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Clarke ADA, Copas C, Hannon O, Padgett C, Knight JM, Falkenberg A, Varto H, Mason K, Wellington CL, van Donkelaar P, Marks J, Shultz SR, Symons GF. Detecting a hidden pandemic: The current state and future direction of screening and assessment tools for intimate partner violence-related brain injury. Neurosci Biobehav Rev 2024; 167:105912. [PMID: 39368636 DOI: 10.1016/j.neubiorev.2024.105912] [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: 06/10/2024] [Revised: 09/21/2024] [Accepted: 09/29/2024] [Indexed: 10/07/2024]
Abstract
Intimate partner violence (IPV) is a major global concern, and IPV victim-survivors are at an increased risk of brain injury (BI) due to the physical assaults. IPV-BI can encompass both mild traumatic brain injury (mTBI) and non-fatal strangulation (NFS), but IPV-BI often goes undetected and untreated due to a number of complicating factors. Therefore, the clinical care and support of IPV victim-survivors could be enhanced by BI screening and assessment in various settings (e.g., first responders, emergency departments, primary care providers, rehabilitation, shelters, and research). Further, appropriate screening and assessment for IPV-BI will support more accurate identifications, and prevalence estimates, improve understanding of health implications, and have the potential to inform policy decisions. Here we overview the seven available tools that have been used for IPV-BI screening and assessment purposes, including the BISA, BISQ-IPV, BAT-L/IPV, OSU TBI-ID, the HELPS, and the CHATS, and outline the advantages and disadvantages of these screening tools in the clinical, community, and research settings. Recommendations for further research to enhance the validity and utility of these tools are also included.
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Affiliation(s)
- Abigail D Astridge Clarke
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
| | - Charlotte Copas
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
| | - Olivia Hannon
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Christine Padgett
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Jennifer Makovec Knight
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
| | - Aimee Falkenberg
- Centre for Trauma & Mental Health Research, Vancouver Island University, Nanaimo, BC, Canada; Forensic Nurse Program, Nanaimo Regional General Hospital, Island Health, Nanaimo, BC, Canada
| | - Hannah Varto
- Embrace Clinic, Fraser Health Authority, Surrey, BC, Canada
| | - Karen Mason
- Supporting Survivors of Abuse and Brain Injury Through Research (Soar), Kelowna, BC, Canada
| | - Cheryl L Wellington
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | | | - Sandy R Shultz
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Centre for Trauma & Mental Health Research, Vancouver Island University, Nanaimo, BC, Canada.
| | - Georgia F Symons
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Centre for Trauma & Mental Health Research, Vancouver Island University, Nanaimo, BC, Canada.
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Vaidya N, Marquand AF, Nees F, Siehl S, Schumann G. The impact of psychosocial adversity on brain and behaviour: an overview of existing knowledge and directions for future research. Mol Psychiatry 2024; 29:3245-3267. [PMID: 38658773 PMCID: PMC11449794 DOI: 10.1038/s41380-024-02556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
Environmental experiences play a critical role in shaping the structure and function of the brain. Its plasticity in response to different external stimuli has been the focus of research efforts for decades. In this review, we explore the effects of adversity on brain's structure and function and its implications for brain development, adaptation, and the emergence of mental health disorders. We are focusing on adverse events that emerge from the immediate surroundings of an individual, i.e., microenvironment. They include childhood maltreatment, peer victimisation, social isolation, affective loss, domestic conflict, and poverty. We also take into consideration exposure to environmental toxins. Converging evidence suggests that different types of adversity may share common underlying mechanisms while also exhibiting unique pathways. However, they are often studied in isolation, limiting our understanding of their combined effects and the interconnected nature of their impact. The integration of large, deep-phenotyping datasets and collaborative efforts can provide sufficient power to analyse high dimensional environmental profiles and advance the systematic mapping of neuronal mechanisms. This review provides a background for future research, highlighting the importance of understanding the cumulative impact of various adversities, through data-driven approaches and integrative multimodal analysis techniques.
