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Campbell JK, Howland J, Insalaco B, Lawrence-Soto G. Knowledge, Perceived Competence, and Behaviors Relative to Traumatic Brain Injury Among a Sample of Domestic Violence Emergency Shelter Advocates in a New England State. Violence Against Women 2024; 30:2808-2827. [PMID: 36942449 DOI: 10.1177/10778012231163577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
This cross-sectional study describes knowledge, perceived competence, and behaviors relative to intimate partner violence (IPV)-related brain injury (BI) among staff in residential domestic violence shelter programs across a New England state. A 23-item questionnaire was administered to registrants of an online IPV-related BI training series. Within this sample, knowledge about IPV-related BI was high, but relative to providing screening, accommodations, and specialized referrals to survivors with BI, perceived competence was low, and behaviors were infrequent. IPV shelter agencies should facilitate IPV-related BI training programs for staff and prioritize developing and implementing BI screening, accommodation, and referral policies and procedures.
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Affiliation(s)
- Julia K Campbell
- Department of Emergency Medicine, Injury Prevention Center, Boston Medical Center, Boston, MA, USA
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Jonathan Howland
- Department of Emergency Medicine, Injury Prevention Center, Boston Medical Center, Boston, MA, USA
- Department of Emergency Medicine, Boston University School of Medicine, Boston, USA
| | - Brie Insalaco
- Statewide Head Injury Program, Massachusetts Rehabilitation Commission, Boston, MA, USA
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Chan JP, Harris KA, Berkowitz A, Ferber A, Greenwald BD, Valera EM. Experiences of Domestic Violence in Adult Patients with Brain Injury: A Select Overview of Screening, Reporting, and Next Steps. Brain Sci 2024; 14:716. [PMID: 39061456 PMCID: PMC11274718 DOI: 10.3390/brainsci14070716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
This select overview examines the important intersection of adult domestic violence, including intimate partner violence and elder abuse, with brain injury. Despite the high prevalence of domestic violence amongst brain injury patients, there is a notable gap in screening and management training for providers. To provide optimal patient care, brain injury medicine clinicians must screen, recognize, and treat patients who have experienced domestic violence. This select overview highlights barriers to screening, validated screening tools from other medical disciplines, and management considerations for the brain injury clinician. A suggested protocol for domestic violence screening and management, as well as recommended resources for providers and patients, is summarized.
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Affiliation(s)
- Jessie P. Chan
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Kristen A. Harris
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Arielle Berkowitz
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Ally Ferber
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Brian D. Greenwald
- JFK Johnson Rehabilitation Institute, Edison, NJ 08820, USA; (J.P.C.); (K.A.H.); (A.B.); (A.F.)
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Eve M. Valera
- Massachusetts General Hospital, Charlestown, MA 02129, USA;
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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Karr JE, Logan T. Post-Concussion Symptoms in Women With Head Injury Due to Intimate Partner Violence. J Neurotrauma 2024; 41:447-463. [PMID: 37485628 PMCID: PMC10908327 DOI: 10.1089/neu.2023.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Limited research has examined the symptom sequelae of head injuries in women survivors of intimate partner violence (IPV), despite this community being at increased risk for neurotrauma due to partner abuse. The current study compared post-concussion symptom severity between women with and without IPV-related head injuries. Women were recruited from court jurisdictions in Kentucky, USA, after receiving a protective order for partner abuse. The sample included 268 women with no prior head injuries (age: M[standard deviation (SD)] = 31.8[9.8], 77.2% White) and 251 women with lifetime IPV-related head injuries (age: M[SD] = 31.8[9.8], 88.0% White). Women with IPV-related head injuries were slightly older (t = 2.46, p = 0.014) with lower education (χ2 = 5.81, p = 0.016), were more frequently unemployed (χ2 = 9.23, p = 0.002), and had a higher likelihood of residing in a rural setting (χ2 = 30.16, p < 0.001). Women with IPV-related head injuries were also more often White (χ2 = 10.47, p = 0.001), but this group difference was almost entirely related to rural versus urban residence. Women with IPV-related head injuries reported a higher severity of lifetime physical IPV (t = 7.27, p < 0.001, d = 0.64, 95% confidence interval [CI]: [.46, .82]) and sexual IPV (t = 4.65, p < 0.001, d = 0.41 [0.24, 0.59]). A three-factor model of post-concussion symptoms, inclusive of cognitive, physical, and emotional symptoms, fit well (χ2 = 368.99, p < 0.0001, comparative fit index [CFI] = 0.974, Tucker-Lewis index [TLI] = 0.968, root mean square error of approximation [RMSEA] = 0.079 [0.071, 0.087]), and showed evidence for strong measurement invariance across women with and without IPV-related head injuries. The subscale and total scores each had acceptable reliability: cognitive (ω = 0.88 [0.86, 0.90]), physical (ω = 0.74 [0.70, 0.77]), and emotional (ω = 0.88 [0.86, 0.89]), and total score (ω = 0.93 [0.92, 0.95]). Women with IPV-related head injuries reported all individual post-concussion symptoms at a significantly higher frequency, with medium group differences in cognitive (t = 7.57, p < 0.001, d = 0.67 [0.50, 0.85]) and physical symptoms (t = 7.73, p < 0.001, d = 0.68 [0.51, 0.86]) and large group differences in emotional (t = 8.51, p < 0.001, d = 0.75 [0.57, 0.93]) and total symptoms (t = 9.07, p < 0.001, d = 0.80 [0.62, 0.98]). All sociodemographic characteristics were independently associated with post-concussion symptoms, as were physical IPV (total score: r = 0.28 [0.19, 0.35], p < 0.001) and sexual IPV severity (total score: r = 0.22 [0.13, 0.30], p < 0.001). In hierarchical regression analyses, controlling for sociodemographic characteristics (i.e., age, race/ethnicity, education, unemployment, and rural/urban residence) and physical and sexual IPV severity, IPV-related head injury was independently significant and accounted for significant additional variance when predicting cognitive (ΔR2 = 0.05, p < 0.001), physical (ΔR2 = 0.03, p < 0.001), emotional (ΔR2 = 0.07, p < 0.001), and total symptoms (ΔR2 = 0.06, p < 0.001). Negative-binomial regression resulted in similar findings. This study demonstrates that multiple sociodemographic and IPV history variables are related to post-concussion symptom severity, but IPV-related head injury was independently associated with greater symptom severity. Women with IPV-related head injuries may be at increased risk for unaddressed health problems spanning cognitive, physical, and emotional domains. Future research is needed to psychometrically evaluate assessment instruments for this population and to assess efficacy of interventions to address their unique health care needs.
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Affiliation(s)
- Justin E. Karr
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - T.K. Logan
- Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA
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Raskin SA, DeJoie O, Edwards C, Ouchida C, Moran J, White O, Mordasiewicz M, Anika D, Njoku B. Traumatic brain injury screening and neuropsychological functioning in women who experience intimate partner violence. Clin Neuropsychol 2024; 38:354-376. [PMID: 37222525 DOI: 10.1080/13854046.2023.2215489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 05/12/2023] [Indexed: 05/25/2023]
Abstract
Objective: The potential for traumatic brain injury (TBI) to occur as the result of intimate partner violence (IPV) has received increased interest in recent years. This study sought to investigate the possible occurrence of TBI in a group of women who survived IPV and to measure the specific profile of cognitive deficits using standardized neuropsychological measures. Method: A comprehensive questionnaire about abuse history; neuropsychological measures of attention, memory and executive functioning; and measures of depression, anxiety and post-traumatic stress disorder were given to women who were IPV survivors, women who were sexual assault (SA) survivors, and a comparison group of women who did not experience IPV or SA. Results: Overall, rates of potential TBI, as measured by the HELPS brain injury screening tool, were high and consistent with previous studies. Consistent with potential TBI, lower scores were demonstrated on measures of memory and executive functioning compared to survivors of SA or those not exposed to violence. Importantly, significant differences on measures of memory and executive functioning remained, after controlling for measures of emotion. Of note, cognitive changes were highest among women who experienced non-fatal strangulation (NFS) compared to IPV survivors who did not. Conclusions: Rates of TBI may be high in women who survive IPV, especially those who survive strangulation. Better screening measures and appropriate interventions are needed as well as larger studies that look at social factors associated with IPV.
