omission by persons who are cohabitating that results in serious injury to other members of the family. c. any physical, emotional or psychological injury inflicted by a husband on his wife. d. any act or omission by a husband upon his wife that results in serious injury. Answer: b 2. Family violence includes which of the following acts? a. criminal offenses. b. behavioral acts. c. medical problems. d. all of the above. Answer: d 3. Straus and Gelles conducted two national family violence surveys in 1975 and 1985. These surveys are considered reliable indications of violence in the family because of which of the following factors a. the sampling procedure, the large number of respondents and the validity of the Conflict Tactics Scale as a measuring instrument. b. the sampling procedure, the socio-economic class of respondents, and the validity of the measuring instrument. c. the follow-up process, the sampling procedure and the definitions used by Straus and Gelles. d. subsequent surveys have validated the initial national survey. Answer: a 4. The Uniform Crime Reports (UCR) is compiled by the Federal Bureau of Investigation and provides data on incidents of family violence that a. is collected by a survey of citizens in the United States. b. is accurate because all incidents of family violence are reported to the police. c. is criminal in nature. d. is prosecuted by the local District Attorney. Answer: c 5. The National Crime Victimization Survey (NCVS) conducts a nationwide sample and interviews these individuals regarding victimization. This annual survey of citizens suffers from which of the following problems? a. some respondents under report crimes. b. some respondents over report crimes. c. it is only an estimate of criminal activity. d. all of the above. Answer: d 6. The Psychopathology Theory of family violence is grounded upon which of the following concepts? a. that some individuals suffered from Posttraumatic stress disorder and therefore cannot help themselves when they commit violence against those that they live with. b. that certain individual suffer from mental disorders that relieve them of criminal responsibility when they commit acts of family violence. c. that certain individuals suffer from personality disorders that cause them to engage in aggressive acts towards their spouses. d. that certain individuals suffer from mental disorders, personality disorders and other dysfunctions that cause them to engage in aggressive acts within the family. Answer: d 7. The Substance Abuse Theory of family violence accepts the proposition that a. alcohol causes family violence. b. drugs and alcohol causes or contributes to family violence. c. illegal drugs cause family violence. d. some persons cannot use drugs or alcohol and therefore when they engage in this activity, they will batter their spouses. Answer: b 8. The Social Learning Theory of family violence a. assumes that the type of behavior that is most frequently reinforced by others is the one that is most often exhibited by the individual. b. is an integration of differential associations with differential reinforcements so that people with whom one interacts are the reinforcers of behavior that results in learning both deviant and non-deviant behavior. c. holds that social learning is accomplished by modeling & reinforcement. d. all of the above. Answer: d 9. The Sociocultural Model of family violence focuses on a. the roles of men and women in our society b. the cultural attitudes towards women in our society c. the acceptance of violence as a cause of family violence d. all of the above Answer: d 10. The Patriarch Theory and the Culture of Violence Theory are examples of which model of family violence a. the Sociocultural Model b. the Social Learning Model c. the Socio-economic Model d. the Cycle of Violence Model Answer: a 11. Which of the following are common features of family violence a. isolation, lower socio-economic class or status, power/powerlessness, low self-esteem and power differentials. b. low self-esteem, power differentials, effect on the victim, lower socio-economic class or status. c. effect on the victim, substance abuse, power/powerlessness, power differentials and isolation. d. the fact that the victim stays with the abuser, the fact that the victim provokes the abuser, and the fact that the abuser was abused as a child. Answer: c 12. The Intergenerational Transmission of Violence Theory a. was invented by Helfer and Kempe when they coined the term “battered child syndrome.” b. asserts that violent behavior is learned within the family and bequeathed from one generation to the next. c. is also known as the Cycle theory of Violence d. both b and c. Answer: b 13. The Intergenerational Transmission of Violence Theory a. indicates that children who have been physically abused were more aggressive towards other children than those who had not been harmed. b. has been discarded as a viable theory of family violence. c. has been accepted as the cause of family violence. d. both a and c. Answer: a 14. The term serious injury encompasses all of the following except: a. physical harm. b. emotional harm. c. arguments. d. a violation of a family member’s rights. Answer: c True-False Questions 1. The cycle of violence theory was originally known as the intergenerational transmission of violence theory. Answer: False 2. Victims of family violence have difficulty trusting others. Answer: True 3. The resource theory analyzes large-scale conflicts, marriages, and the communication process. Answer: False 4. The resource theory is based on the proposition that the one who controls resources is in the dominant position in a relationship. Answer: True 5. The ecological theory is based on an analysis of the organism and the environment. Answer: True 6. The sociocultural model of family violence is a macro level of analysis that focuses on the variables that cause violence. Answer: True 7. The psychopathology theory of family violence is based on substance abuse as the cause of family violence. Answer: False 8. The UCRs are published by the U.S. Congressional Committee on Crime. Answer: False 9. The NCVS does not provide data regarding the victims of crime. Answer: False 10. In 2011, Casey Anthony was convicted of causing the death of her daughter. Answer: False Essay Questions 1. Compare and contrast the general theories regarding family violence. Answer: Overview of Family Violence Theories 1. Social Learning Theory • Focus: Learned behaviors through observation. • Key Points: Emphasizes modeling and reinforcement. • Criticism: Overlooks biological and psychological factors. 