Children who are victims of domestic violence are frequently injured attempting to protect their mother from an abusive partner. Injuries are visible by inspection or self-report. Physical abuse of an adult may be also be evident by inspection with visible cuts and/or bruises or self report.
Sexual abuse of both a child and an adult can be diagnosed with a history from the victim. Victims can be assessed for ejaculatory evidence from the perpetrator. Ejaculatory specimens can be retrieved from the mouth, rectum, and clothing. Tests for sexually transmitted diseases may be performed.
Elderly abuse can be suspected if the elderly patient demonstrates a fear from the caretaker. Additionally, elderly abuse can be suspected if there are signs indicating intentional delay of required medical care or a change in medical status.
Substance abuse can be suspected in a person who continues to indulge in their drug of choice despite recurrent negative consequences. The diagnosis can be made after administration of a comprehensive bio-psychosocial exam and standardized chemical abuse assessments by a therapist.
Children who are victims of physical or sexual abuse typically require psychological support and medical attention. A complaint may be filed with the local family social services that will initiate investigations. The authorities will usually follow up the allegation or offense. Children may also be referred for psychological evaluation and/or treatment. The victim may be placed in foster care pending the investigation outcome. The police may also investigate physical and sexual abuse of an adult. The victim may require immediate medical care and long-term psychological treatment. It is common for children to be adversely affected by domestic violence situations and the local family services agency may be involved.
Substance abusers should elect treatment, either inpatient or outpatient, depending on severity of addiction. Long term treatment and/or medications may be utilized to assist in abstinence. The patient should be encouraged to participate in community centered support groups
The prognosis depends on the diagnosis. Usually victims of physical and sexual abuse require therapy to deal with emotional distress associated with the incident. Perpetrators require further psychological evaluation and treatment. Victims of abuse may have a variety of emotional problems including depression, acts of suicide, or anxiety. Children of sexual abuse may as adults enter abusive relationships or have problems with intimacy. The substance abuser may experience relapses, since the cardinal feature of all addictive disorders is a tendency to return to symptoms. Elderly patients may suffer from further medical problems and/or anxiety, and in some cases neglect may precipitate death.
Prevention programs are geared to education and awareness. Detection of initial symptoms or characteristic behaviors may assist in some situations. In some cases treatment may be sought before incident. The professional treating the abused persons must develop a clear sense of the relationship dynamics and the chances for continued harm.