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Affiliation(s)
- Sarah A Raskin
- Department of Psychology, Trinity College, Hartford, CT, USA
- Neuroscience Program, Trinity College, Hartford, CT, USA
| | | | | | - Chloe Ouchida
- Neuroscience Program, Trinity College, Hartford, CT, USA
| | - Jocelyn Moran
- Neuroscience Program, Trinity College, Hartford, CT, USA
| | - Olivia White
- Neuroscience Program, Trinity College, Hartford, CT, USA
| | | | - Dorothy Anika
- Neuroscience Program, Trinity College, Hartford, CT, USA
| | - Blessing Njoku
- Neuroscience Program, Trinity College, Hartford, CT, USA
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Chiou KS, Rajaram SS, Garlinghouse M, Reisher P. Differences in Symptom Report by Survivors With and Without Probable Intimate Partner Violence-Related Brain Injury. Violence Against Women 2023; 29:2812-2823. [PMID: 37559478 DOI: 10.1177/10778012231192594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Survivors of intimate partner violence (IPV) are at heightened risk of sustaining a brain injury (BI). Problematically, a high overlap between BI and trauma symptoms leads to difficulties in identifying when an IPV-related BI has occurred. This paper investigated differences in symptom reports between survivors with (n = 95) and without (n = 42) probable IPV-related BI. Chi-squared analyses isolated a constellation of symptoms found to be specifically associated with BI status. These symptomatic markers may assist professionals in discerning BI from other comorbid conditions present in IPV, and thus help survivors access BI-specific treatments and resources.
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Affiliation(s)
- Kathy S Chiou
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Shireen S Rajaram
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Matthew Garlinghouse
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
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Dams-O'Connor K, Bulas A, Haag H(L, Spielman LA, Fernandez A, Frederick-Hawley L, Hoffman JM, Goldin Frazier Y. Screening for Brain Injury Sustained in the Context of Intimate Partner Violence (IPV): Measure Development and Preliminary Utility of the Brain Injury Screening Questionnaire IPV Module. J Neurotrauma 2023; 40:2087-2099. [PMID: 36879469 PMCID: PMC10623077 DOI: 10.1089/neu.2022.0357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Abstract Intimate partner violence (IPV) is associated with risk for multi-etiology brain injury (BI), including repetitive head impacts, isolated traumatic brain injuries (TBI), and anoxic/hypoxic injury secondary to nonfatal strangulation (NFS). IPV-related injuries are often unreported, but evidence suggests that survivors are more likely to report when asked directly. There are currently no validated tools for screening of brain injury related to IPV that meet World Health Organization guidelines for this population. Here, we describe measure development methods and preliminary utility of the Brain Injury Screening Questionnaire IPV (BISQ-IPV) module. We culled items from existing IPV and TBI screening tools and sought two rounds of stakeholder feedback regarding content coverage, terminology, and safety of administration. The resulting stakeholder-informed BISQ-IPV module is a seven-item self-report measure that uses contextual cues (e.g., being shoved, shaken, strangled) to query lifetime history of IPV-related head/neck injury. We introduced the BISQ-IPV module into the Late Effects of TBI (LETBI) study to investigate rates of violent and IPV-specific head/neck injury reporting in a TBI sample. Among those who completed the BISQ-IPV module (n = 142), 8% of the sample (and 20% of women) reported IPV-related TBI, and 15% of the sample (34% of women) reported IPV-related head or neck injury events that did not result in loss or alteration of consciousness. No men reported NFS; one woman reported inferred BI secondary to NFS, and 6% of women reported NFS events. Those who endorsed IPV-BI were all women, many were highly educated, and many reported low incomes. We then compared reporting of violent TBIs and head/neck injury events among individuals who completed the core BISQ wherein IPV is not specifically queried (administered from 2015-2018; n = 156) to that of individuals who completed the core BISQ preceded by the BISQ-IPV module (BISQ+IPV, administered from 2019-2021; n = 142). We found that 9% of those who completed the core BISQ reported violent TBI (e.g., abuse, assault), whereas 19% of those who completed the BISQ+IPV immediately preceding the core BISQ reported non-IPV-related violent TBI on the core BISQ. These findings suggest that standard TBI screening tools are inadequate for identifying IPV-BI and structured cueing of IPV-related contexts yields greater reporting of both IPV- and non-IPV-related violent BI. When not queried directly, IPV-BI remains a hidden variable in TBI research studies.
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Affiliation(s)
- Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ashlyn Bulas
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Halina (Lin) Haag
- Department of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Lisa A. Spielman
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Angela Fernandez
- Department of OBGYN and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lynn Frederick-Hawley
- Department of OBGYN and Reproductive Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeanne M. Hoffman
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Yelena Goldin Frazier
- Yelena Goldin Frazier Curect Neuropsychology of New York, East Rockaway, New York, USA
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Park S, Kim SH. A Systematic Review and Meta-Analysis of Randomized Controlled Trials for Intimate Partner Violence: The Effects of the Programs Based on Their Purposes. TRAUMA, VIOLENCE & ABUSE 2023; 24:2115-2129. [PMID: 35427459 DOI: 10.1177/15248380221084748] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: Intimate partner violence (IPV) is a complex global problem that has serious health consequences for victims. Many intervention programs have been introduced for IPV, with various target populations, purposes, designs, and outcomes. However, a consensus has not been reached regarding which type of program has the greatest impact. Therefore, the purpose of this study was to examine the effects of existing interventions on IPV risk and to compare the effects of the interventions based on their purposes and designs. Method: A systematic review and meta-analytic method were utilized in this study. Through a rigorous database search, 13 randomized controlled trials that met the inclusion and exclusion criteria were selected and included in the analysis. Results: The included interventions had a small effect size, which was statistically significant. The couple interventions aiming to reduce the risk of IPV perpetration and victimization simultaneously showed the greatest impact, compared to bystander interventions and interventions targeting either perpetrators or victims. The interventions aiming to reduce the risk of IPV perpetration showed a significant impact on changing gender equality-related knowledge and attitudes, and those aiming to reduce the risk of IPV victimization were effective in increasing knowledge and changing attitudes related to traditional norms, empowerment, and health conditions. The interventions targeting bystanders showed significant effects on increasing bystander-related attitudes and behaviors. Conclusion: Our findings provide strong evidence for future intervention programs for IPV. Long-term research to follow-up actual IPV reductions after interventions will be needed to confirm the findings of this study.