2. Ecological Systems Theory • Focus: Interaction of multiple systems (family, society). • Key Points: Considers individual, familial, and societal influences. • Criticism: Broad and complex to study. 3. Feminist Theory • Focus: Gender and power dynamics. • Key Points: Highlights male dominance and societal norms. • Criticism: May overlook other forms of violence. 4. Attachment Theory • Focus: Early attachment experiences. • Key Points: Links insecure attachments to maladaptive behaviors. • Criticism: May not address situational factors. 5. Systems Theory • Focus: Family as an interrelated system. • Key Points: Dysfunctional dynamics affect all members. • Criticism: May neglect external influences. 6. Psychopathology Theory • Focus: Individual psychological issues. • Key Points: Mental health and substance abuse. • Criticism: Overlooks social context. 7. Biological and Genetic Theories • Focus: Genetic and neurobiological factors. • Key Points: Hormones, brain structure, genetic markers. • Criticism: Risk of determinism, neglects environment. Comparison • Focus: Environmental (Social Learning, Ecological), Gender/Power (Feminist), Relational (Attachment, Systems), Individual (Psychopathology, Biological). • Approach: Holistic (Social Learning, Ecological) vs. Individual (Psychopathology, Biological). • Intervention: Societal change (Feminist) vs. therapeutic/medical interventions (Attachment, Biological). Integrating these theories provides a comprehensive understanding of family violence, guiding effective prevention and intervention strategies. 2. List and discuss some of the more common forces present in all forms of family violence. Answer: Common Forces in Family Violence 1. Power and Control • Central to many forms of family violence. • Perpetrators use violence to exert dominance and maintain control. 2. Cycle of Violence • Repetitive pattern: tension building, violent incident, reconciliation. • Traps victims in a recurring cycle of abuse. 3. Intergenerational Transmission • Children exposed to violence are more likely to exhibit violent behavior as adults. • Perpetuates a cycle of violence across generations. 4. Socioeconomic Factors • Economic stress, poverty, and unemployment increase the likelihood of violence. • Financial dependence can make it harder for victims to leave. 5. Substance Abuse • Alcohol and drug abuse are linked to increased aggression and impaired judgment. • Leads to more frequent and severe violence. 6. Cultural and Societal Norms • Cultural beliefs and societal norms can normalize and perpetuate violence. • Traditional gender roles may discourage victims from seeking help. 7. Mental Health Issues • Mental health problems can contribute to both perpetrating and experiencing violence. • Complicates efforts to address and resolve family violence. 8. Isolation • Abusers often isolate victims from support networks. • Makes it difficult for victims to seek help. 9. Jealousy and Possessiveness • Extreme jealousy drives controlling and violent behaviors. • Restricts victims’ activities and increases power imbalance. 10. Low Self-Esteem • Both perpetrators and victims often suffer from low self-esteem. • Perpetuates the cycle of violence. 11. Stress and Frustration • High stress and frustration levels can trigger violent behavior. • Results in aggressive responses to minor provocations. Discussion These forces interact in complex ways, requiring comprehensive intervention strategies, including legal, social, psychological, and economic support to effectively address family violence. 3. Discuss the intergenerational transmission of violence theory, including a summary of the theory’s holding. Answer: Intergenerational Transmission of Violence Theory Summary: The theory posits that individuals who experience or witness violence in their family of origin are more likely to exhibit violent behaviors in their own adult relationships and families. This is due to learned behaviors through direct observation and experience. Key Components: 1. Learning Through Observation: • Children observe and internalize violent behaviors as acceptable conflict resolution methods. 2. Normalization of Violence: • Repeated exposure normalizes violence, making it an expected part of relationships. 3. Modeling and Reinforcement: • Children mimic violent behaviors, believing they are acceptable and effective. 4. Emotional and Psychological Impact: • Exposure to violence causes trauma, leading to aggression in adulthood. 5. Behavioral Conditioning: • Violence becomes a conditioned response to stress or conflict. Supporting Evidence: Empirical Studies: • Research shows a higher likelihood of adult violence in those exposed to family violence as children. Psychological Assessments: • Many individuals with violent tendencies have histories of childhood trauma. Criticisms: 1. Oversimplification: • May not account for genetic, socioeconomic, or cultural factors. 