Silence Hurts
Alcohol Abuse and Violence Against Women

Supplements

Assessing Physical Abuse

Have you been physically injured by intimate partner violence?1

If you are in an abusive relationship, the injuries that typically result include the following (check off those that apply using the scale below):

1 = Does not apply
2 = Once, but not serious
3 = Once and needed medical care
4 = Two to four times
5 = Two to four times and needed medical care
7 = Five or more times and needed medical care

Physical Injuries

_____ Bruises

_____ Bleeding, cuts, lacerations

_____ Swelling and pain

_____ Nose bleeds

_____ Unconsciousness, concussion, and other head injuries

_____ Injuries to the neck and throat

_____ Injuries to extremities (arms, legs)

_____ Injuries to trunk area

_____ Black eyes, ear problems, and facial injuries

_____ Broken bones (jaw, nose, rib, arms, legs, fingers, etc.)

_____ Scratches on body

_____ Muscle sprains and torn ligaments

_____ Spinal and back injuries

_____ Internal injuries (requiring surgery)

_____ Burns

_____ Hair loss

_____ Chronic pain (neck, back, headaches)

_____ Chronic Temporomandibular Joint Disorder (TMJ)

_____ Broken/missing teeth

_____ Internal bleeding

_____ Permanent physical disability

_____ Suicide attempts

_____ Gunshot wounds

_____ Knife wounds

_____ Miscarriage/abortion

_____ Vaginal and perineal tears and other injuries of sex organs

_____ Breast mutilation

_____ Sexually transmitted disease

_____ HIV/AIDS transmission and complications

_____ Exacerbation of stress-based illnesses

[1] Created by Dr. Lenore Walker, Domestic Violence Institute, Denver, Colorado.

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