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Affiliation(s)
- Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Clinical Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany.
| | - Andre F Marquand
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Sebastian Siehl
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Clinical Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Centre for Population Neuroscience and Stratified Medicine (PONS), Institute for Science and Technology of Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, China
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3
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Spencer CM, Keilholtz BM, Palmer M, Vail SL. Factors Associated with Non-Fatal Strangulation Victimization in Intimate Relationships: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:2103-2114. [PMID: 37941372 DOI: 10.1177/15248380231207874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Intimate partner violence (IPV) is a public health crisis across the globe, and one particular act of IPV, non-fatal strangulation, warrants serious attention. Non-fatal strangulation is a risk factor for intimate partner homicide (IPH) and can create long-term negative mental and physical health consequences. In this meta-analysis, we sought to examine factors associated with non-fatal strangulation victimization among women to help inform education and assessment efforts. Using database searches and Boolean search terms, a total of 16 studies met the inclusion criteria. A total of 16 factors that were found in at least two unique studies were examined. The strongest associated factors included physical IPV victimization, physical injury, IPH, and sexual IPV victimization. Other significant associated factors included lower education, anxiety symptoms, perceived risk of harm, post-traumatic stress symptoms, depressive symptoms, stalking victimization, and identifying as a Black woman. Experiencing childhood trauma, the length of the relationship, age, substance use, and identifying as Hispanic were not significantly related to strangulation victimization by an intimate partner. Education and assessment implications are discussed.
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Adhikari SP, Daugherty JC, Quiroz Molinares N, Maldonado-Rodriguez N, Wallace C, Smirl J, Perez-García M, De Los Reyes-Aragón CJ, Hidalgo-Ruzzante N, van Donkelaar P, Valera EM. A Four-Country Study of Strangulation-Related Alterations in Consciousness in Women Who Have Experienced Intimate Partner Violence: Co-Occurrence with Traumatic Brain Injuries and Measures of Psychological Distress. J Neurotrauma 2024; 41:e1666-e1677. [PMID: 38666734 DOI: 10.1089/neu.2023.0440] [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: 07/18/2024] Open
Abstract
At least one in three women experience intimate partner violence (IPV) in their lifetime. The most commonly sustained IPV-related brain injuries include strangulation-related alterations in consciousness (S-AICs) and traumatic brain injuries (TBIs). Moreover, survivors of IPV-related S-AICs and/or TBIs often demonstrate psychological distress such as depression, anxiety, and post-traumatic stress. However, the co-occurrence of S-AICs and TBIs, and whether such TBIs may be moderate to severe, has not been systematically examined, and most data have been collected from women in North America. The purpose of this study was to examine the co-occurrence of IPV-related S-AICs and TBIs across a range of geographical locations and to determine the extent to which these S-AICs are related to psychological distress. Women who had experienced physical IPV (n = 213) were included in this secondary analysis of retrospectively collected data across four countries (Canada, the United States, Spain, and Colombia). The Brain Injury Severity Assessment (BISA) was used to assess IPV-related BI across all sites. Because various questionnaires were employed to assess levels of depression, anxiety, and post-traumatic stress disorder at each site, we created a standardized composite score by converting raw scores into Z-scores for analysis. Mann-Whitney U tests and chi-square tests were conducted to examine differences between women with and without experience of S-AICs and to discover if there was a relationship between the occurrence of S-AICs and TBIs. Analysis of variance and analysis of covariance (to control for the potential confounding effects of age, education, and non IPV-related TBI) were used to compare levels of psychological distress in women who had or had not experienced S-AICs. Approximately, 67% of women sustained at least one IPV-related BI (i.e., TBI and/or S-AIC). In a subsample of women who sustained at least one IPV-related BI, approximately 37% sustained both S-AICs and TBIs, 2% sustained only S-AICs (with no TBIs), and 61% sustained TBIs exclusively (with no S-AICs). Furthermore, women who had sustained S-AICs (with or without a TBI) were more likely to have experienced a moderate-to-severe BI than those who had not sustained an S-AIC (BISA severity subscale: U = 3939, p = 0.006). In addition, women who experienced S-AICs (with or without a TBI) reported higher levels of psychological distress compared with women who never experienced S-AICs, irrespective of whether they occurred once or multiple times. These data underscore the importance of assessing for S-AIC in women who have experienced IPV and when present, to also assess for TBIs and the presence of psychological distress. Unfortunately, there were methodological differences across sites precluding cross-site comparisons. Nonetheless, data were collected across four culturally and geographically diverse countries and, therefore, highlight IPV-related BIs as a global issue that needs to be aggressively studied with policies established and then implemented to address findings.
