Abstract
The number of women in the United States that experience blows to the head during assaults by intimate partners is substantial. The number of head blows that result in a traumatic brain injury (TBI) is virtually unknown, but estimates far exceed numbers of TBI in parallel populations (e.g., blast exposure, accidents, sports) combined. Research on the impact of TBI on post-traumatic stress disorder (PTSD) in survivors of intimate partner violence (IPV) is sparse. This methodology paper describes the comprehensive, multi-method approach used by a multi-disciplinary team of investigators from several different fields of expertise to assess the interaction of psychiatric, cognitive, psychological, and physical conditions that result from IPV. Using state-of-the-art instruments, a comprehensive assessment of lifetime trauma exposure, lifetime history of TBI, psychiatric history, and a full assessment of current cognitive, neuropsychological and biomedical function was conducted with 51 female survivors of IPV who screened positive for PTSD. This multi-method assessment included clinician-administered diagnostic interviews modified to specifically assess the sequelae of IPV, standardized self-report surveys, neuropsychological tests, structural, diffusion, and functional neuroimaging and blood-based biomarkers. The specific details and full report of the results of the full study are beyond the scope of this methodology paper. Descriptive characteristics of the complex clinical presentation observed in this unique sample are described. The sample reported high rates of trauma exposure across the lifespan and 80% met full criteria for current PTSD. Women also reported high rates of lifetime subconcussive head injury (88.2%) and TBI (52.9%) from various etiologies (35.3% secondary to IPV). Descriptive findings from the methodological protocol described here have begun to reveal information that will advance our understanding of the impact of subconcussive head injury and TBI on recovery from mental injury among IPV survivors.
Highlights
Intimate partner violence (IPV), defined as physical violence, sexual violence, stalking or psychological aggression by a current or former intimate partner, is a public health crisis in the United States [1, 2]
Women were recruited from a mid-size, midwestern metropolitan area via flyers sent to agencies that serve survivors of IPV and through advertisement on social media
Women between the ages of 18–45 years old who reported a history of IPV and screened positive for probable Post-traumatic stress disorder (PTSD) on the PTSD Checklist for DSM-5 [PCL-5; [59]] screener during phone intake were invited to participate in the study, as these were the study’s inclusion criteria
Summary
Intimate partner violence (IPV), defined as physical violence, sexual violence, stalking or psychological aggression by a current or former intimate partner, is a public health crisis in the United States [1, 2]. 1 in 3 adult women (34%) experience physical IPV during their lifetime, with 1 in 4 women (23%) experiencing severe physical IPV such as being hit with a fist or hard object, strangled, beaten, or assaulted with a weapon [3]. Women and men both experience IPV, women are more likely than men to experience severe physical IPV and, subsequently, incur more injuries [3, 4]. Neck, and face are most frequently described and, are reported by 35–94% of IPV survivors [7]. 50% of IPV survivors report attempted strangulation at the hands of a partner [8], adding to the potential for damage to the brain secondary to anoxia
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