Society For Assistance International
 
  VIOLENCE

Violence is a threat or actual physical force against a person or a group that results in injury, morbidity or death.

Violence:

  1. Physical is the most common at 65%
  2. Aggravated assault 18%
  3. ommunity Violence
  4. school Violence
  5. Intimate partner Violence/ Dating Violence
  6. Media Violence
  7. Work place Violence
  8. Youth Violence
  9. Sexual Assault 6%
11% of all murders are secondary to violence.30% of these are female victims nationwide.

Domestic Violence:

Domestic violence and child abuse go together. 50% of the times wife/spouse or children are abused at the same time. CPS and Family violence squad do not work together most of the times. Impact of witnessing violence by the children is similar to having been abused. Approximately 9 million children witness domestic violence. This is creating a cycle of youth and subsequent adult violence. Singer did a study on 3,735 students and came to the conclusion that " Being a recent victim or witnessing a violent act is strongly associated with youth violence". 80-90% of the children are usually aware of the violence at home Factors that adversely affect are similar to that of child abuse; Drug use, Alcohol abuse, Psychopathic personalities, frustration, depression, poverty, Social isolation, poor resources, illiteracy, poor community support, etc.,. Children witnessing and growing up with survival skills in the midst of violence are growing up awaiting for their chance to use physical force as a problem solving strategy and the " CYCLE OF VIOLENCE" continues in the society.

Intimate Partner Violence:

By a current or former boy friend, spouse, dating heterosexuals / homosexuals. Uses threats, abuse, physical force, and emotional/verbal abuse. Abuser struggles for power or control. Victims are usually 85% of the times women and 3% men. Risk factors are similar to Domestic Violence. Of 22.3 million children in USA, 9 million witness domestic violence, 3.9 million sustain serious injury, 1.8 million sexually assaulted.

Dating Violence:
Under reported.
22% are school aged and 32% are college bound. Physical, sexual and verbal assaults are common mode. Risk factors include , Young age of menarche, dating, early sexual activity, aggressive sexually active peer group, Past history of sexual assault and finally drug and alcohol use.

School Violence:
In general schools provide a buffer for the abused children, now there has been recent increase in school violence 1999-2001.Still schools are considered as a safe place. Less than 1% of total murders are school related. 1995-1996 49 deaths at school vs 34 deaths in 1999. Non fatal injuries are 43/1000. Serious crime like rape, assault, robbery, aggravated battery 9/1000. Weapon threats 7-8/1000. Violence against teachers was 4/1000. 4% were attacked and 12% were threatened.

Types of violence

  1. Shootings and murder
  2. Assaults with or without weapons
  3. Gang violence
  4. Physical threats
  5. Hostile threats
  6. Destructive acts
  7. Bullying and physical fights
  8. Hostile remarks
  9. Gang violence.
  10. School violence is a reflection of violence stemming from domestic problems and ultimately trickling into the community as community violence.
Media Violence:
TV VCR terrorism truth
violence - virtues
vices - values
crime character
rape responsibility.
Average child watches 3-4 hrs of television per day An average 18 year old would have watched 200,000 acts of violence on TV even without any influence of domestic violence in personal life. Gives an opinion that the " World is a bad place and the way of sustenance is through power of physical force and violence".

IMPACT OF TRAUMA / VIOLENCE ON THE BRAIN

  • Biological Relativity.
  • Culture and experience
  • Behavior and development
  • Experience is the key to the individuality and growth
  • Individual, family and community are the biological units of the society.
  • Growth includes a constant learning process.
  • Human culture is a product of group thoughts, acts and experience.
  • Modern technological advances and monetary needs place great demands on the individual and the family.
  • Various activities for the adults and children; time spent as a family with communications is shrinking.
  • What is the impact of the modern demands?
  • What is the role for parents in making adjustments to connect with the children?
  • What is the role for the modern parent(s) in optimizing the windows of opportunity for brain growth in nurturing and empowering the children with self respect, self confidence with humility to succeed as a wholesome person?
  • How can the child become immune to the massive violence surrounding him/her?
  • How can we be human and maintain the core human values in the society? If a child in the family grows up with morally sound values that promote creativity, self confidence and humility with determination to succeed with discipline of the mind and body, automatically the societal norms will be morally sound.
Mental functional status is the result of
  • Dynamic neurodevelopmental functional organization is a use dependent, experience based phenomenon.
  • Behavior is the result of this state dependent organization of the brain. Adverse experiences will have profound negative impact on the Cognitive, social, physical, neuro physiological, cultural, intellectual, emotional functioning of the child.
Effect of Trauma:
  • Acute
  • Chronic
  • Predictable and unpredictable
What activates a stress response? Perceived, actual or posed threat. Actual stress response and Homeostasis.

