Lecture 13: Sexual Assault And Abuse PDF

Lecture 13: Sexual Assault and Abuse Today’s Objectives 1. Identify: Categories of abuse. 2. Recognize: Human, physical, and psychological dynamics of rape. 3. Discuss: Paramedic roles in caring for rape/sexual assault victims....

Lecture 13: Sexual Assault and Abuse Today’s Objectives 1. Identify: Categories of abuse. 2. Recognize: Human, physical, and psychological dynamics of rape. 3. Discuss: Paramedic roles in caring for rape/sexual assault victims. 4. Discuss: Therapeutic approaches to sexual assault victims. Phases of Violence Tension Phase Triggering event precipitates this phase; tension builds. Abuser starts losing control: Verbally humiliates the abused. Blames the abused for the situation. Verbal assaults and threats escalate to pushing or slapping. Abused attempts to placate the abuser (coping mechanism). Emotional and psychological detachment of the abused increases. Crisis Phase Anxiety reaches its peak; abuser becomes unpredictable. Assaults range from minor (repeated over time) to major, potentially causing serious injury or death. Lasts minutes to hours. Abuser may isolate or restrain the abused. Lecture 13: Sexual Assault and Abuse 1  The abused adapts to survive, may escape temporarily but often returns after the crisis ends. Calm Phase Abuse stops temporarily. Abuser asks for forgiveness and shows loving behavior but still blames the abused. Both abuser and abused feel relief that the crisis is over but are emotionally and physically exhausted. Abused wants to believe the abuse will not recur. Profile of Abusers Low self-esteem and feelings of powerlessness. Blames others for their actions (projection). Lacks confidence and struggles with close relationships. Feels threatened easily. Uses violence to assert power and control. Manipulative; minor events trigger abusive episodes. Four Types of Abuse 1. Intimate Partner Violence Definition (CDC): Physical, sexual, stalking, or psychological violence directed at a current/former partner or spouse. Can occur in heterosexual or same-sex relationships, with or without sexual intimacy. Forms: Physical Violence: Harming a partner using physical force. Lecture 13: Sexual Assault and Abuse 2  Sexual Violence: Forcing/attempting sex acts, touching, or sexting without consent. Stalking: Unwanted, repeated attention causing fear. Psychological Aggression: Harmful verbal/non-verbal communication to exert control. 2. Child Abuse Deliberate harm/injury inflicted by parents/caregivers. Forms: Neglect: Failing to provide basic needs. Physical Injury: Serious bodily harm. Mental Injury: Psychological/intellectual harm. Sexual Abuse: Coercing children into sexual conduct (e.g., molestation, exploitation). 3. Elder Abuse Harm/neglect inflicted on individuals aged 60 or older. Includes physical, psychological, neglect, sexual abuse, financial exploitation, and rights violations. Frequently underreported. 4. Rape Definition: Forcible sexual intercourse with an unwilling partner. Includes sodomy, and it is a violent act, not a sexual one. Facts: Never invited by dress/behavior. Victims (survivor): if they died and were raped than they would be surveyors, span all demographics, including infants, elderly, LGBTQ2+, and disabled individuals. Lecture 13: Sexual Assault and Abuse 3  Predominantly affects women and girls but can also occur in men and boys. Statistics on Sexual Assault Canada (2020): Rates of sexual assault vary by province (e.g., highest: Nunavut; lowest: Prince Edward Island). Demographics: 98% of perpetrators are male (2001 data). 70% of perpetrators are known to the victim. 6/10 victims in 2020 were under 17. 83% of women with disabilities report sexual assault during their lifetime. Three Types of Rapists 1. Angry Rapist: Displaces anger onto the victim. Uses excessive physical force and degrades the victim. 2. Power Rapist: Most common; uses minimal force to subdue the victim. Seeks control and dominance. 3. Sadistic Rapist: Least common; aggression is sexually gratifying. Aroused by the victim’s pain or death. Four Crisis Stages in Recovery from Rape 1. Shock/Disbelief/Fear: Lasts 2–3 weeks. 2. Adjustment: Denial is common; outward behavior may seem normal. Lecture 13: Sexual Assault and Abuse 4  3. Depression: Self-doubt, anxiety, and the need to discuss the event. Sleep disturbances are common. 4. Recovery: Recognizes abuser’s responsibility; rebuilds trust and comfort. Recovery Factors How others respond: (if others have either positive or negative reaction to your problem, it could determine whether you recover or not) Survivor’s personal development. Participation in crisis counseling. Indicators of Abuse Behavioral: Aggression, withdrawal, unusual sexual knowledge in children. Physical: Burns, bruises, genital injuries, unplanned pregnancies. Emotional: Escapism into fantasy. Legal Obligations (BLS Standards) Mandatory Reporting: Child in need of protection must be reported to CAS. Key Findings to Report: Submersion injuries, burns, poisonings, falls. Signs of abuse or neglect. Scene observations indicating violence, substance abuse, or neglect. Treatment of the Sexual Assault Victim Approach slowly and calmly. Gain consent and reassure safety. Assess for critical injuries/illnesses. Encourage hospital assessment and treatment. Lecture 13: Sexual Assault and Abuse 5  Discourage washing or altering the scene to preserve evidence. Avoid implying blame on the patient. What Happens at the Hospital Examination: Physical and covert injuries. Evidence Collection: Hair, body fluids, clothing. Treatment: For unwanted pregnancy or STDs. Referrals: Counseling services. Lecture 13: Sexual Assault and Abuse 6