Traumatic Brain Injury in Intimate Partner Violence: A Critical Review of Outcomes and Mechanisms

Abstract

The prevalence of intimate partner violence (IPV) is striking, as are its consequences to the lives of women. The IPV often includes physical assault, which can include injuries to the head and attempted strangulation injuries. Both types of injuries can result in traumatic brain injury (TBI). The TBI sustained during IPV often occurs over time, which can increase the risk for health declines and postconcussive syndrome (PCS). Current studies have identified sequelae of cognitive dysfunction, posttraumatic stress disorder, and depression in women experiencing IPV, yet, most fail to determine the role of TBI in the onset and propagation of these disorders. Although imaging studies indicate functional differences in neuronal activation in IPV, they also have not considered the possibility of TBI contributing to these outcomes. This review highlights the significant gaps in current findings related to neuropsychological complications and medical and psychosocial symptoms that likely result in greater morbidity, as well as the societal costs of failing to acknowledge the association of IPV and TBI in women.

Screening and Counseling for Intimate Partner Violence: A Vision for the Future

“…The complex interacting mental and physical health sequelae of IPV and other trauma often results in co-morbid conditions, such as PTSD co-occurring with depression, 30 traumatic brain injury and neurological sequelae, 31 suicidality, and PTSD co-occurring with depression and substance abuse as described by Weaver and colleagues in this issue. 32 Although a few validated interventions exist for IPV-exposed women who are pregnant 25 or suicidal, 33 we have yet to have persuasive evidence supporting the efficacy of interventions for IPV and other comorbidities, such as mental health and substance use disorders.…”

Screening for Traumatic Brain Injury in Prostituted Women

“…For example, from 30% to 74% of women seeking emergency shelter or hospital emergency room treatment for IPV and 10% of IPV survivors in general populations had sustained TBI (Kwako et al, 2011;Yau et al, 2013). We know of only two studies that report the prevalence of TBI among women in prostitution, finding rates of 53% and 72% (Farley et al, 2016).…”

Intimate Partner Violence and Traumatic Brain Injury

“…A literature review on violence against women (using search terms such as domestic violence, strangled, abusive relationship, battered women, spousal abuse, and IPV) combined with TBI found 15 articles about TBI and IPV, and 9 examined head injury in the presence of IPV. 5,9,10,[16][17][18][19][20] References from selected articles were manually retrieved and reviewed. These articles used loss of consciousness, 5,10 blunt head trauma from abuse, 9,18,20 postconcussive syndrome, 17 TBI, 16 and strangulation 19 as classification for head injury.…”

“…5 However, based on this review of literature, data supporting the head as a common target in IPV assaults include (a) reports of 35% to 92% of women in shelters who experienced at least 1 head injury during a violent attack, 5,9,10,18 (b) a 74% prevalence rate of TBI among women who were in shelters or who were completing a protection order, 19 and (c) 92% of abused women in a pilot study reporting being hit in the head or the face. 9 A study comparing women of African descent in the United States with those of the US Virgin Islands found that abused women were 7 times more likely to report a head injury with loss of consciousness than nonabused women in the same study sample (odds ratio [OR], 7.21; 95% confidence interval, 2.79-18.61; P < .001).…”