Extreme Control and Instability: Insight Into Head Injury From Intimate Partner Violence

Abstract

Aim: The aim of this study was to understand the social context of the lives of women who experienced a head injury from intimate partner violence. Background: Sixty percent to 92% of survivors of intimate partner violence receive head trauma during the abuse. Little research exists regarding the episodes of abuse when women receive a head injury, or the reasons women might not seek medical care for the head injury or the abuse. Method: Twenty-one interviews from nine women who self-reported passing out from being hit in the head were analyzed using thematic analysis. Findings: Themes of extreme control and manipulation from abusers emerged, and women described living with instability from cycles of incarceration, drug and alcohol use, and fear of losing their children. Women did not receive medical care for head injury because the abusers often used forced sex immediately after the head injury to instill fear and authority. Implications for Forensic Nursing: Hitting women in the head is not only about physical abuse, but also about exerting dominance and creating an environment of extreme control. Forensic nurses are uniquely positioned to screen for head injuries during initial assessments and follow-up visits and connect women with appropriate resources.

Battered and Brain Injured: Traumatic Brain Injury Among Women Survivors of Intimate Partner Violence—A Scoping Review

“…Ivany & Schminkey, 2016; St. Ivany et al, 2018a, 2018b; Valera et al, 2018). Physical symptoms include headaches, fatigue, sleep disturbances, vertigo, and pain, while cognitive symptoms affect attention, concentration, and executive functioning, suggesting interventions should serve to strengthen the capacity of the survivor to process and interpret information (Corrigan et al, 2003; Jackson et al, 2002; Murray et al, 2016; Valera & Berenbaum, 2003; Valera et al, 2018).…”

“…The onus of screening, assessment, and triage for IPV largely falls on frontline professionals in health-care and community contexts. As early screening and intervention can lead to improved outcomes, routine screening for TBI when IPV is disclosed or suspected was encouraged by a number of authors (Ackerman & Banks, 2009; Amoroso & Iverson, 2017; Baumann et al, 2018; Campbell et al, 2018; Corrigan et al, 2003; Davis, 2014; Farley et al, 2018; Iverson et al, 2017; Iverson & Pagoda, 2015; Jackson et al, 2002; Monohan & O’Leary, 1999; Murray et al, 2016; Smith & Holmes, 2018; Stern, 2004; St. Ivany, Kools, Sharps,& Bullock, 2018b; Zieman et al, 2017).…”

“…Many authors cited the need to establish a reliable, valid, and standardized screening tool to identify TBI in survivors of IPV (Anderson et al, 2015; Baumann et al, 2018; Campbell et al, 2018; Corrigan et al, 2003; Davis, 2014; Goldin et al, 2016; Iverson & Pogoda, 2015; Kwako et al, 2011; Monohan & O’Leary, 1999; St. Ivany & Schminkey, 2016; St. Ivany et al, 2018b; Valera & Berenbaum, 2003).…”

Impact of mild traumatic brain injury on physical, mental and cognitive functioning of abused women admitted to emergency units

“…The study found that frequent control via psychological abuse overlapped with an increased risk of danger in abused women and a head injury became a way to exhibit an extreme form of control including removing the women's ability to seek external help (St Ivany et al, 2018).…”

Intimate Partner Violence and Brain Injury Screening

“…M. Valera, 2018; E. M. Valera et al, 2019), despite increasing evidence of the high risk for BI in this vulnerable population (Baxter & Hellewell, 2019; Goldin et al, 2016; Haag et al, 2019; Kwako et al, 2011; St Ivany, Kools et al, 2018).…”