2. Variability in Outcomes: • Not all exposed individuals become violent; some develop resilience. Intervention and Prevention: • Effective interventions and support systems can break the cycle of violence. • Early childhood and family support are crucial for prevention. Conclusion: The theory highlights the need for comprehensive intervention and prevention strategies to address and mitigate family violence, promoting healthy, non-violent relationships across generations. Chapter 2 Physical Child Abuse TEACHING POINTS • The term battered child syndrome, was coined in 1961 by Dr. C.H. Kempe. • After Kempe’s study, society began to accept the fact that parents, caretakers, and siblings do in fact engage in occasional or systematic battering of young children. • Battered child syndrome is a medicolegal term that describes the diagnosis of a medical expert based on scientific studies that indicate that when a child suffers certain types of continuing injuries, those injuries were not caused by accidental means. • All states have child abuse reporting laws mandating that caretakers report suspected cases of child abuse. • Physical child abuse may be defined as any act that results in a nonaccidental physical injury by a person who has care, custody, or control of a child. This definition contains two key aspects: the act is intentional or willful, and the act resulted in a physical injury. An accidental injury does not qualify as child abuse. • The physical battering of children is not a new phenomenon. Children have suffered trauma at the hands of their parents and caretakers since the beginning of recorded history. • The physical battering of children is not a new phenomenon. Children have suffered trauma at the hands of their parents and caretakers since the beginning of recorded history. • The industrial revolution was characterized by repeated maltreatment of children. Young children were forced to work long hours under inhumane conditions in factories or other heavy industries. • Every state now has laws preventing the physical abuse of children. • Cynthia Crosson Tower grouped several theories into three distinct models: the psychopathological model, the interactional model, and the environmental–sociological– cultural model. • Children of all ages, all races, both genders, and all socioeconomic backgrounds have been victims of physical abuse. Several studies have examined whether certain children are more at risk of being abused than others. • Richard Asher coined the term Munchausen syndrome in 1951 to describe patients who fabricated histories of illness. • Munchausen syndrome by proxy was first described in 1977 by a Dr. Roy Meadow. • Shaken baby syndrome (SBS) is neurological damage caused by shaking the child violently back and forth. (The term whiplash shaken baby syndrome was originally used by Caffey to explain and highlight this type of injury.) • Craniofacial, head, face, and neck injuries are present in more than half of all the cases of child abuse. Some authorities believe that the oral cavity may be the central focus of abuse because of its role in communication and nutrition. • Parricide is a form of family violence that has received little attention in any research and discussion. • The most common parricide offender may be a chronically abused child who as an adolescent kills the abusing parent. TEST BANK FOR CHAPTER 2 Multiple Choice Questions 1. Doctor John Caffey studied children with subdural hematomas who also had other injuries. He came to the conclusion that in the absence of a skeletal disease, children who have both subdural hematomas and long bone fractures are victims of trauma. This condition became known as a. the Battered Child Syndrome. b. Caffey’s Syndrome. c. Kempe’s Syndrome. d. Kempe and Caffey’s Syndrome Answer: b 2. The Battered Child Syndrome is a. no longer a valid medical-legal diagnosis because of our advances in medical science. b. is a medical-legal term used to describe children who are suffering from long bone fractures and subdural hematomas. c. is a term that describes the characteristics of children who are abused as a result of the Cycle of Violence. d. is a medicolegal term that describes the diagnosis of a medical expert based upon scientific studies that indicate when a child suffers certain types of continuing injuries that those injuries were not caused by accidental means. Answer: d 3. Physical Child Abuse is defined as a. any act which results in nonaccidental physical injury by a person who has care, custody or control of a child. b. includes sexual, emotional and neglectful acts against a child. c. any act which causes a physical injury to the child. d. both a and c. Answer: a 4. The Psychopathological Model of family violence a. stresses the characteristics of the abuser as the primary cause of abuse. b. is no longer considered a valid theory to explain child abuse. c. discounts the abuser’s personality as a factor in child abuse. d. both b and c. Answer: a 5. The Psychopathological Model of family violence includes the following approaches to child abuse a. the cycle of violence model, the mental illness model, and the character-trait model. b. the character-trait model, the mental illness model, and the psychodynamic model. c. the social learning model, the mental illness model and the psychiatric model. d. the mental illness model, the social learning model and the character-trait model. Answer: b 6. The Interactional Model of child abuse views it as the result of dysfunctional system. This model focuses on the following factors in child abuse a. the role of the child, planned events and the background of the parent. b. the perceptions of the parent, the role of the child and chance events. c. the family structure, the role of the child and the background of the parents. d. the family structure, chance events, and the role of the child. Answer: d 7. The Environmental-Sociological-Cultural Model of child abuse views it a result of stresses in society that are the primary causes of abuse. This model includes the following causes of child abuse a. the environmental stress model, the psychosocial model, the social-learning model and the social-psychological model b. the social learning model, the psychological model, the environmental stress model and the social-psychological model. c. the psychological