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Victimization of Persons with Traumatic Brain Injury Or Other Disabilities: a Fact Sheet for Professionals

Victimization of Persons with Traumatic Brain Injury Or Other Disabilities: a Fact Sheet for Professionals

Victimization of Persons with Traumatic Brain Injury or Other : A Fact Sheet for Professionals

What is victimization?

According to the U.S. Department of • Emotional occurs when a Justice (2004), victimization occurs when person is “threatened, terrorized, “…a person suffers direct or threatened or severely rejected, ignored, or physical, emotional, and/or financial verbally attacked.”(Nosek et al. harm.” Victimization can include physical 2001) It includes, but is not limited to, , sexual violence, psychological “episodes of yelling, , or acts or emotional abuse, and . The meant to humiliate or hurt feelings.” Centers for Disease Control and Prevention (Curry et al. 2003) (CDC) acknowledges such victimization as a serious and preventable public • Neglect is a “situation in which the problem. basic needs of a person (such as food, clothing, hygiene, protection, • is “the intentional Physical violence or medical care) are temporarily or use of physical force with the potential permanently not met.”(Verdugo and for causing death, , injury, Bermejo 1997) It includes, but is not or harm.”(Rosenberg and Mercy limited to, “preventing a person with 1991; CDC 2006) It includes, but is disabilities from using a wheelchair, not limited to, “scratching, pushing, cane, respirator, or other assistive shoving, throwing, grabbing, biting devices as well as failure to address choking, shaking, slapping, punching, basic needs for food, clothing, shelter, burning, use of a weapon, and or hygiene.”(McFarlane et al. 2001) use of restraints or one’s body, size, or strength against another

person.”(CDC 2006)

• Sexual violence is “the use of physical force to compel a person to engage in a sexual act against his or her will, whether or not the act is completed; an attempted or completed sex act involving a person who is unable to understand the nature or condition of the act, to decline participation, or to communicate unwillingness to engage in the sexual act; and abusive sexual contact.” (CDC 2004)

 What is the extent Who commits acts of of the problem? victimization?

Current knowledge about victimization of persons • More men than women, either as intimate with disabilities is based on a small number of partners or as workers (Brown studies, and little is known about victimization of and Turk 1994; Marley and Buila 2001), are important groups such as persons with traumatic reported to commit acts of physical violence, brain injury (TBI) (Marge 2003). sexual violence, emotional abuse, or neglect against persons with disabilities. • Persons with disabilities are 4 to 10 times more • members have been reported to commit likely to become a victim of violence, abuse, of victimization while caring for a or neglect than persons without disabilities relative with disabilities (Milberger et al. 2003; (Petersilia 2001). Stromsness 1993). • Children with disabilities are more than twice • Personal home care attendants (Oktay and as likely to be physically or sexually abused as Tompkins 2004; Saxton et al. 2001) or health children without disabilities (Petersilia 2001; care workers at institutions (Brown and Turk Sobsey and Mansell 1994). 1994; Sequeira and Halstead 2001) have • Similar proportions of women with and without been reported to perpetrate emotional disabilities report having experienced episodes abuse and sexual violence against persons of physical violence, sexual violence, or with disabilities. emotional abuse (Sobsey and Mansell 1994). • In institutional settings, persons with disabilities Women with disabilities, however, report may commit acts of physical violence or sexual greater numbers of perpetrators and longer violence against other persons with disabilities time periods of episodes than women (Sobsey and Doe 1991). without disabilities (Young et al. 1997).

Where does victimization occur? What factors make a person with disabilities • Victimization can occur anywhere; however, it susceptible to victimization? usually happens in isolated locations where a person with disabilities has little or no control of Societal Factors: the environment (Sobsey and Mansell 1994), • Misperceptions about disability include and the setting is away from the view of law “having a disability protects a person from enforcement (Verdugo and Mermejo 1997). victimization”; the risks to a person with • Institutional settings are risk locations for disabilities are to be less than the risks persons with disabilities because multiple to a person who has none (Young et al. 1997). episodes of physical and sexual violence, • Unemployment or underemployment of emotional abuse, neglect, or violence may persons with disabilities restricts their income be committed against them by staff or other and limits their choices for caregivers, residents and yet go undetected or unreported leading to an increased risk of physical and (Sobsey and Mansell 1994; Brown and Turk sexual violence, emotional abuse, or neglect

1994; Turk and Brown 1993). (Stromsness 1993).

• Lack of money often causes persons with disabilities to live in areas where rates are high and the potential for physical and sexual violence is greater than in wealthier neighborhoods (Curry et al. 2001).

 Community Factors: • Community resources for victims of physical and • TBI outcomes others’ perceptions of a sexual violence, emotional abuse, or neglect person’s ability to honestly and accurately report are usually designed to assist people without an incident of victimization (DOJ 1998). disabilities (Swedlund and Nosek 2000; Chang et al. 2003; Cramer et al. 2003). Organizations • Persons with TBI or other disabilities may that provide such resources do not routinely experience physical and sexual violence, collaborate with organizations that assist emotional abuse, or neglect by a caregiver persons with disabilities (Curry et al. 2001; in return for access to medication, adaptive Swedlund and Nosek 2000; Chang et al. 2003). equipment, or assistance with activities of daily life (Oktay and Tompkins 2004). • Frequently, health care (Swedlund and Nosek 2000; Chang et al. 2003; Cramer et al. 2003) and law enforcement (DOJ 1998) professionals are uninformed about victimization of persons Individual Factors: with disabilities. Thus, they may not have the • A TBI can cause cognitive problems that specialized knowledge or skills to identify and reduce one’s ability to perceive, remember, or assist these when victimized. understand risky situations that could lead to an incident of physical or sexual violence (Kim What factors make a person 2002; Levin 1999). with a traumatic brain injury, or • Persons with a TBI may engage in at-risk TBI, susceptible to victimization? drinking or drug use that place them in situations or relationships that lead to episodes of Relationship Factors: victimization (Kwasnica and Heinemann 1994; Li et al. 2000). • Persons living with a TBI often have difficulty with management, which may prompt • In some persons, a TBI causes uninhibited others to use undue physical force or that lead to risky sexual engagement, inappropriate medication (Kim 2002). exposing them to HIV/AIDS or other sexually transmitted diseases (Jaffe et al. 2000; Kramer • Misperceptions about TBI and its effects may et al. 1993). lead to treatment that is demeaning or abusive (Sequeira and Halsted 2001).

Information and Support

Brain Injury Association of America 800-444-6443 www.biausa.org At the national and state level, the Association serves as a clearinghouse for community service information for persons with TBI, their , and sponsors of educational programs. Defense and Veterans Brain Injury Center 800-870-9244 www.dvbic.org Serves active-duty and veterans who acquired TBI in the 662-6345 (DSN) line of duty; provides medical care and educational programs for them and their dependents. National Disability Rights Network 202-408-9514 www.ndm.org Voluntary association of protection and advocacy systems and client- 202-408-9521 assistance programs. Promotes rigorous enforcement of laws protecting the (TTY) civil and rights of persons with disabilities, including those with TBI. National Hotline 800-799-SAFE www.ndvh.org Provides information and advice about domestic violence; makes referrals to 800-787-3224 local resources and shelters. (TTY)



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