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Affiliation(s)
| | - Julia C Daugherty
- Université Clermont Auvergne, CNRS, LAPSCO, Clermont-Ferrand, France
| | | | | | - Colin Wallace
- Department of Kinesiology, Okanagan College, Kelowna, Canada
| | - Jonathan Smirl
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Miguel Perez-García
- Mind, Brain and Behavior Research Center, (CIMCYC), University of Granada, Granada, Spain
| | | | | | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Eve M Valera
- Psychiatry, Harvard Medical School and Massachusetts General Hospital, Charlestown, Massachusetts, USA
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5
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Benjumeda Wynhoven I, Yago Alonso C. Protective factors for the risk of suffering intimate partner violence in help-seeking women survivors from a social organization in Chile. FRONTIERS IN SOCIOLOGY 2024; 9:1419182. [PMID: 38957646 PMCID: PMC11218744 DOI: 10.3389/fsoc.2024.1419182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/22/2024] [Indexed: 07/04/2024]
Abstract
Objective Intimate partner violence (IPV) is a major public health problem in Latin America. The present study investigates the protective factors that contribute to minimizing the risk of exposure to IPV analyzing different variables in a sample of Chilean women victims of IPV. Methods We used data from the Cicatrices Foundation, a nonprofit Chilean organization providing psychological support to IPV victims. Relevant variables for IPV prevention were identified analyzing a database containing all the information reported by victims during a structured interview. A final sample of 444 women suffering IPV was used in the present study. Results Logistic regression analysis was calculated in order to make predictions related to IPV protective factors, showing that having a support network (OR = 2.85), treatment compliance (OR = 2.05) and being younger (OR = 0.95) increased the probability of not living with the aggressor. Another logistic regression analysis was calculated in order to predict IPV victims´ health taking medication intake as an indicator. A significant association was observed between this variable and working outside (p = 0.002) and between mediation intake and age (p < 0.001), with an OR of 1.987 and 0.93, respectively. Working outside and being younger were identified as protective factors against consuming medication. Conclusion To the best of our knowledge, this is one of the first studies conducted in Chile on the prevention of IPV in a sample of victims seeking for help. Our results will contribute to guide policy makers, researchers and other women in the prevention of potential risks for IPV.
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Affiliation(s)
| | - Carmen Yago Alonso
- Departamento de Psiquiatría y Psicología Social, Universidad de Murcia, Murcia, Spain
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Adhikari SP, Stranges TN, Tehrani SNZ, Porter S, Mason K, van Donkelaar P. Investigating the Efficacy of a Community Support Network Rehabilitation Intervention for Improving Resiliency, Quality of Life, and Neurocognitive Function in Survivors of Intimate Partner Violence-Caused Brain Injury: Protocol for a Feasibility Study. JMIR Res Protoc 2024; 13:e54605. [PMID: 38788207 PMCID: PMC11177797 DOI: 10.2196/54605] [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: 11/15/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Globally, approximately 1 in 3 women experience intimate partner violence (IPV) in their lifetime. Brain injury (BI) is a common, yet often unrecognized, consequence of IPV. BIs caused by IPV tend to be mild, occur repetitively over the course of months or years, are remote in time, and result in chronic symptoms. Similar to BI from other causes, therapeutic treatment for women with IPV-caused BI (IPV-BI) is crucial to help resolve any physical or cognitive impairments, enhance the quality of life (QoL), and minimize longer-term neurodegeneration. OBJECTIVE This study aims to investigate the feasibility and efficacy of a community support network (CSN) rehabilitation intervention regarding its impact on resiliency, QoL, and neurocognitive function. METHODS In this pre- and