model, the family structure model and cultural model.. d. the environmental model, the cultural model and the sociological model. Answer: a 8. Which of the following physical indicators should alert a professional to the possibility of physical child abuse a. unexplained bruises or welts and/or unexplained burns b. unexplained lacerations to the mouth, lips, arms and/or legs. c. appearance of injuries after a weekend or vacation d. all of the above Answer: d 9. When interviewing caretakers regarding their explanation of injuries to a child, a. care must be taken not to plant ideas in the minds of the caretakers. b. the caretakers should be interviewed separately. c. consistent explanations by the caretakers may indicate child abuse d. all of the above Answer: b 10. Bruises that are yellow in color typically indicate that the injury occurred a. 0-5 days ago b. 5-7 days ago c. 7-10 days ago d. 10-14 days ago Answer: c 11. Which of the following does not indicate the possibility of physical child abuse a. allergic shiners b. grab marks on the upper arms c. pressure marks on the inner thighs d. runaway or delinquent behavior Answer: a 12. Pattern burns are a form of child abuse a. where the abuser engages in a pattern of conduct which results in the child being repeatedly burned by a hot object. b. which are caused by holding or pressing a portion of the child’s body against a hot object. c. which are very difficult to prove. d. both a and b. Answer: b 13. Munchausen Syndrome by Proxy is also known as a. The False Disease Disorder. b. The Wrong Disease Diagnosis Syndrome. c. Fictitious Disorder by Proxy d. both a and c. Answer: c 14. Spiral fractures are a. a very strong indication of physical child abuse. b. usually a break in the humerus or femur that is the result of a twisting motion. c. can occur if a child under three years old catches his or her foot and falls down causing the injury. d. both a and b. Answer: d 15. The whiplash shaken baby syndrome a. was a term coined by Kempe in 1961 when he was trying to attract attention to child abuse. b. is not an accepted medical diagnosis. c. is neurological damage caused by shaking the child violently back and forth. d. both a and b. Answer: c 16. Subdural hematomas (SDH) a. is a very strong indication of physical child abuse. b. may result if the child falls off a couch and injuries his or her head. c. occur over the surface of the brain and are caused by the tearing of the bridging veins between the brain and the dura. d. all of the above Answer: c 17. A concussion is a. a mild form of diffuse brain injury associated with the acceleration-deceleration or shaking of the child’s head. b. the same as a subdural hematomas. c. is a very strong indication of physical child abuse. d. all of the above. Answer: a True-False Questions 1. Kempe and his associates invented the term Battered Child Syndrome to call attention to child abuse. Answer: True 2. Caffey’s syndrome is the same as the whiplash shaken baby syndrome. Answer: False 3. Munchausen Syndrome by Proxy is easy to diagnose. Answer: False 4. A cerebral contusion is the bruising of the brain without the puncture of tearing of the pia membrane. Answer: True 5. A spiral fracture in a child under the age of 3 is nearly always accidental. Answer: False 6. The membrane next to the brain is the pia matter. Answer: True 7. There are differences of opinions as what types of discipline should be considered as child abuse. Answer: True 8. Numerous fractures are a strong indicator of physical abuse. Answer: True 9. Mary Ellen was probably the first reported case on child abuse in the United States. Answer: True 10. Chest and abdominal injuries are common physical child abuse injuries. Answer: True Essay Questions 1. Compare and contrast the various theories of abuse established by Crosson-Tower. Answer: Psychodynamic Theory • Focus: Early childhood experiences and unconscious conflicts. • Strengths: Emphasizes emotional health and early relationships. • Limitations: Difficult to empirically validate; may oversimplify abuse. Social Learning Theory • Focus: Behavior learned through observation and imitation. • Strengths: Empirical support for the impact of environmental exposure to violence. • Limitations: May not account for individual resilience. Ecological Theory • Focus: Multiple levels of influence (family, community, society). • Strengths: Comprehensive framework recognizing complex factors. • Limitations: Challenging to address all factors simultaneously. Attachment Theory • Focus: Early bonding and attachment relationships. • Strengths: Strong empirical support linking attachment styles to behavior. • Limitations: Focuses primarily on early relationships, not later experiences. Cognitive-Behavioral Theory • Focus: Relationship between thoughts, feelings, and behaviors. • Strengths: Effective in therapeutic settings with actionable strategies. • Limitations: May not address deeper emotional issues. Sociocultural Theory • Focus: Societal and cultural norms. • Strengths: Highlights the role of cultural and societal context. • Limitations: Difficult to change entrenched norms. Comparison • Commonalities: Importance of early experiences and environmental influences; multifaceted nature of abuse. • Differences: Varying focus from individual psychological processes (psychodynamic, attachment) to learned behaviors (social learning, cognitive-behavioral) and broader societal factors (ecological, sociocultural). • Applications: Therapeutic interventions (cognitive-behavioral, social learning) vs. policy-making and community-based interventions (ecological, sociocultural). 