Physicians can broaden their knowledge of domestic violence and earn two continuing medical education credits at no charge in an online course at www.dvcme.org.

The curriculum explores the nature and dynamics of domestic violence; screening, assessment, and documentation; presentations and assessment in the clinic; safety planning; referrals; legal aspects of domestic violence; child victims of domestic violence; and the perpetrator. Men and women who have survived domestic violence discuss their experiences in video and audio reports.

The course was developed for the American Medical Women’s Association with funding from the U.S. Department of Justice. Its codirectors are psychiatrist Marjorie Braude, M.D., of Los Angeles and emergency medicine specialist Peggy Goodman, M.D., of Greenville, N.C. Psychiatrist Carole Warshaw, M.D., of Chicago serves as a consultant. Course contents are adapted from manuals of the Family Violence Prevention Fund.

About 100 physicians have completed the course since its launching in December 1999, Braude said, and 12,000 people have reviewed sections of the site. They include medical students and residents, social workers, police officers, and others working with victims and perpetrators of domestic violence. The Web site is linked to and recommended by the American Society of Emergency Physicians, the American Pediatric Society, and the American Medical Association.

Psychiatrists may be especially interested in Unit 3, which aims to help users in various specialties assess behavioral, psychological, and substance abuse presentations. This section notes, for example, that some symptoms that psychiatrists and mental health professionals are trained to describe as manifestations of psychological illness are normal responses to repeated physical and psychological attack. "One should be very reserved about assigning psychiatric diagnoses to describe these behaviors," the text cautions.

"A woman who is living in a situation of repeated and often unanticipated physical pain and injury, as well as emotional abuse, often feels depression, anxiety, and experiences disturbed sleep," it states. "Many women may also be experiencing an acute traumatic response, as well as PTSD from their past episodes of trauma. Some women may dissociate from parts of the experience. A woman may try to numb the pain and fear with substance abuse. All or part of her behavioral symptoms may leave when she acquires safety."

The study guide describes how psychiatric concepts and treatments can be used to help victims recover.

Plans are under way, Braude said, to add more case material and make the site more interactive. "A Web site," she said, "is always a work in progress."

Information on domestic abuse is available from the National Domestic Violence Hotline by phone at (800) 799-7233 and on the Web at www.ndvh.org; and the National Resource Center on Domestic Violence by phone at (800) 537-2238. ▪