A more inclusive categorization of abuse involves physical abuse, sexual abuse, emotional abuse, neglect, and financial exploitation. The wide variation in estimates of individuals who have suffered violence at the hands of family members and significant others is related to several factors. These factors include fear of reporting the problem, shame of having to acknowledge the person responsible, unprecedented growth in the number of people over 65 years of age, and lack of statutory provisions and definitive reporting systems. Physical and emotional signs of abuse are often overlooked or perhaps not accurately identified. Women, in particular, rarely report incidents of sexual assault to law enforcement agencies. Adult victims of violence are most often female, although males smaller than their spouses are victims as well. Substance abuse is a major factor in assessing violence potential. Characteristics that may assist the practitioner in identifying adult abuse include repeated office or medical facility visits, history of being "accident-prone," soft tissue injuries, implausible or vague explanation of injuries, psychosomatic complaints, pain, self-destructive behavior, eating and sleeping disorders, lack of energy, depression, and substance abuse. Specific inspection should be undertaken by the medical team to examine for bruises, burns, head injuries, abdominal injuries, fractures, failure to thrive, sexual abuse, and urogenital injuries. 13 references and 1 table