2. List the various indicators of abuse. Answer: Physical Indicators • Bruises: Unexplained or recurring. • Burns: Unusual patterns (cigarette, immersion). • Fractures: Unexplained or repeated. • Lacerations/Abrasions: Unexplained cuts. • Head Injuries: Unexplained head trauma. • Bite Marks: Human bites. Behavioral Indicators • Withdrawal: Social withdrawal or isolation. • Aggression: Increased violent behavior. • Fearfulness: Excessive fear of people or places. • Regressive Behaviors: Bedwetting, thumb-sucking. • Hypervigilance: Excessive alertness. Emotional Indicators • Depression: Signs of sadness or hopelessness. • Anxiety: Excessive worry or nervousness. • Low Self-Esteem: Feelings of worthlessness. • Developmental Delays: Physical, emotional, or intellectual delays. • Self-Harm: Evidence of self-inflicted injuries. Environmental Indicators • Home Environment: Unsafe or unhealthy conditions. • Parental Behavior: Hostility, favoritism, or rejection. • Frequent Absences: Regular school absences. • Neglect: Lack of hygiene, clothing, or nutrition. Specific Indicators Physical Abuse • Frequent Injuries: Recurrent with inconsistent explanations. • Medical Neglect: Unattended health issues. Sexual Abuse • Sexualized Behavior: Inappropriate for age. • Physical Signs: Genital pain, infections. • Behavioral Changes: Sudden aggression or withdrawal. Emotional Abuse • Verbal Abuse: Frequent belittling or shaming. • Emotional Neglect: Lack of affection or support. Neglect • Malnutrition: Underweight or distended stomach. • Poor Hygiene: Persistent uncleanliness. • Inadequate Supervision: Left alone for long periods. These indicators help identify and respond to abuse, considering patterns and context. 3. In your opinion, which is the most serious form of child abuse: bruises, burns, fractures, or head and internal injuries? Answer: All forms of child abuse are serious and damaging, and the severity can vary depending on the specific circumstances. However, head and internal injuries are often considered the most serious form of physical abuse because they can lead to long-term health complications, disabilities, or even death. These injuries can result from severe physical trauma, such as shaking, hitting, or throwing a child with significant force. It's important to recognize and address all forms of abuse promptly to protect the well-being of children. 4. Describe the causes of Shaken Baby Syndrome (SBS) and the effects it has on the child. Answer: Shaken Baby Syndrome (SBS), also known as abusive head trauma, is a form of abusive injury inflicted on infants and young children. It occurs when a caregiver shakes a baby or young child violently, leading to brain injury and, in severe cases, death. Causes of SBS • Violent Shaking: The main cause of SBS is shaking a baby or young child violently, often out of frustration or anger. • Unstable Neck Muscles: Infants have weak neck muscles, making them more susceptible to brain injury from shaking. • Impact: Shaking can cause the brain to move within the skull, leading to bleeding, swelling, and other types of traumatic brain injury. Effects of SBS • Brain Injury: The shaking motion can cause the brain to impact against the skull, leading to bruising, bleeding, and swelling. • Neurological Damage: SBS can result in long-term or permanent neurological damage, including cognitive impairments, developmental delays, and learning disabilities. • Physical Disabilities: In severe cases, SBS can cause physical disabilities, such as vision or hearing loss, paralysis, or difficulty with motor skills. • Behavioral Issues: Children who survive SBS may experience behavioral problems, including impulsivity, hyperactivity, and difficulty with emotional regulation. • Death: In the most severe cases, SBS can result in death, either immediately or from complications arising from the brain injury. It's crucial to prevent SBS by educating caregivers about the dangers of shaking infants and providing support and resources to help them cope with the challenges of caring for young children. Early recognition and intervention can also help mitigate the effects of SBS and improve outcomes for affected children. 5. List the various bruise colors and estimate the time progression which these may demonstrate. Answer: Bruises can change color as they heal, indicating different stages of the healing process. The progression of bruise colors can vary depending on the individual and the severity of the injury, but generally follows a similar pattern: 1. Red: Immediately after an injury, a bruise may appear red due to the presence of blood from broken capillaries under the skin. 2. Blue/Purple: Within a day or two, the bruise may darken to a blue or purple color as the blood pools under the skin. 3. Green: After a few days, the bruise may turn green as the body breaks down the hemoglobin in the blood, releasing biliverdin, a green pigment. 4. Yellow: As the bruise continues to heal, it may turn yellow or yellowish-green as the body metabolizes biliverdin into bilirubin, a yellow pigment. 5. Brown: In the final stages of healing, a bruise may fade to a brownish color before disappearing completely. The time it takes for a bruise to progress through these colors and heal completely can vary depending on factors such as the severity of the injury, the individual's healing process, and their skin tone. Generally, bruises will resolve within 1 to 2 weeks, but larger or more severe bruises may take longer to heal. Chapter 3 Child Sexual Abuse TEACHING POINTS • Child sexual abuse is one of the most emotional topics in the field of family violence. • The U.S. population has a widespread interest in child abuse. However, the true magnitude of this problem is difficult to establish. • Child sexual abuse is sexual exploitation or sexual activities with a child under circumstances that indicate that the child’s health or welfare is harmed or threatened. • Intrafamilial sexual abuse includes incest and refers to any type of exploitative sexual contact occurring between relatives. • Extrafamilial sexual abuse refers to exploitative sexual contact with perpetrators who may be known to the child (neighbors, babysitters, live-in partners) or unknown to the child. • From a legal perspective, harm to the victim is not an element of the