Influences

  1. individual
  2. heterogeneous influences
  3. intensity
  4. duration
  5. timing and context
  6. pattern
  7. individual goals, coping skills and support systems
  8. age of occurrence
  9. history of previous trauma
Two most important responses individually and in combination is Acute trauma induced HYPER AROUSAL and HYPER AROUSAL CONTINUUM. ACUTE DISSOCIATION and DISSOCIATION CONTINUUM.
Three areas are involved: brain stem, HPA axis, and A.N.S.

Changes occur in the following areas:
Physical : Attention to avert danger , attention to warding off danger. Also a freezing phenomenon
Physiological changes: Rapid heart rate, increased BP, RR, Temp.,.
Emotional : Anxiety, alarm, fear, sleep disorder, phobias, calm, vigilance, anxiety, loss of control to terror and complete dissociation.
Cognitive: Associations are poor as the brain is blocking any sensible information other than avoiding injury.
Behavioral: Hyperactive, oppositional, irritable, hypersensitive, night terrors Impulsive.
V-P split is common

Dissociation: A symptom complex of disengagement Dopaminergic, endogenous opiod, response. Altered pain perception, Altered sense of time, place and person. Altered sense of reality
Dissocaitive symptoms
Dissociative disorders
Freezing /ODD

Protective and risk factors:

  1. Age, time and context of occurrence
  2. Physical threat, loss of limb etc.,.
  3. Family level of functioning.
  4. Number, nature and pattern of trauma
  5. Early intervention, avoiding re sensitization responses.
  6. DO not like the loss of control, so bring them to feel the control.
Clinical presentation:
Behavioral: aggressive, anti social, hyperactive, impulsive or withdrawal.
Emotional: anxiety, mood irritability, depression, PTSD. Social: watch violence and use violence to solve problems
Cognitive: lower verbal and better performance skills; usually poor.
Long term : PTSD/Depression
These can be chronic symptoms of
REENACTMENT: a willful, negative attention seeking behavior, aggressive predatory and assaultive.
REGRESSIVE: defensive, fearful, anxious, purposeless.

Clinical Intervention
For intervention to help, mind needs to be calm.
Most of the symptoms are from the brain stem and mid brain level.
Brain region that is not used should be brought into cognize with trust, love and calm ness of mind. Talking will not help.
Therapy should be brain region directed.
Cognitive association with life application of goal directed, positive biofeed back need to be used.

Self audit
Belief that the whole world is not violent should be realized.
Self respect taught through love, peace and trust with life application of positive thoughts.
Predictable, nurturing environment is provided.
Family should get involved.
Building a trusting relationship is the key to successful intervention.
Al of the above will soften the anxiety and potentially will reroute the ND organization in the organizing brain.
Psychotherapy, Individual, Family and Group.
Psychopharmacotherapy.

Violence is a learned behavior and youth are the solution for youth violence.
Spectrum of Prevention:

  1. Provide individual knowledge and skill : Self protection against injury.
  2. Promote community education: Projects for peer, professionals
  3. Educating providers: Knowledge and skill that can be transmitted.
  4. Fostering coalitions and networks: Bring individuals & groups for brain storming for more ideas
  5. Change organizational practices: Create new models of care, health and safety.
  6. Influence policy makers: Bring about new legislation.
Give youth chance to show talents and skills. Alternate vocational therapy needs to be encouraged to build the strengths of the individuals.
Focus in the training period on the life application of academic curriculum, so that the knowledge makes sense to the student.
Unite communities through interdependent service. Create cooperative opportunities than competing with the skills.

Mental health is an essential part of the individual health. It decides on our communication skills, how we socialize, work, and resolve conflicts. Our ability to learn and engage in meaningful employment is also dependent on good mental health. It help to respond and react adaptively to stress. Positive interpersonal relationships depend on healthy mind and heart.
" Tell me your company, I will tell you what you are."

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