Brain Injury and Mental Health Among the Victims of Intimate Partner Violence: A Case-Series Exploratory Study.

Gunnur Karakurt,Mark J Lowe,Stephen M Rao,Kathleen Whiting,Stephen E Jones

doi:10.3389/fpsyg.2021.710602

Abstract

Intimate partner violence (IPV) survivors frequently report face, head, and neck as their injury site. Many mild traumatic brain injuries (TBIs) are undiagnosed or underreported among IPV survivors while these injuries may be linked to changes in brain function or pathology. TBI sustained due to IPV often occurs over time and ranges in severity. The aim of this case-series study was to explore risk factors, symptoms, and brain changes unique to survivors of intimate partner violence with suspicion of TBI. This case-series exploratory study examines the potential relationships among IPV, mental health issues, and TBI. Participants of this study included six women: 3 women with a history of IPV without any experience of concussive blunt force to the head, and 3 women with a history of IPV with concussive head trauma. Participants completed 7T MRI of the brain, self-report psychological questionnaires regarding their mental health, relationships, and IPV, and the Structured Clinical Interview. MRI scans were analyzed for cerebral hemorrhage, white matter disturbance, and cortical thinning. Results indicated significant differences in resting-state connectivity among survivors of partner violence as well as differences in relationship dynamics and mental health symptoms. White matter hyperintensities are also observed among the survivors. Developing guidelines and recommendations for TBI-risk screening, referrals, and appropriate service provision is crucial for the effective treatment of TBI-associated IPV. Early and accurate characterization of TBI in survivors of IPV may relieve certain neuropsychological consequences.

Highlights

Intimate partner violence (IPV) is a public health concern that can lead to physical, sexual, and psychological harm (Breiding et al, 2015)
Frequently reported various neurological symptoms and mental health issues including anxiety, depression, and Post Traumatic Stress Disorder (PTSD; Bonomi et al, 2006; Black, 2011). While some of these neuropsychological disorders maybe related to Traumatic Brain Injury (TBI), i.e., due to changes in brain function or developing brain pathology as a result of external force (Brain Injury Association of America, 2020), these changes might go unnoticed due to the similarity with non-traumatic brain injuries (TBIs) related IPV comorbidities (Kwako et al, 2011)
The result is a z-score map of connectivity to the posterior cingulate cortex (PCC) commonly referred to in the literature as the default mode network (DMN) (Greicius et al, 2003) indicated a significant difference between the group averaged z-score map for women with no head trauma subtracted from the average z-score map for women with head trauma for DMN

Summary

Introduction

Intimate partner violence (IPV) is a public health concern that can lead to physical, sexual, and psychological harm (Breiding et al, 2015). TBI and IPV frequently reported various neurological symptoms and mental health issues including anxiety, depression, and Post Traumatic Stress Disorder (PTSD; Bonomi et al, 2006; Black, 2011). While some of these neuropsychological disorders maybe related to Traumatic Brain Injury (TBI), i.e., due to changes in brain function or developing brain pathology as a result of external force (Brain Injury Association of America, 2020), these changes might go unnoticed due to the similarity with non-TBI related IPV comorbidities (Kwako et al, 2011). Many mild TBIs are undiagnosed or underreported (Davis, 2014)

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