postexperimental design, women (aged 18 to 50 years) who are survivors of IPV and IPV-BI will be recruited from various community organizations serving survivors of IPV. Exclusion criteria will include current pregnancy and any diagnosed neurological disorder known to affect cerebrovascular, neurocognitive, or sensorimotor function. A CSN rehabilitation intervention that includes aerobic exercise, cognitive training, mindfulness meditation, and counseling will be administered. A trauma-informed approach will be integrated into the design and implementation of the program. Furthermore, the program will include a participant navigator who will provide trauma- and violence-informed advocacy and systems navigation support to participants, in addition to facilitating a monthly peer support group. The intervention will be provided for 2.5 hours a day and 2 days a week for 3 months. Participants will complete psychological assessments and provide clinic-demographic information in the first assessment. In the second (before intervention), third (after intervention), and fourth (at follow-up) sessions, they will complete tests of resiliency, QoL, and neurocognition. The estimated sample size is 100. The objective of this study will be accomplished by quantitatively measuring resiliency, QoL, and neurocognition before and immediately after the intervention. A follow-up assessment will occur 3 months after the completion of the intervention to evaluate the maintenance of any improvements in function. One-way ANOVAs will be used to evaluate the intervention outcome across the testing times. Relationships among various variables will be explored using regression analysis. RESULTS We anticipate that the CSN rehabilitation intervention will be effective in improving resiliency, QoL, and neurocognitive function in women who have experienced IPV-BI. Furthermore, we anticipate that this intervention will be feasible in terms of study recruitment, adherence, and retention. CONCLUSIONS The CSN rehabilitation intervention will have a positive impact on resiliency, QoL, and neurocognitive functions in survivors of IPV-BI. Subsequently, a comparative study will be conducted by recruiting a control group receiving usual care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54605.
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Affiliation(s)
| | - Tori N Stranges
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | | | | | - Karen Mason
- Supporting Survivors of Abuse and Brain Injury Through Research (SOAR), Kelowna, BC, Canada
| | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
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Zhu J, Exner-Cortens D, Dobson K, Wells L, Noel M, Madigan S. Adverse childhood experiences and intimate partner violence: A meta-analysis. Dev Psychopathol 2024; 36:929-943. [PMID: 37009672 DOI: 10.1017/s0954579423000196] [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: 04/04/2023]
Abstract
Intimate partner violence (IPV) represents a significant public health concern. Adverse childhood experiences (ACEs) represent one risk factor for IPV, however, the results of existing research on the association between ACEs and IPV demonstrate mixed findings. The present research sought to meta-analytically examine the association between ACEs and (a) IPV perpetration and (b) IPV victimization. Moderator analyses were conducted to determine factors that may impact the association between ACEs and IPV involvement. Electronic searches were conducted in MEDLINE, Embase, and PsycINFO in August of 2021. One-hundred and twenty-three records were screened for inclusion. All studies included a measure of ACEs and IPV victimization or perpetration. Among the 27 studies and 41 samples included in the meta-analysis, 65,330 participants were included. The results of the meta-analyses demonstrated that ACEs were positively associated with IPV perpetration and victimization. Significant methodological and measurement moderators further inform our understanding of ACEs and IPV involvement. The present meta-analyses demonstrates that trauma-informed approaches to IPV screening, prevention, and intervention may be useful, given that individuals who are involved with IPV may be more likely to possess a history of ACEs exposure.