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Affiliation(s)
- Sihyun Park
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Sin-Hyang Kim
- Department of Nursing, Shinsung University, Dangjin-Si, South Korea
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Park S, Woo H. Types of Bystanders Among South Koreans Based on Their Subjective Reactions to Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231162652. [PMID: 37070815 DOI: 10.1177/08862605231162652] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Intimate partner violence (IPV) can occur when bystanders are present, and these bystanders may intervene to prevent the situation from worsening and assist the victims. Despite the importance of bystanders' roles and behaviors in relation to IPV incidents, as well as extensive research to understand and promote it, there have been relatively few studies aimed at understanding their reactions in non-Western populations. Moreover, bystanders' subjective opinions and thoughts have largely been neglected when predicting their intention to intervene. Therefore, the current study identified the types of bystanders in South Korea based on their subjective reactions when witnessing IPV incidents. Q-methodology was utilized. A Q-set comprising 31 statements describing the possible range of bystander reactions was constructed using a systematic review method. The 42 participants were asked to sort the Q-set based on their agreement and provide qualitative responses regarding the reasons behind their sorting. The data were analyzed using the PQMethod software. Consequently, three types of bystander groups were extracted based on the participants' sorting statement patterns: (1) hesitant helpers needing justification, (2) outsiders denouncing the couple, and (3) active interveners opposing the violence. Each type of bystander expressed different opinions and thoughts about bystander reactions and behaviors in IPV situations. However, participants frequently showed a willingness to intervene when they knew the victim personally and when the victim directly requested help. With our findings as a reference, we expect that various bystander programs with specified purposes will be developed to effectively increase the competency of diverse bystanders to maximize their roles in relation to IPV.
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Affiliation(s)
| | - Hyunji Woo
- Chung-Ang University, Seoul, South Korea
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9
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Toccalino D, Moore A, Cripps E, Gutierrez SC, Colantonio A, Wickens CM, Chan V, Nalder E, Haag H(L. Exploring the intersection of brain injury and mental health in survivors of intimate partner violence: A scoping review. Front Public Health 2023; 11:1100549. [PMID: 36935693 PMCID: PMC10018197 DOI: 10.3389/fpubh.2023.1100549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/26/2023] [Indexed: 03/06/2023] Open
Abstract
Rationale Intimate partner violence (IPV) is the most commonly occurring form of violence against women. The most common site of injury in IPV is the head, face, and neck, resulting in possible brain injury (BI). Independently, mental health (MH) concerns are highly prevalent among both IPV survivors and individuals with BI; however, no systematic review exists on the combined experience of BI and MH in IPV. Objective The aim of this review was to describe the identification of and relationships between BI, MH, and IPV in the literature and the implications for health policy and practice. Methods A search strategy including text words and subject headings related to BI, IPV, and MH was developed for MEDLINE and translated to EMBASE, PsycINFO, CINAHL, Cochrane, Scopus, and Web of Science. Two reviewers independently assessed articles for inclusion. Articles discussing MH, BI, and IPV in relation to one another were included in the review. Results Twenty-eight articles were identified for inclusion. Methods for identifying IPV, BI, and MH were highly variable across studies. Fourteen studies reported significantly higher MH scores in IPV survivors with BI than in those without BI. Articles predominantly focused on cis gender women in heterosexual relationships and the impact of race and ethnicity were largely overlooked. Healthcare access was explored by eight articles, though none discussed the implications of co-occurring BI and MH. Conclusion Brain injury and MH are highly prevalent among IPV survivors; however, little research discusses the implication for healthcare. Future research should explore healthcare-related needs and experiences to inform policy and practice and better represent the diversity of IPV survivors.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- *Correspondence: Danielle Toccalino
| | - Amy Moore
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Elizabeth Cripps
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Sophia Chuon Gutierrez
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Angela Colantonio
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Christine M. Wickens
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Vincy Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Emily Nalder
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Halina (Lin) Haag
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, ON, Canada
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Fitts MS, Cullen J, Kingston G, Wills E, Soldatic K. "I Don't Think It's on Anyone's Radar": The Workforce and System Barriers to Healthcare for Indigenous Women Following a Traumatic Brain Injury Acquired through Violence in Remote Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14744. [PMID: 36429463 PMCID: PMC9691172 DOI: 10.3390/ijerph192214744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Aboriginal and Torres Strait Islander women experience high rates of traumatic brain injury (TBI) as a result of violence. While healthcare access is critical for women who have experienced a TBI as it can support pre-screening, comprehensive diagnostic assessment, and referral pathways, little is known about the barriers for Aboriginal and Torres Strait Islander women in remote areas to access healthcare. To address this gap, this study focuses on the workforce barriers in one remote region in Australia. Semi-structured interviews and focus groups were conducted with 38 professionals from various sectors including health, crisis accommodation and support, disability, family violence, and legal services. Interviews and focus groups were audiotaped and transcribed verbatim and were analysed using thematic analysis. The results highlighted various workforce barriers that affected pre-screening and diagnostic assessment including limited access to specialist neuropsychology services and stable remote primary healthcare professionals with remote expertise. There were also low levels of TBI training and knowledge among community-based professionals. The addition of pre-screening questions together with professional training on TBI may improve how remote service systems respond to women with potential TBI. Further research to understand the perspectives of Aboriginal and Torres Strait Islander women living with TBI is needed.
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Affiliation(s)
- Michelle S. Fitts
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW 2751, Australia
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT 0871, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD 4878, Australia
| | - Jennifer Cullen
- Synapse Australia, Brisbane, QLD 3356, Australia
- College of Healthcare Sciences, James Cook University, Cairns, QLD 4878, Australia
| | - Gail Kingston
- Townsville Hospital and Health Service, Townsville, QLD 4814, Australia
| | - Elaine Wills
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW 2751, Australia
| | - Karen Soldatic
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW 2751, Australia
- School of Social Sciences, Western Sydney University, Parramatta, NSW 2751, Australia
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11
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Haag H(L, Jones D, Joseph T, Colantonio A. Battered and Brain Injured: Traumatic Brain Injury Among Women Survivors of Intimate Partner Violence-A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1270-1287. [PMID: 31170896 PMCID: PMC9425721 DOI: 10.1177/1524838019850623] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The objective of this scoping review is to examine the extent, range, and nature of literature targeting health-care professionals on the prevalence and outcome of intimate partner violence (IPV)-related traumatic brain injury (TBI). The purpose is to gain an understanding of prevalence, investigate screening tool use, generate IPV/TBI-specific support recommendations, and identify suggestions for future research. METHOD The review was guided by Arksey and O'Malley's five stages for conducting a scoping review. A comprehensive search of nine databases revealed 1,739 articles. In total, 42 published research papers that focused specifically on TBI secondary to IPV were included in the study. SYNTHESIS The literature reports inconsistencies in prevalence rates from IPV-related TBI. There are no current standardized screening practices in use, though the literature calls for a specialized tool. Frontline professionals would benefit from education on signs and symptoms of IPV-related TBI. Empirical studies are needed to generate reliable data on prevalence, experience, and needs of brain-injured survivors of TBI. CONCLUSIONS Findings from this study demonstrate the need for the development of an IPV-sensitive screening tool, more accurate data on prevalence, an interprofessional approach to care, and raised awareness and education on the diffuse symptoms of IPV-related TBI.