crime of child sexual abuse. If certain physical acts occur, the crime is complete. In criminal proceedings it is not necessary to prove that the perpetrator intended to harm or actually harmed the child. • Child sexual abuse can be distinguished from rape in that the perpetrator may use a variety of different “techniques to achieve the objective of sexual gratification.” • Numerous studies indicate that child abusers do not fit any stereotype. • The motivation to abuse a child sexually includes emotional congruence, sexual arousal, and blockage. • Traditionally, the abuser is thought of as a male and the victim as a young female. However, studies indicate that boys may be the victims of sexual abuse at a higher rate than previously thought. • The high-risk years for child sexual abuse range between four and nine years old. • Contrary to popular belief, the actual physical attractiveness of the female child has little if anything to do with whether she becomes a victim of molestation. • Children are at a higher risk of sexual abuse if they are socially isolated or left alone and unsupervised. • Early warnings of sexual abuse may take the form of indirect statements made by the child or acted out in play. • Although not all behavioral patterns will be present in every sexual abuse case, any professional who observes these symptoms should be alert to the possibility of child sexual abuse. • Physical characteristics may suggest that a child has been, or currently is, a victim of sexual abuse. However, lack of any physical findings only means that the acts did not leave any physical evidence. • Unlike rape, few children are brought into an emergency room right after a sexual assault. A child may exhibit behavioral, physical, and/or medical symptoms of abuse, and professionals must be aware of these characteristics. Only by recognizing these indicators of sexual abuse can it be prevented. • No clearly defined pattern or course of conduct leads to sexual child abuse. • Pedophilia is a term used to describe a sexual fixation on young children that is usually translated into sexual acts with the victim. • One of the most common consequences of child sexual abuse is the exhibition of stress. Stress may be classified as acute, secondary, or tertiary. TESTBANK FOR CHAPTER 3 Multiple Choice Questions 1. While the figures may vary from study to study regarding the types and incidents of child sexual abuse, most scholars agree that which of the following commits the most incidents of abuse a. acquaintances of the child b. family members of the child c. strangers d. siblings of the child Answer: b 2. Child sexual abuse includes which of the following conditions a. the offender must be a family member b. there must be actual penetration of the body of the child c. the health or welfare of the child must be harmed or threatened d. the offender must be an adult Answer: c 3. Extrafamilial sexual abuse refers to a. any type of exploitative sexual contact occurring between relatives. b. those members of the family who abuse the child but do not live in the child’s home at the time of the sexual act. c. sexual acts committed by members of the family outside the home. d. exploitative sexual contact with the perpetrator who may be known to the child or unknown to the child. Answer: d 4. Child sexual abuse is distinguished from rape in that a. the perpetrator may use a variety of different techniques to achieve the objective of sexual gratification. b. Rape normally involves sexual acts as the result of force or fear. c. Child sexual abuse may include manipulation of the child. d. all of the above. Answer: d 5. Finkelhor established the Four Preconditions Model of Sexual Abuse Theory, which stated that certain factors or preconditions create a personal and social context for expressing sexually abusive behavior. These factors include a. factors that concern the victim’s ability to resist the sexual advance, factors outside the control of the perpetrator, factors that the perpetrator must overcome internally that would normally prevent him from sexually abusing the child and factors that prevent abuse such as the lack of social support for the mothers. b. factors outside the control of the perpetrator, factors that concern the victim’s ability to resist the sexual advance, factors that the perpetrator must overcome internally that would normally prevent him from sexually abusing the child and motivation to sexual abuse the child. c. factors outside the control of the perpetrator, factors that concern the victim’s ability to resist the sexual advance, and motivation to sexual abuse the child. d. facts that prevent abuse such as the lack of social support for the mothers, the child’s availability, the age and sophistication of the child, and the child’s previous sexual experience. Answer: b 6. Young boys may be victims of child sexual abuse. Which of the following is a reason that they may not report these acts or incidents? a. boys may not want to be viewed as sissies or perceived as weak. b. boys do not normally have to account for their movements to the same degree that young girls do. c. stereotypes lead us to look for sexual abuse with girls, not boys. d. all the above. Answer: d 7. Which of the following is not a behavioral indicator of child sexual abuse? a. fear, inability to trust, anger and hostility and inappropriate sexual behavior. b. depression, guilt or shame and problems in school. c. frequent urinary tract or yeast infection, and stained or bloody underwear. d. somatic complaints, sleep disturbances and regressive behavior. Answer: c 8. When a child has been sexually abused, medical evidence is found a. in only 10 to 50 percent of all cases. b. in all cases where there has been penetration by the perpetrator. c. in 80 to 90 percent of all cases. d. in 80 to 90 percent of cases involving sexual intercourse. Answer: a 9. The prohibition against incest includes which of the following