2. Indicators

‘When assessing your patient… remember that most presentations of family violence are probably hidden and not the obvious black eye.’

The following are indicators associated with victims of family violence.

Indicators in adults Indicators in children

Physical

  • Unexplained bruising and other injuries
  • Bruises of various ages
  • Head, neck and facial injuries
  • Injuries on parts of the body hidden from view (including breasts, abdomen and/or genitals), especially if pregnant
  • ‘Accidents’ occurring during pregnancy
  • Miscarriages and other pregnancy complications
  • Injuries to bone or soft tissues
  • Injuries sustained do not fit the history given
  • Bite marks, unusual burns
  • Chronic conditions including headaches, pain and aches in muscles, joints and back
  • Ulcers
  • Dizziness
  • Sexually transmitted disease
  • Other gynaecological problems

Psychological / behavioural

  • Emotional distress e.g. anxiety, indecisiveness, confusion, and hostility
  • Sleeping and eating disorders
  • Anxiety / depression / pre-natal depression
  • Psychosomatic and emotional complaints
  • Drug abuse
  • Self-harm or suicide attempts
  • Evasive or ashamed about injuries
  • Multiple presentations at the surgery /  client appears after hours
  • Partner does most of the talking and insists on remaining with the patient.
  • Seeming anxious in the presence of the partner.
  • Reluctance to follow advice
  • Social isolation / no access to transport
  • Frequent absences from work or studies
  • Submissive behaviour / low self esteem
  • Alcohol or drug abuse

Physical

  • Difficulty eating / sleeping
  • Slow weight gain (in infants)
  • Physical complaints
  • Eating disorders

Psychological / behavioural

  • Aggressive behaviour and language
  • Depression, anxiety and/or suicide attempts
  • Appearing nervous and withdrawn
  • Difficulty adjusting to change
  • Regressive behaviour in toddlers
  • Delays or problems with language development
  • Psychosomatic illness
  • Restlessness and problems with concentration
  • Dependent, sad or secretive behaviours
  • Bedwetting
  • ‘Acting out’, for example cruelty to animals
  • Noticeable decline in school performance
  • Fighting with peers
  • Over protective or afraid to leave mother
  • Stealing and social isolation
  • Abuse of siblings or parents
  • Alcohol and other drug use
  • Psychosomatic and emotional complaints
  • Exhibiting sexually abusive behaviour
  • Feelings of worthlessness
  • Transience

Figure 1: indicators associated with victims of family violence.

‘Frequently there are no visible signs of assault or rape in domestic violence presentations. This does not mean that the emotional or psychological effects of the assault are… any less devastating to the victim.’

  1. What is family violence?

3. How to ask your patient  


[6] Kelsey Hegarty, ‘Identification and management role of GPs for women experiencing partner abuse’(Paper presented at the 25th Congress Medical Women’s International Association, Sydney, 19 April 2001) 1, available at http://www.regional.org.au/au/mwia/papers/full/17_hegarty.htm
[7] Jane London, above n 2, at 7.