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Affiliation(s)
| | - Dayna Jones
- University of Toronto, Toronto, Ontario, Canada
| | | | - Angela Colantonio
- University of Toronto, Toronto, Ontario, Canada
- Author is also affiliated to Toronto Rehabilitation Hospital - UHN
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12
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Stubbs A, Szoeke C. The Effect of Intimate Partner Violence on the Physical Health and Health-Related Behaviors of Women: A Systematic Review of the Literature. TRAUMA, VIOLENCE & ABUSE 2022; 23:1157-1172. [PMID: 33541243 DOI: 10.1177/1524838020985541] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM The long-term effects of intimate partner violence (IPV) on physical health outcomes and health-related behaviors are underresearched in comparison to the effects on mental health and pregnancy. This systematic review examines the recent research in this area from 2012 through 2019. METHODS SCOPUS, PubMed, EBSCOhost, and gray literature were searched using the key words "intimate partner violence" and "health." To meet inclusion criteria, studies needed to be original research and focus on IPV during adulthood and its effects on the physical health or health-related behaviors of women. Fifty-two studies were qualitatively analyzed, with results grouped into broad categories of effects, including cardiovascular, endocrine, infectious diseases, and health screening. RESULTS IPV was shown to have negative effects on physical health outcomes for women, including worsening the symptoms of menopause and increasing the risk of developing diabetes, contracting sexually transmitted infections, engaging in risk-taking behaviors including the abuse of drugs and alcohol, and developing chronic diseases and pain. It also has significant effects on human immunodeficiency virus outcomes, worsening CD4+ cell depletion. Results varied regarding the effects of IPV on cardiovascular health outcomes. CONCLUSION The result of this review demonstrates that women who have experienced violence and abuse are at significantly increased risk of poor health outcomes in a variety of areas and so require specialized and tailored primary care. This review highlights significant gaps in this field of research, particularly in relation to cardiovascular disease, endocrine dysfunction, and neurological symptoms and conditions. It demonstrates a need for additional long-term studies in this field to better inform the health care of women who have experienced IPV and to establish the physiological mediators of these outcomes.
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Affiliation(s)
- Anita Stubbs
- Department of Medicine, Dentistry and Health Sciences, University of Melbourne and Austin Health, Australia
| | - Cassandra Szoeke
- Centre for Medical Research (Royal Melbourne Hospital), Department of Medicine, 2281University of Melbourne, Australia
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13
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Meyer JE, Jammula V, Arnett PA. Head Trauma in a Community-Based Sample of Victims of Intimate Partner Violence: Prevalence, Mechanisms of Injury and Symptom Presentation. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP15255-NP15274. [PMID: 33993780 DOI: 10.1177/08862605211016362] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The present study aimed to explore the prevalence of subconcussive head trauma, traumatic brain injury (TBI), potential hypoxic events, and hypoxic brain injury (HBI) in victims of physical intimate partner violence (IPV). The study also aimed to characterize the injury presentation and mechanisms of injury in this population. METHOD A group of 47 female participants with a history of at least one relationship that included physical violence completed a structured interview assessing for subconcussive hits, TBI, and HBI. Participants ranged in age from 19 to 55, and had an average of 15.3 years of education. Forty-four participants completed the structured interview in person and three participants completed the interview over the phone. RESULTS The majority of participants reported sustaining at least one impact to the head and approximately half of the participants sustained at least one impact that resulted in a mild TBI. Approximately half of the participants experienced at least one incident of having difficulty breathing due to a violent act from their partner, and approximately one-third of participants reported symptoms consistent with mild HBI. The most common mechanisms of injury were being hit with a closed fist and being strangled. CONCLUSIONS The high levels of head trauma observed in this study highlight the need for clinical and community providers to screen victims of physical IPV for head trauma. The unique characteristics of this population (female sex, high frequency of injuries, and presence of HBIs) indicate that research evaluating the cognitive effects of injuries in this population is needed.
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Affiliation(s)
- Jessica E Meyer
- Summa Health System, Department of Psychiatry, Akron, OH, USA
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA
| | - Varna Jammula
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA
| | - Peter A Arnett
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA
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14
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The Prevalence of Brain Injury Among Survivors and Perpetrators of Intimate Partner Violence and the Prevalence of Violence Victimization and Perpetration Among People With Brain Injury: a Scoping Review. CURR EPIDEMIOL REP 2022. [DOI: 10.1007/s40471-022-00302-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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15
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Daugherty JC, Verdejo-Román J, Pérez-García M, Hidalgo-Ruzzante N. Structural Brain Alterations in Female Survivors of Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4684-NP4717. [PMID: 32954938 DOI: 10.1177/0886260520959621] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Intimate partner violence (IPV) has been related to brain alterations in female survivors. Nonetheless, few studies have used an exploratory approach, focusing on brain regions that are traditionally studied in other populations with post-traumatic stress. Traumatic brain injury (TBI), strangulation, and childhood trauma are highly prevalent among this population, and have also been associated with brain alterations and functional deterioration. As such, it is difficult to determine how different brain regions are affected by the complex interplay of these factors in female survivors. The aim of this study is to assess (a) brain alterations in female survivors of IPV as compared to non-victim females and (b) the potential causal mechanisms associated with such alterations. We hypothesized that structural brain differences would be found between female survivors of IPV and non-victims, and that these differences would be related to IPV-related TBI, strangulation, IPV severity, depression, post-traumatic stress, generalized anxiety, and childhood adverse experiences. A total of 27 non-victims and 28 survivors completed structural magnetic resonance imaging and questionnaires to measure the potential causal mechanisms for brain alterations. Structural brain differences were found between groups, principally in volumetric analyses. The brain regions in which between-group differences were found were related to attempted strangulation, IPV-related TBI, severity of IPV, adverse childhood experiences, and post-traumatic stress. These results demonstrate that a wider range of brain regions may be impacted by IPV and that various factors are implicated in the structural brain alterations found in female survivors. This study demonstrates the importance of post-traumatic stress, childhood and adult trauma, and physical violence in assessing brain alterations in IPV survivors. Further, it serves as a critical first step in assessing an extensive list of potential causal mechanisms for structural brain alterations, using a more comprehensive a whole-brain structural analysis of IPV female victims, a largely understudied and vulnerable population.
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Affiliation(s)
| | - Juan Verdejo-Román
- University of Granada (CIMCYC-UGR), Granada, Spain
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Madrid, Spain
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Sex and Gender Science: The World Writes on the Body. Curr Top Behav Neurosci 2022; 62:3-25. [PMID: 35253110 DOI: 10.1007/7854_2022_304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Sex and Gender Science seeks to better acknowledge that the body cannot be removed from the world it inhabits. We believe that to best answer any neuroscience question, the biological and the social need to be addressed through both objective means to learn, "how it is like" and subjective means to learn, "what it is like." We call bringing the biological and social together, "Situated Neuroscience" and the mixing of approaches to do so, Very Mixed Methods. Taken together, they constitute an approach to Sex and Gender Science. In this chapter, we describe neural phenomena for which considering sex and gender together produces a fuller knowledge base: sleep, pain, memory, and concussion. For these brain phenomena examples, studying only quantitative measures does not reveal the full impact of these lived experiences on the brain but studying only the qualitative would not reveal how the brain responds. We discuss how Sex and Gender Science allows us to begin to bring together biology and its social context and acknowledge where context can contribute to resolving ignorance to offer more expansive, complementary, and interrelating pictures of an intricate neuro-landscape.
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17
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Update on Domestic Violence and Traumatic Brain Injury: A Narrative Review. Brain Sci 2022; 12:brainsci12010122. [PMID: 35053865 PMCID: PMC8773525 DOI: 10.3390/brainsci12010122] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 11/25/2022] Open
Abstract
Research on traumatic brain injury (TBI) as a result of domestic violence has greatly increased in the past decade, with publications addressing the prevalence, diagnosis, evaluation, and treatment. Although TBI due to domestic violence has recently been found to occur quite frequently, it was not widely understood until the 1990s. Individuals who suffer from domestic violence TBI often experience sequelae such as decreased cognitive functioning, memory loss, and PTSD. The goal of this article is to increase awareness about TBI secondary to domestic violence, with the intent that it will highlight areas for future research on the diagnosis, evaluation, and treatment of TBI in this population. The articles in this study were first found using the search terms traumatic brain injury and domestic violence. Although, in recent years, there has been a significant increase in research on TBI due to domestic violence, the overall conclusion of this review article is that there is still a need for future research in many areas including the effects on minority populations, the effects of COVID-19, and improvements of screening tools.