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Affiliation(s)
- Jenney Zhu
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Deinera Exner-Cortens
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Keith Dobson
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Lana Wells
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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Tang A, Wong A, Khurana B. Imaging of Intimate Partner Violence, From the AJR Special Series on Emergency Radiology. AJR Am J Roentgenol 2023; 220:476-485. [PMID: 36069484 DOI: 10.2214/ajr.22.27973] [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: 01/26/2023]
Abstract
Intimate partner violence (IPV) is a highly prevalent public health issue with multiple adverse health effects. Radiologists are well suited to assessing a patient's likelihood of IPV. Recognition of common IPV injury mechanisms and resulting target and defensive injury patterns on imaging and understanding of differences between patients who have experienced IPV and those who have not with respect to use of imaging will aid radiologists in accurate IPV diagnosis. Target injuries often involve the face and neck as a result of blunt trauma or strangulation; defensive injuries often involve an extremity. Awareness of differences in injury patterns resulting from IPV-related and accidental trauma can aid radiologists in detecting a mismatch between the provided clinical history and imaging findings to support suspicion of IPV. Radiologists should consider all available current and prior imaging in assessing the likelihood of IPV; this process may be aided by machine learning methods. Even if correctly suspecting IPV on the basis of imaging, radiologists face challenges in acting on that suspicion, including appropriately documenting the findings, without compromising the patient's confidentiality and safety. However, through a multidisciplinary approach with appropriate support mechanisms, radiologists may serve as effective frontline physicians for raising suspicion of IPV.
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Affiliation(s)
- Anji Tang
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
- Trauma Imaging Research and Innovation Center, Brigham and Women's Health, Boston, MA
| | - Andrew Wong
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Bharti Khurana
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
- Trauma Imaging Research and Innovation Center, Brigham and Women's Health, Boston, MA
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Shymanskaya A, Kohn N, Habel U, Wagels L. Brain network changes in adult victims of violence. Front Psychiatry 2023; 14:1040861. [PMID: 36816407 PMCID: PMC9931748 DOI: 10.3389/fpsyt.2023.1040861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Stressful experiences such as violence can affect mental health severely. The effects are associated with changes in structural and functional brain networks. The current study aimed to investigate brain network changes in four large-scale brain networks, the default mode network, the salience network, the fronto-parietal network, and the dorsal attention network in self-identified victims of violence and controls who did not identify themselves as victims. Materials and methods The control group (n = 32) was matched to the victim group (n = 32) by age, gender, and primary psychiatric disorder. Sparse inverse covariance maps were derived from functional resting-state measurements and from T1 weighted structural data for both groups. Results Our data underlined that mostly the salience network was affected in the sample of self-identified victims. In self-identified victims with a current psychiatric diagnosis, the dorsal attention network was mostly affected underlining the potential role of psychopathological alterations on attention-related processes. Conclusion The results showed that individuals who identify themselves as victim demonstrated significant differences in all considered networks, both within- and between-network.
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Affiliation(s)
- Aliaksandra Shymanskaya
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
| | - Nils Kohn
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmengen, Netherlands
| | - Ute Habel
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Brain Structure and Function, INM-10, Institute of Neuroscience and Medicine, Jülich Research Centre, Jülich, Germany
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Likitlersuang J, Salat DH, Fortier CB, Iverson KM, Werner KB, Galovski T, McGlinchey RE. Intimate partner violence and brain imaging in women: A neuroimaging literature review. Brain Inj 2023; 37:101-113. [PMID: 36729954 DOI: 10.1080/02699052.2023.2165152] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PRIMARY OBJECTIVE Despite a high prevalence of intimate partner violence (IPV) and its lasting impacts on individuals, particularly women, very little is known about how IPV may impact the brain. IPV is known to frequently result in traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). In this overview of literature, we examined literature related to neuroimaging in women with IPV experiences between the years 2010-2021. RESEARCH DESIGN Literature overview. METHODS AND PROCEDURES A total of 17 studies were included in the review, which is organized into each imaging modality, including magnetic resonance imaging (structural, diffusion, and functional MRI), Electroencephalography (EEG), proton magnetic resonance spectroscopy (pMRS), and multimodal imaging. MAIN OUTCOMES AND RESULTS Research has identified changes in brain regions associated with cognition, emotion, and memory. Howeverto date, it is difficult to disentangle the unique contributions of TBI and PTSD effects of IPV on the brain. Furthermore, experimental design elements differ considerably among studies. CONCLUSIONS The aim is to provide an overview of existing literature to determine commonalities across studies and to identify remaining knowledge gaps and recommendations for implementing future imaging studies with individuals who experience IPV.