theories? a. multidimensional, multifactor, biological, social and psychological. b. multidimensional, feminist, biological, familial, and psychological. c. feminist, biological, social, psychological and multifactor. d. multifactor, familial, psychological, biological and feminist. Answer: b 10. Obscenity a. is the same as pornography. b. is protected under the First Amendment. c. may be regulated as outside the scope of the First Amendment. d. both a and c. Answer: c 11. The factors that affect the degree of stress or trauma a child victim experiences are s a. type of abuse b. identity of the abuser. c. extent of abuse d. All of the above are correct. Answer: d 12. High-risk years for child sexual abuse are: a. 4-9 years old. b. 2-5 years old. c. 10-13 years old. d. 14-18 years old. Answer: a 13. Tower’s factors which affect the degree of stress or trauma which a child victim may experience may include all but what? a. The identity of the offender or the duration of the abuse. b. The age the abuse started or the extent of the abuse. c. The type of abuse or personality of the child. d. The methodological impact or political context of the abuse. Answer: d True-False Questions 1. The most common initial behavioral indicator of child sexual molestation is fear on the part of the victim. Answer: True 2. If a child has been sexual molested, there will always be physical indicators such as genital bruises or bleeding. Answer: False 3. Most authorities agree that medical evidence is found in only 10 to 50 percent of all child sexual abuse cases. Answer: True 4. Harm to the victim is an element of child sexual abuse. Answer: True 5. Intrafamilial sexual abuse includes incest. Answer: True 6. Touching sexual offenses include fondling. Answer: True 7. Strangers are more often the offenders in child sexual abuse cases. Answer: False 8. Numerous studies indicate that child sexual abusers do not fit any stereotype. Answer: True 9. Nonsexual behavioral indicators in older children include substance abuse. Answer: True 10. Non sexual behavioral indicators in young children include the fear of being left alone. Answer: True Essay Questions 1. Explain Tower’s five phases of child sexual abuse. Answer: Tower's five phases of child sexual abuse describe the process through which an offender gradually gains access to a child and engages in abusive behavior. These phases are: 1. The love and trust phase: The offender gains the child's trust and establishes a close relationship, often by offering attention, affection, and gifts. This phase is characterized by building a bond with the child and gaining their trust. 2. The secrecy phase: The offender works to ensure that the abusive behavior remains hidden from others. This may involve manipulating the child into keeping the abuse a secret, using threats, or making the child feel guilty or responsible for the abuse. 3. The disclosure phase: At some point, the abuse is discovered or disclosed, either by the child or someone else. This phase can be triggered by various factors, such as the child's growing awareness of the abuse, changes in behavior, or external intervention. 4. The suppression phase: After the abuse is disclosed, there may be attempts to suppress or deny the abuse. This can include minimizing the abuse, blaming the victim, or manipulating others to protect the offender. 5. The reenactment phase: In some cases, the offender may repeat the abusive behavior with other victims. This phase reflects a cycle of abuse where the offender continues to seek out and abuse victims. These phases highlight the complex and manipulative nature of child sexual abuse, as offenders often use tactics to manipulate and control their victims while maintaining secrecy to avoid detection. 2. Discuss Goth’s classification of sexual molester. What are the criticisms, if any, of his approach? Answer: Goth's classification of sexual molesters is a widely cited typology that categorizes offenders based on their motivations and behaviors. His typology includes five categories: 1. Fixated Regressed Offenders: These individuals are primarily fixated on children as sexual objects and may have a history of pedophilic behavior. They are often socially isolated and have poor interpersonal skills. 2. Regressed Situational Offenders: This category includes individuals who are not primarily fixated on children but may engage in opportunistic sexual acts with children under certain circumstances, such as when under the influence of alcohol or drugs. 3. Morally Indiscriminate Offenders: These offenders have a general disregard for social norms and may engage in a wide range of antisocial behaviors, including sexual offenses against children. 4. Sexually Indiscriminate Offenders: This category includes individuals who have a high level of sexual arousal but are not specifically focused on children. They may target children due to their vulnerability or availability. 5. Narrowly Fixated Offenders: These individuals have a specific, narrow focus of sexual interest that may include children. They are often socially competent and may hold positions of authority or trust. Criticism of Goth's typology includes concerns about its generalizability and the lack of empirical support for some of the categories. Critics argue that the typology may oversimplify the complex nature of sexual offending and that offenders may exhibit behaviors that do not neatly fit into one category. Additionally, some researchers suggest that the typology does not adequately account for the role of situational factors and individual differences in offending behavior. 3. Compare and contrast the five theories that attempt to explain the prohibition against incest. Answer: Several theories attempt to explain the prohibition against incest. Here are five prominent ones, along with a brief comparison and contrast: 1. Biological Theory: This theory suggests that the taboo against incest has evolved because it helps prevent inbreeding and the negative genetic consequences associated with it. By avoiding mating with close relatives, populations increase genetic diversity and reduce the risk of harmful genetic mutations. This theory is supported by evidence from biology and anthropology. 