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18
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Prevalence and Perception of Intimate Partner Violence-Related Traumatic Brain Injury. J Head Trauma Rehabil 2022; 37:53-61. [PMID: 34985034 DOI: 10.1097/htr.0000000000000749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a serious and often undiagnosed consequence of intimate partner violence (IPV). Data on prevalence of TBI among IPV survivors are emerging, but prevalence of IPV among patients presenting to TBI clinics is unknown. Identification of IPV is important to ensure patients with TBI receive appropriate intervention and referrals. OBJECTIVE To determine the proportion of women 18 years and older presenting to an acquired brain injury (ABI) clinic with confirmed or suspected concussion who reported experiencing IPV in the last 12 months or their lifetime. METHODS Single-center cross-sectional cohort study. Proportion of IPV-related TBI or head, neck, or facial) injuries were determined using a modified HELPS Brain Injury Screening Tool and the Neurobehavioral Symptom Inventory. RESULTS Of the 97 women approached, 50 were enrolled in the study. The average age was 46.1 years and 32 women (64.0%) reported a relationship history with a violent partner; 12-month prevalence of IPV was 26.5% and lifetime prevalence was 44.0%. Within their lifetime, all (44.0%) who reported an IPV history reported emotional abuse, 24.0% reported physical abuse, and 18.0% sexual abuse. HELPS responses indicated a high potential of lifetime IPV-related TBI for 29.2%, most commonly from being hit in the face or head (20.8%). CONCLUSION Implementation of IPV screening in community-based ABI clinics is a pivotal step toward understanding the potential scope of TBI and addressing the wide range of somatic, cognitive, and affective symptoms experienced by IPV survivors. IPV screening also will lead to timely referral and follow-up and increase patient safety after discharge from rehabilitation.
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19
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Saleem GT, Champagne M, Haider MN, Leddy JJ, Willer B, Asante I, Kent A, Joseph T, Fitzpatrick JM. Prevalence and Risk Factors for Intimate Partner Physical Violence-Related Acquired Brain Injury Among Visitors to Justice Center in New York. J Head Trauma Rehabil 2022; 37:E10-E19. [PMID: 34985036 DOI: 10.1097/htr.0000000000000750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The recent United States Government Accountability Office report highlights the need for improved data on the prevalence of intimate partner violence (IPV)-related acquired brain injury (ABI) to help direct Health & Human Services public efforts. This article identifies the prevalence and risk factors for IPV-related ABI among survivors of IPV at a Justice Center in New York. SETTING Community Justice Center. PARTICIPANTS Forty survivors of IPV, aged 17 to 73 years (median 32, interquartile range: 25.25, 42) were assessed within 60 days of sustaining physical violence. DESIGN Retrospective chart review. MAIN MEASURES The HELPS and the Danger Assessment-Revised were used at the initial Center visit. RESULTS Of the 40 physical IPV survivors screened, all (100%) reported a prior history of partner-induced ABI within the past 60 days. Thirty-seven (92.5%) survivors also reported sustaining at least 1 potential hypoxic brain injury from strangulation. However, only 16 (40%) survivors screened positive on the HELPS for a history of IPV-related mild traumatic brain injury. Females (95%) and individuals with low income (67.5%) largely comprised our sample. Compared with the County's average, the proportion of African Americans/Blacks and refugees was 227% higher (42.5% vs 13%) and 650% higher (7.5% vs 1.09%), respectively. Refugee status (P = .017) also correlated with number of previous ABIs. On an exploratory binary logistic regression with stepwise selection, only balance difficulties (P = .023) and difficulty concentrating/remembering (P = .009) predicted a positive screen for mild traumatic brain injury. CONCLUSIONS Consistent with previous findings, our data indicate a high prevalence of IPV-related ABI among visitors to a New York Justice Center. An overrepresentation of African Americans/Blacks and refugees in our sample relative to the region signified a higher prevalence of IPV in these populations and warrants a provision of more trauma-informed ABI resources to these groups/communities. Intimate partner violence survivors visiting Justice Centers should be screened for motor/neurocognitive symptoms suggestive of mild traumatic brain injury. Further research to identify the prevalence and risk factors of IPV-related ABI statewide and nationwide is urgently needed to improve resource allocation and clinical management.
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Affiliation(s)
- Ghazala T Saleem
- Department of Rehabilitation Sciences, University at Buffalo, The State University of New York (Dr Saleem); Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo (Mss Champagne, Kent, and Joseph); UBMD Department of Orthopaedics and Sports Medicine (Drs Haider and Leddy) and Department of Psychiatry (Willer), Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo; Department of Public Health, School of Public Health and Health Professions, The State University of New York, Buffalo (Mr Asante); and Department of Social Work, The State University of New York, Buffalo State College (Dr Fitzpatrick)
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20
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Oakley LD, Luebke J, Dosch NC, Snedden TR, Hernadez H, Lemke M, Voland RP. Traumatic Brain Injury Screening and the Unmet Health Needs of Shelter-Seeking Women with Head Injuries Related to Intimate Partner Violence. WOMEN'S HEALTH REPORTS 2021; 2:586-593. [PMID: 35141707 PMCID: PMC8820403 DOI: 10.1089/whr.2021.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/21/2022]
Abstract
Background: Unmet health needs of women with head injuries sustained by intimate partner violence (IPV) include risk of traumatic brain injury (TBI). The purpose of this evaluation was to explore the potential effectiveness of TBI screening as a health promotion strategy for shelter-seeking women with IPV head injuries. We wanted to learn if shelter-seeking women, willing to disclose IPV, would accept TBI screening if offered. Methods: An extended version of the HELPS TBI screening tool and survey of daily symptoms and health needs were used to screen new residents of an urban shelter for women. Results: The participants (N = 18) primarily were educated black women with one or more self-reported IPV-related head injury. Most participants (77.8%) had positive TBI screens for probable brain injury. The majority (88.8%) lived with one or more daily symptoms they did not have before sustaining a IPV head injury. The symptoms reported most frequently were depression (88.9%), anxiety (77.8%), and headache (66.7%). All participants had one or more unmet health need. Although most (77.8%) needed to see a primary care provider, mental health care was the most important health need identified. Conclusions: TBI screening could be considered an effective health promotion strategy for IPV survivors if screening facilitates treatment for positive screens and other unmet health needs. Further research is needed to properly assess this.
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Affiliation(s)
| | - Jeneile Luebke
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Natalie C. Dosch
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Traci R. Snedden
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Melissa Lemke
- Urban Medicine and Public Health Triumph Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Rick P. Voland
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
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21
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Karakurt G, Whiting K, Jones SE, Lowe MJ, Rao SM. Brain Injury and Mental Health Among the Victims of Intimate Partner Violence: A Case-Series Exploratory Study. Front Psychol 2021; 12:710602. [PMID: 34675836 PMCID: PMC8523682 DOI: 10.3389/fpsyg.2021.710602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/09/2021] [Indexed: 12/03/2022] Open
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.
