Women suffer adverse health consequences due to battering and other forms of abuse. As a result, domestic violence has been identified as a significant public health problem in the United States.34 The risk for abuse, effects of abuse on health, and barriers to seeking help for disabled women remain largely undocumented.31
The literature on women in general indicates that domestic violence and other forms of abuse result in:
medical complaints 39-41
drug and alcohol abuse36,39,42
Sexual abuse survivors may experience:
chronic anxiety and tension44
anxiety attacks and phobias
sleep and appetite disturbance
Many survivors also have more medical complaints including:
It is important to note that many of these conditions are already more prevalent among women with disabilities, making it more likely for physicians to attribute causation to the disability and fail to pursue abuse as a possible cause. Survivors also experience exaggerated feelings of guilt and shame, negatively affecting their self-esteem and enhancing feelings of worthlessness.45 These feelings often result in poor body image, leading to obesity or eating disorders.40,46-47 Self-destructive behavior, self mutilation, drug abuse, and alcoholism occur more frequently than among non-abused women.36,39,42 A history of abuse may have serious effects on a woman's relationship and sexuality issues, engendering feelings of passivity, powerlessness, lack of trust, and isolation. Left untreated, sexual abuse may lead to serious psychological sequelae.38
Based on excerpts from Nosek, M.A., Hughes, R.B., Taylor, H.B., Howland, C.A. (2004) Violence against women with disabilities: The role of physicians in filling the treatment gap. In: S.L. Welner and F. Haseltine (Eds.) Welner's Guide to Care of Women with Disabilities.(pp. 333-345) Lippincott, Williams & Wilkins, Philadelphia.
31. Hassouneh-Phillips D, Curry MA. Abuse of women with disabilities: State of the science. Rehabilitation Counseling Bulletin, 2002, 45, 96-104.
32. Hughes RB, Taylor HB, Shelton ML, Nosek MA. Dynamics of violence against women with disabilities: A qualitative study (in preparation). 2003.
33. Centers for Disease Control and Prevention. Webcast: Sexual violence prevention: Building leadership and commitment to underserved communities. Accessed April 3, 2003.
34. U.S. Department of Health and Human Services. Disability and secondary conditions. In Healthy people 2010. Washington, DC: U.S. Department of Health and Human Services, 2000.
35. Kellerman A, Mercy J. Men, women, and murder: Gender-specific differences in rates of fatal violence and victimization. Journal of Trauma, 1992, 33, 1-5.
36. Finkelhor D, Araji S, Baron L, Browne A, Peters SD, Wyatt GE. Sourcebook on child sexual abuse. Newbury Park, CA: Sage, 1986.
37. Murphy PA. Taking an abuse history in the initial evaluation. NARPPS, 1992, 7, 187-190.
38. Ratican KL. Sexual abuse survivors: Identifying symptoms and special treatment considerations. J Counsel Dev, 1992, 71, 33-38.
39. Faria G, Belohlavek N. Treating female adult survivors of childhood incest. Social Casework, 1984, 65, 465-471.
40. Courtois CA, Watts DC. Counseling adult women who experienced incest in childhood or adolescence. The Personnel and Guidance Journal, 1982, 60, 275-279.
41. Cunningham J, Pearce T, Pearce P. Childhood sexual abuse and medical complaints in adult women. Journal of Interpersonal Violence, 1988, 3, 131-144.
42. Briere J, Zaidi LY. Sexual abuse histories and sequelae in female psychiatric emergency room patients. Am J Psychiatry, 1989, 146, 1602-1606.
43. Browne A, Finkelhor D. Impact of child sexual abuse: A review of the research. Psych Bull, 1986, 99, 66-77.
44. Briere J, Runtz M. Symptomatology associated with childhood sexual victimization in a nonclinical adult sample. Child Abuse & Neglect, 1988, 12, 51-59.
45. Bradshaw JS. Healing the shame that binds you (Cassette Recording No. 1-55874-043-0). Deerfield Beach, FL: Health Communications, 1989.
46. Gordy P. L. Group work that supports adult victims of childhood incest. Social Casework, 1983, 64, 300-307.
47. Kearney-Cooke A. Group treatment of sexual abuse among women with eating disorders. Women and Therapy, 1988, 7, 5-21.