2. Psychological Theory: According to this theory, the prohibition against incest is rooted in psychological mechanisms that prevent sexual attraction between close relatives. This may be due to the Westermarck effect, which suggests that individuals raised together from an early age are less likely to be sexually attracted to each other. 3. Social-Structural Theory: This theory posits that the incest taboo is a social norm that helps maintain social order and cohesion within families and communities. By prohibiting sexual relationships between close relatives, societies establish rules that promote cooperation and reduce conflict within families. 4. Cultural-Relativist Theory: This theory argues that the prohibition against incest is not universal but varies across cultures. It suggests that cultural norms and beliefs play a significant role in shaping attitudes towards incest and that the taboo may be stronger in cultures where it is more strongly enforced. 5. Evolutionary-Psychological Theory: This theory combines elements of biological and psychological explanations, suggesting that the incest taboo has evolved as a result of both genetic and cultural factors. It argues that while biological mechanisms may predispose individuals to avoid incest, cultural norms and beliefs reinforce and institutionalize this prohibition. In comparing these theories, it is evident that they differ in their emphasis on biological, psychological, and cultural factors. The biological theory focuses on genetic diversity and inbreeding avoidance, while the psychological theory emphasizes psychological mechanisms such as the Westermarck effect. The social-structural theory highlights the role of social norms in maintaining social order, while the cultural-relativist theory acknowledges the variability of incest taboos across cultures. The evolutionary-psychological theory seeks to integrate these various factors into a comprehensive explanation of the prohibition against incest. 4. Compare and contrast pornography and obscenity. Answer: Pornography and obscenity are often used interchangeably, but they have distinct meanings and legal implications. Here's a comparison and contrast of the two: 1. Definition: • Pornography: Generally refers to sexually explicit material intended to arouse sexual desire. It often includes images or descriptions of sexual acts. • Obscenity: Refers to material that is considered offensive, vulgar, or morally repugnant. It is often defined by community standards regarding what is acceptable or offensive. 2. Legal Status: • Pornography: In many jurisdictions, pornography is legal as long as it does not involve minors or non-consensual acts. It is protected by the First Amendment in the United States. • Obscenity: Obscenity is illegal in many jurisdictions and is not protected by free speech laws. However, the definition of obscenity can vary widely and is often subject to interpretation. 3. Purpose: • Pornography: The primary purpose of pornography is to sexually arouse or titillate the audience. • Obscenity: Obscenity does not necessarily have a specific purpose beyond being offensive or morally objectionable. 4. Subjectivity: • Pornography: The classification of material as pornography can be subjective and may vary depending on cultural and personal beliefs. • Obscenity: The determination of whether material is obscene is often based on community standards, which can also be subjective. 5. Regulation: • Pornography: Pornography is often regulated to ensure that it does not violate laws regarding obscenity, child pornography, or non-consensual acts. • Obscenity: Obscenity is regulated more strictly and may be subject to censorship or legal action if deemed obscene. In summary, while both pornography and obscenity deal with sexually explicit material, pornography is generally legal and protected by free speech laws as long as it does not violate other laws, such as those regarding obscenity or exploitation. Obscenity, on the other hand, is considered morally repugnant and is often subject to stricter legal regulation and censorship. 5. What are Conte’s characteristics of child sexual abusers? Answer: Conte identified several characteristics of child sexual abusers: 1. Emotional congruence: Abusers often lack the ability to appropriately express their emotions and may seek emotional fulfillment through inappropriate relationships with children. 2. Sexual arousal: Abusers are typically sexually aroused by children and may have a primary or exclusive sexual interest in them. 3. Blockage: Abusers may have difficulty forming appropriate adult sexual relationships and may use children as a substitute due to emotional or physical limitations. 4. Distorted beliefs: Abusers often have distorted beliefs about children, sex, and relationships, which justify their abusive behavior. 5. Empathy deficit: Abusers may lack empathy for their victims and fail to recognize the harm caused by their actions. 6. Intimacy deficits: Abusers often have difficulties forming healthy, intimate relationships with adults and may use children to fulfill their need for intimacy. 7. Sexual compulsivity: Abusers may have a compulsive need for sexual gratification and use children as a means to fulfill this need. 8. Cognitive distortions: Abusers may distort reality to justify their abusive behavior, such as believing that the child seduced them or enjoyed the abuse. These characteristics can help identify individuals who may be at risk of sexually abusing children and inform interventions to prevent abuse. Test Bank for Family Violence: Legal, Medical, and Social Perspectives Harvey Wallace, Cliff Roberson 9780205959877
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