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Affiliation(s)
- Gunnur Karakurt
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, United States
- University Hospital Cleveland Medical Center, Cleveland, OH, United States
| | - Kathleen Whiting
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Stephen E. Jones
- Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, United States
| | - Mark J. Lowe
- Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, United States
| | - Stephen M. Rao
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland, OH, United States
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22
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Rowe RK, Murphy SM, Handmaker H, Lifshitz J. Population-Level Epidemiology of Concussion Concurrent with Domestic Violence in Arizona, USA. J Neurotrauma 2021; 38:2301-2310. [PMID: 33794670 DOI: 10.1089/neu.2021.0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Domestic violence (DV) is a chronic societal epidemic that often involves physical assault to the head, neck, and face, which increases the risk of traumatic brain injuries (TBIs) in DV victims. However, epidemiological data on the extent of TBI-DV at the population scale remain sparse. We performed a statewide, multi-institution, retrospective review of all medical records for patients diagnosed with a concussion, the most common type of TBI, at health care facilities in Arizona, USA, that were licensed by Arizona Department of Health Services (ADHS) during 2016-2018. De-identified records were extracted from discharge data reported to ADHS, which we decoded and transformed to spatiotemporal demographic data of patients who were diagnosed with concussion concurrent with DV. Among 72,307 concussion diagnoses, 940 were concurrent with DV. Sixteen patients died as a result of TBI-DV injuries, where TBI is defined as concussion. Although females were most of the TBI-DV diagnoses, median ages for males and females were 1 and 32 years, respectively, demonstrating that males were predominantly child abuse victims. Whites and Hispanics were victims most diagnosed with concussion and DV, but Native Americans and Blacks comprised a much greater proportion of diagnoses compared with the representative state demographics. Although likely underreported, approximately half of the cases were inflicted by intimate partners, which corresponded closely to marital status. Surprisingly, 61% of victims sought medical treatment for non-concussion injuries and then concussion was entered as a primary diagnosis. The demographic and health care facility disparities demand TBI/concussion screening in suspected DV patients, education and training of care providers, and potential redistribution of resources to select health care facilities.
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Affiliation(s)
- Rachel K Rowe
- Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
- Phoenix VA Health Care System, Phoenix, Arizona, USA
| | - Sean M Murphy
- Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
- The CACTIS Foundation, Scottsdale, Arizona, USA
| | - Hirsch Handmaker
- The CACTIS Foundation, Scottsdale, Arizona, USA
- Department of Radiology, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
| | - Jonathan Lifshitz
- Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
- Phoenix VA Health Care System, Phoenix, Arizona, USA
- The CACTIS Foundation, Scottsdale, Arizona, USA
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23
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Esopenko C, Meyer J, Wilde EA, Marshall AD, Tate DF, Lin AP, Koerte IK, Werner KB, Dennis EL, Ware AL, de Souza NL, Menefee DS, Dams-O'Connor K, Stein DJ, Bigler ED, Shenton ME, Chiou KS, Postmus JL, Monahan K, Eagan-Johnson B, van Donkelaar P, Merkley TL, Velez C, Hodges CB, Lindsey HM, Johnson P, Irimia A, Spruiell M, Bennett ER, Bridwell A, Zieman G, Hillary FG. A global collaboration to study intimate partner violence-related head trauma: The ENIGMA consortium IPV working group. Brain Imaging Behav 2021; 15:475-503. [PMID: 33405096 PMCID: PMC8785101 DOI: 10.1007/s11682-020-00417-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
Intimate partner violence includes psychological aggression, physical violence, sexual violence, and stalking from a current or former intimate partner. Past research suggests that exposure to intimate partner violence can impact cognitive and psychological functioning, as well as neurological outcomes. These seem to be compounded in those who suffer a brain injury as a result of trauma to the head, neck or body due to physical and/or sexual violence. However, our understanding of the neurobehavioral and neurobiological effects of head trauma in this population is limited due to factors including difficulty in accessing/recruiting participants, heterogeneity of samples, and premorbid and comorbid factors that impact outcomes. Thus, the goal of the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium Intimate Partner Violence Working Group is to develop a global collaboration that includes researchers, clinicians, and other key community stakeholders. Participation in the working group can include collecting harmonized data, providing data for meta- and mega-analysis across sites, or stakeholder insight on key clinical research questions, promoting safety, participant recruitment and referral to support services. Further, to facilitate the mega-analysis of data across sites within the working group, we provide suggestions for behavioral surveys, cognitive tests, neuroimaging parameters, and genetics that could be used by investigators in the early stages of study design. We anticipate that the harmonization of measures across sites within the working group prior to data collection could increase the statistical power in characterizing how intimate partner violence-related head trauma impacts long-term physical, cognitive, and psychological health.
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Affiliation(s)
- Carrie Esopenko
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107, USA.
- Department of Health Informatics, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107, USA.
| | - Jessica Meyer
- Department of Psychiatry, Summa Health System, Akron, OH, 44304, USA
| | - Elisabeth A Wilde
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
| | - Amy D Marshall
- Department of Psychology, Pennsylvania State University, University Park, PA, 16802, USA
| | - David F Tate
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
| | - Alexander P Lin
- Department of Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Inga K Koerte
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, 80336, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Kimberly B Werner
- College of Nursing, University of Missouri, St. Louis, MO, 63121, USA
| | - Emily L Dennis
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
| | - Ashley L Ware
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- Department of Psychology, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Nicola L de Souza
- School of Graduate Studies, Biomedical Sciences, Rutgers, The State University of New Jersey, Newark, NJ, 07103, USA
| | | | - Kristen Dams-O'Connor
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Dan J Stein
- Department of Psychiatry and Neuroscience Institute, South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, 7501, South Africa
| | - Erin D Bigler
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
| | - Martha E Shenton
- College of Nursing, University of Missouri, St. Louis, MO, 63121, USA
- Departments of Psychiatry and Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Veterans Affairs, Boston Healthcare System, Boston, MA, 02130, USA
| | - Kathy S Chiou
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, 68588, USA
| | - Judy L Postmus
- School of Social Work, University of Maryland, Baltimore, USA
| | - Kathleen Monahan
- School of Social Welfare, Stony Brook University, Stony Brook, NY, 11794-8231, USA
| | | | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Tricia L Merkley
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Carmen Velez
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
| | - Cooper B Hodges
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
| | - Hannah M Lindsey
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
| | - Paula Johnson
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, 84148, USA
- Neuroscience Center, Brigham Young University, Provo, UT, 84602, USA
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA
- Denney Research Center Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, 90089, USA
| | - Matthew Spruiell
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Esther R Bennett
- Rutgers University School of Social Work, New Brunswick, NJ, 08901, USA
| | - Ashley Bridwell
- Barrow Concussion and Brain Injury Center, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Glynnis Zieman
- Barrow Concussion and Brain Injury Center, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Frank G Hillary
- Department of Psychology, Pennsylvania State University, University Park, PA, 16802, USA
- Social Life and Engineering Sciences Imaging Center, University Park, PA, 16802, USA
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Nicol B, van Donkelaar P, Mason K, Gainforth H. Using Behavior Change Theory to Understand How to Support Screening for Traumatic Brain Injuries Among Women Who Have Experienced Intimate Partner Violence. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:305-315. [PMID: 34476413 PMCID: PMC8409233 DOI: 10.1089/whr.2020.0097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 05/10/2023]
Abstract
Background: Women who experience intimate partner violence (IPV) are at a high risk for traumatic brain injuries (TBIs). Women's shelters may be an ideal location for TBI screening. Behavior change theory can help understand factors that influence screening at women's shelters and develop interventions to promote screening. Objective: To use behavior change theory to understand the local context of women's shelters, factors influencing screening for TBIs among staff who work at women's shelters, and co-develop intervention recommendations to promote screening of TBIs at women's shelters. Methods: The research was conducted in three phases in partnership with the Kelowna Women's Shelter. In phase 1, participants (staff at women's shelters across Canada) completed an online survey that assessed their current TBI screening behaviors, knowledge of TBIs, and factors influencing screening. In phase 2, participants (staff at women's shelters in the Okanagan) completed an interview regarding the factors that influence screening for TBIs. In both phases, factors were analyzed using the Theoretical Domains Framework. In phase 3, intervention recommendations were co-developed using the Behavior Change Wheel. Results: In phase 1, findings indicate that participants (n = 150) lack skills (mean = 2.1, standard deviation [SD] = 1.9) and knowledge (mean = 2.9, SD = 2.2) with regard to screening and are nervous to screen (mean = 3.0, SD = 2.4) for TBIs. In phase 2, 194 barriers to screening for TBI were extracted from 10 interviews with staff members. Prominent domains included knowledge (37%), beliefs about capabilities (16%), and environmental context and resources (15%). Finally, in phase 3, five intervention recommendations were co-developed for interventions aiming to promote TBI screening in women's shelters. Conclusions: This thesis was the first theory-based study to develop intervention recommendations for promoting screening of TBIs at women's shelters. The recommendations have the potential to increase TBI screening at women's shelters ultimately improving the quality of life of women who have experienced a TBI from IPV.
