Physiological and Behavioral Function of a Female Survivor of Partner Violence with Repetitive Head Impacts

Abstract

<h3>Research Objectives</h3> To identify the autonomic nervous system (ANS), cognitive, and psychological function of a survivor of intimate partner violence (IPV) with a history of subconcussive head impacts (SHI). <h3>Design</h3> Case report. <h3>Setting</h3> Telehealth. <h3>Participants</h3> A 24-year old female with a six-year history of IPV and complaints of strangulation, dizziness, fatigue, headaches, and poor appetite was screened for anxiety, depression, post-traumatic stress disorder (PTSD), cognitive and ANS function. One virtual study visit, lasting about 1.5 hours, was completed. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Structured interview, the Generalized Anxiety Disorder Questionnaire (GAD-7), PHQ-9 Depression Scale, Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), Montreal Cognitive Assessment (MOCA), and COMPASS-31 were used to identify SHI, anxiety, depression, PTSD, cognitive and ANS function. <h3>Results</h3> The female survivor demonstrated a positive history of IPV-related SHI and reported being hit in the head, neck, or face at least once a week for more than 2 years. She scored a total of 19 on GAD-7, indicating moderate anxiety. Her PHQ-9 score was 24, suggesting major depression. The PC-PTSD total score was 5 (a score of 3 indicates probable PTSD). The MOCA's total score was 21 which indicated mild cognitive impairment. She scored a cumulative of 15 on COMPASS 31. A score of 13 had implied ANS dysfunction in patients with neurological disorders. <h3>Conclusions</h3> Previously, repetitive head impacts have led to impaired regulation of homeostasis via ANS in athletes. Alteration in heart rate mediated by ANS may influence cognitive and motor function. ANS disruption could be more pronounced in IPV survivors due to psychological distress. This case report suggests that ANS function should be objectively evaluated in survivors presenting with IPV-related SHI and psychological disturbance. <h3>Author(s) Disclosures</h3> The authors declare no conflict of interest.