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Affiliation(s)
- Blake Nicol
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Okanagan, Canada
- *Address correspondence to: Blake Nicol, MSc, School of Health and Exercise Sciences, University of British Columbia, 1147 Research Rd., Kelowna, BC, Canada, V1V 1V7.
| | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Okanagan, Canada
| | | | - Heather Gainforth
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Okanagan, Canada
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25
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Jacob B, Cullen N, Haag HL, Chan V, Stock D, Colantonio A. Assault by strangulation: sex differences in patient profile and subsequent readmissions. Canadian Journal of Public Health 2020; 111:492-501. [PMID: 32048232 DOI: 10.17269/s41997-019-00286-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/10/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Assault by strangulation has the potential for severe brain injury or death. The objectives of this study were to describe the profile of individuals who had strangulation-related emergency department (ED) or acute care visits, and to explore 1-year readmission outcomes among survivors. METHODS A population-based retrospective cohort study was conducted using health administrative data in Ontario, Canada. Adults aged 15 years and older who were seen in the ED or acute care with assault by strangulation between fiscal years 2002/2003 and 2016/2017 were included in the study. Bivariate analyses were conducted to compare the patient profile and subsequent readmissions within 1 year of discharge, stratified by sex. RESULTS A total of 586 patients were included in the study. The majority of these patients were seen in the ED (93%), predominantly female (70%), aged ≤ 39 years (68%), and of lower income quintiles of ≤ 3 (73%). Of the 579 patients who survived the initial admission, 52% had subsequent ED readmission and 21% had acute care readmission within 1 year. In sex-stratified analyses, a higher proportion of females were between 20 to 39 years (58.7% vs. 44.1%, p = 0.001), discharged home (88% vs. 81%, p < 0.001), and had ED readmission within 1 year of discharge (56% vs. 17%, p = 0.002). Males had comparatively higher 1-year acute care readmissions. CONCLUSION The study shows high readmissions with sex differences among individuals with an assault by strangulation, suggesting sex-specific approach to health care practices to support the needs of this vulnerable population, thus reducing health system inefficiencies.
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Affiliation(s)
- Binu Jacob
- KITE, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada. .,Toronto General Hospital, University Health Network, Toronto, Canada.
| | - Nora Cullen
- KITE, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada.,West Park Healthcare Centre, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Halina Lin Haag
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Wilfrid Laurier University, Waterloo, Canada
| | - Vincy Chan
- KITE, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada
| | - David Stock
- KITE, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada.,Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Angela Colantonio
- KITE, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
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26
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Ballan MS, Freyer M. Intimate Partner Violence and Women With Disabilities: The Role of Speech-Language Pathologists. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1692-1697. [PMID: 31419158 DOI: 10.1044/2019_ajslp-18-0259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This article is a call to action for speech-language pathologists to address the overlooked problem of intimate partner violence (IPV) among women with communication disorders (CDs). The article aims to heighten awareness of the higher rates of IPV in women with disabilities compared to those without, and to identify types of CDs that can result from IPV. The article provides background on CDs and IPV and delineates the role speech-language pathologists can play in identifying abuse and assisting patients to disclose IPV. Practice recommendations are provided, including enhanced IPV assessment for women with CDs, best practices for intervention emphasizing a trauma-informed approach, and the importance of collaboration and appropriate referrals.
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Affiliation(s)
| | - Molly Freyer
- School of Social Welfare, Stony Brook University, New York, NY
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27
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Iverson KM, Dardis CM, Grillo AR, Galovski TE, Pogoda TK. Associations between traumatic brain injury from intimate partner violence and future psychosocial health risks in women. Compr Psychiatry 2019; 92:13-21. [PMID: 31203176 DOI: 10.1016/j.comppsych.2019.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/31/2019] [Accepted: 05/08/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE The effects of traumatic brain injury (TBI) incurred during military service are widely studied; however, less is known about TBI resulting from intimate partner violence ("IPV-related TBI"). Women Veterans are at high risk for IPV, yet no research has examined future psychosocial health risks associated with IPV-related TBI history in this population. METHODS We examined psychiatric and physical health outcomes, as well as IPV, in a sample of women Veterans who, at Time 1, reported IPV-related TBI with (n = 13) or without (n = 20) persistent symptoms; that is, symptoms such as memory problems, balance problems or dizziness, sensitivity to bright light, irritability, headaches, and sleep problems that began or got worse immediately following the IPV-related TBI and occurred within the past week. These women completed web-based surveys 18 months later (Time 2), which included validated measures of psychiatric and physical health symptoms as well as past-year IPV. We conducted linear regressions to model whether T1 IPV-related TBI with persistent symptoms predicted worse health outcomes at T2, in comparison to T1 IPV-related without persistent symptoms. RESULTS Controlling for significant covariates (i.e., military sexual trauma; MST), IPV-related TBI with persistent symptoms at Time 1 was associated with significantly worse outcomes at Time 2 across all health outcome domains (sr2 range: 0.12-0.37). After controlling for MST and probable posttraumatic stress disorder (PTSD) at Time 1, IPV-related TBI with persistent symptoms at Time 1 remained significantly associated with worse Time 2 symptoms of insomnia, depression, and physical health (sr2 range: 0.12-0.25). CONCLUSION Women who experience IPV-related TBI with persistent symptoms are at higher risk for worse psychosocial health outcomes 18 months later. Findings necessitate screening IPV survivors for TBI with persistent symptoms and tailoring TBI and psychosocial interventions to reduce risk for ongoing health sequelae.
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Affiliation(s)
- Katherine M Iverson
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA 02130, United States of America; Boston University School of Medicine, Boston, MA 02118, United States of America.
| | - Christina M Dardis
- Department of Psychology, Towson University, Towson, MD 21252, United States of America
| | - Alessandra R Grillo
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA 02130, United States of America
| | - Tara E Galovski
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA 02130, United States of America; Boston University School of Medicine, Boston, MA 02118, United States of America
| | - Terri K Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA 02130, United States of America; Boston University School of Public Health, Boston, MA 02118, United States of America
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28
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Haag HL, Sokoloff S, MacGregor N, Broekstra S, Cullen N, Colantonio A. Battered and Brain Injured: Assessing Knowledge of Traumatic Brain Injury Among Intimate Partner Violence Service Providers. J Womens Health (Larchmt) 2019; 28:990-996. [PMID: 31050575 PMCID: PMC6645196 DOI: 10.1089/jwh.2018.7299] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Traumatic brain injury (TBI) as a result of intimate partner violence (IPV) is a significant health concern; yet, little is known about the intersection between the two. Existing research is scarce, limiting the ability of health care providers to develop effective supports. This pilot project surveyed the IPV support community in Toronto, Canada to understand the degree of existing TBI-specific knowledge and relevant services available among these service providers and to seek to bridge the divide between research and practice by developing a national knowledge-to-practice network to support brain-injured women survivors of IPV. Materials and Methods: In phase 1, 68 agencies providing IPV support services were invited to complete an anonymous online survey. In phase 2, 22 stakeholders attended a workshop held to disseminate existing knowledge, develop a national knowledge-to-practice network, and determine next steps in research and practice. Results: The results highlighted a general lack of TBI awareness and understanding among IPV service providers. In addition, participants stated that frontline workers and women survivors of IPV alike do not recognize signs or symptoms of TBI. Recommendations addressing research gaps, professional and public education, and service development were identified and are discussed herein. Conclusions: The identified lack of TBI knowledge among IPV service providers highlights the immediate need to increase education among management and frontline workers. Further investigation identifying best practices for knowledge transfer are suggested. The development of a national strategy addressing education, research, and funding is critical for successful uptake and integration of TBI-sensitive services within the IPV sector.
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Affiliation(s)
- Halina Lin Haag
- 1Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Kitchener, Canada
| | - Sandra Sokoloff
- 2Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | | | | | - Nora Cullen
- 4West Park Healthcare Centre, Toronto, Canada
| | - Angela Colantonio
- 2Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,5Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,6Toronto Rehabilitation Institute-UHN, Toronto, Canada
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King D, Hume PA, Hardaker N, Pearce A, Cummins C, Clark T. Traumatic brain injuries in New Zealand: National Insurance (Accident Compensation Corporation) claims from 2012 to 2016. J Neurol Sci 2019; 399:61-68. [PMID: 30776729 DOI: 10.1016/j.jns.2019.01.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 11/25/2022]
Abstract
AIM To provide epidemiological data and related costs to the national health insurance scheme for traumatic brain injury (TBI) in New Zealand. METHOD A retrospective analytical review utilising detailed descriptive minor and moderate-to-severe epidemiological TBI data obtained from the Accident Compensation Corporation (ACC) for 2012-2016. Injuries were analysed by three levels of increasing severity: moderate, moderate-to-serious (MSC) and severe claims categories. RESULTS Over the January 2012 to December 2016 period there were 97,955 claims for TBI costing ACC $1,450,643,667 [equivalent to £$743,417,120]. Falls accounted for nearly half (41.7%, 8262), and over a quarter (39.9%; $67,626,000 [£34,662,176]) of the moderate claims for TBI. Motor vehicle accidents recorded the highest percentage (36.5%), total costs ($610,978,229 [£313,170,000]) and highest mean cost per-moderate claim per-year ($47,372 ± $2401 [£24,282 ± £1231]) for MSC TBI claims. This was similar for severe claims where motor vehicles accidents accounted for 56% of the total serious claims, 65.1% of the costs with a mean cost per-serious claim of $64,913 ± 4331 [£32,759 ± £2186] per-year. CONCLUSION There were 97,955 TBI injury claims lodged over the duration of the study with 36% (n = 35,304) classified as MSC. The incidence of total TBI in New Zealand was 432 per 100,000 population, and 155 per 100,000 for MSC TBI claims. Despite the growing number of studies reporting on the effects of sports-related TBI, there is a paucity of studies reporting on the longitudinal effects of TBI in falls, assaults and motor vehicle accidents. Further research is warranted into the assessment and management of intimate partner violence and child abuse victims for TBI's.
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Affiliation(s)
- Doug King
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand; School of Science and Technology, University of New England, Armidale, NSW, Australia.
| | - Patria A Hume
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand; National Institute of Stroke and Applied Neuroscience (NISAN), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
| | - Natalie Hardaker
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand; Accident Compensation Corporation, Wellington, New Zealand
| | - Alan Pearce
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | - Cloe Cummins
- School of Science and Technology, University of New England, Armidale, NSW, Australia; Institute for Sport Physical Activity and Leisure, Leeds Beckett University, Leeds, United Kingdom
| | - Trevor Clark
- Australian College of Physical Education, Department of Sport Performance, Sydney Olympic Park NSW, Australia
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30
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St Ivany A, Kools S, Sharps P, Bullock L. Extreme Control and Instability: Insight Into Head Injury From Intimate Partner Violence. JOURNAL OF FORENSIC NURSING 2018; 14:198-205. [PMID: 30433908 PMCID: PMC6250067 DOI: 10.1097/jfn.0000000000000220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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.
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Affiliation(s)
- Amanda St Ivany
- Department of Community and Family Medicine, Dartmouth College
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31
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Barthélemy EJ, Park KB, Johnson W. Neurosurgery and Sustainable Development Goals. World Neurosurg 2018; 120:143-152. [DOI: 10.1016/j.wneu.2018.08.070] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/09/2018] [Accepted: 08/11/2018] [Indexed: 12/14/2022]
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32
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Mollayeva T, Mollayeva S, Colantonio A. Traumatic brain injury: sex, gender and intersecting vulnerabilities. Nat Rev Neurol 2018; 14:711-722. [DOI: 10.1038/s41582-018-0091-y] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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33
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Iverson KM, Dardis CM, Pogoda TK. Traumatic brain injury and PTSD symptoms as a consequence of intimate partner violence. Compr Psychiatry 2017; 74:80-87. [PMID: 28126481 DOI: 10.1016/j.comppsych.2017.01.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/29/2016] [Accepted: 01/10/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To effectively diagnose and treat women who have experienced intimate partner violence (IPV), it is important to identify the full range of physical and mental health consequences, including hidden wounds such as traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). We aimed to identify the occurrence of IPV-related TBI and associated PTSD symptoms among women veterans who experienced IPV. METHODS A web-based survey was administered in 2014 to a national sample of U.S. women veterans. Among 411 respondents (75% participation rate), 55% reported IPV during their lives. These participants (N=224) completed screening measures of IPV-related TBI, PTSD, and past-year IPV and comprised the current sample. RESULTS A total of 28.1% (n=63) met criteria for IPV-related TBI history, and 12.5% (n=28) met criteria for IPV-related TBI with current symptoms. When adjusting for race, income, and past-year IPV, women with IPV-related TBI with current symptoms were 5.9 times more likely to have probable IPV-related PTSD than those with no IPV-related TBI history. Despite symptom overlap between TBI and PTSD, women with IPV-related TBI with current symptoms were significantly more likely to meet criteria for all four DSM-5 PTSD symptom clusters compared to women with an IPV-related TBI history without current symptoms (Cramér's V's=.34-.42). CONCLUSION Findings suggest there may be clinical utility in screening women who experience lifetime IPV for both TBI and PTSD symptoms in order to help clinicians better target their examinations, treatment, and referrals.
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Affiliation(s)
- Katherine M Iverson
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue (116B-3), Boston, MA, 02130, United States; Department of Psychiatry, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, United States.
| | - Christina M Dardis
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue (116B-3), Boston, MA, 02130, United States; Department of Psychiatry, Boston University School of Medicine, 72 East Concord Street, Boston, MA, 02118, United States
| | - Terri K Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 S. Huntington Avenue (Building 9), Boston, MA, 02130, United States; Department of Health Law, Policy & Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, United States
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