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Affiliation(s)
- Jirapat Likitlersuang
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, Massachusetts, USA.,Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - David H Salat
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, Massachusetts, USA.,Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital Department of Radiology, Charlestown, Massachusetts, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Katherine M Iverson
- Women' Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kimberly B Werner
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Tara Galovski
- Women' Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA
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11
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Jaroenkajornkij N, Lev-Wiesel R, Binson B. Use of Self-Figure Drawing as an Assessment Tool for Child Abuse: Differentiating between Sexual, Physical, and Emotional Abuse. CHILDREN 2022; 9:children9060868. [PMID: 35740805 PMCID: PMC9221832 DOI: 10.3390/children9060868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022]
Abstract
Child abuse is a worldwide phenomenon with adverse short- and long-term mental and physical negative consequences, with a huge gap between the prevalence of child abuse and disclosure rates. The study aimed to examine and validate the self-figure drawing as an assessment tool to differentiate between three forms of child abuse, i.e., child sexual abuse (CSA), child physical abuse (CPA), and child emotional abuse (CEA). Following the ethical approval, 1707 Thai children (13–18 years old) from the general population (schools) were asked to complete a self-report anonymous questionnaire consisting of four measures (Demographics, Childhood Trauma Questionnaire (CTQ), The Medical Somatic Dissociation Questionnaire (MSDQ), and The Disclosure of Trauma Questionnaire (DTQ)). After completion, they were asked to draw themselves. There was a significantly positive link between the reluctance to disclose and the experience of abuse, indicating that the more severe the abuse the higher the reluctance to disclose. The findings broaden the knowledge of movement and symbols as representations of inner personal conflictual material. Additionally, it substantiates self-figure drawing as an assessment tool and assists practitioners in early child abuse detection.
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Affiliation(s)
- Nisara Jaroenkajornkij
- Faculty of Creative Arts Therapies, University of Haifa, 199 Aba Khoushy Av., Haifa 3498838, Israel
- Correspondence: ; Tel.: +972-66644022148
| | - Rachel Lev-Wiesel
- The Emili Sagol Research Center for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel;
- Social Work, Tel Hai College, Qiryat Shemona 1220800, Israel
| | - Bussakorn Binson
- Faculty of Fine and Applied Arts, Chulalongkorn University, Bangkok 10330, Thailand;
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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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Maldonado-Rodriguez N, Crocker CV, Taylor E, Jones KE, Rothlander K, Smirl J, Wallace C, van Donkelaar P. Characterization of Cognitive-Motor Function in Women Who Have Experienced Intimate Partner Violence-Related Brain Injury. J Neurotrauma 2021; 38:2723-2730. [PMID: 34036801 DOI: 10.1089/neu.2021.0042] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Intimate partner violence (IPV) affects at least one in three women worldwide, and up to 92% report symptoms consistent with brain injury (BI). Although a handful of studies have examined different aspects of brain structure and function in this population, none has characterized potential deficits in cognitive-motor function. This knowledge gap was addressed in the current study by having participants who had experienced IPV complete the bimanual Object Hit & Avoid (OHA) task in a Kinesiological Instrument for Normal and Altered Reaching Movement (KINARM) End-Point Laboratory. BI load, post-traumatic stress disorder (PTSD), anxiety, depression, substance use, and history of abuse were also assessed. A stepwise multiple regression was undertaken to explore the relationship between BI load and task performance while accounting for comorbid psychopathologies. Results demonstrated that BI load accounted for a significant amount of variability in the number of targets hit and the average hand speed. PTSD, anxiety, and depression also contributed significantly to the variability in these measures as well as to the number and proportion of distractor hits, and the object processing rate. Taken together, these findings suggest that IPV-related BI, as well as comorbid PTSD, anxiety, and depression, disrupt the processing required to quickly and accurately hit targets while avoiding distractors. This pattern of results reflects the complex interaction between the physical injuries induced by the episodes of IPV and the resulting impacts that these experiences have on mental health.
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Affiliation(s)
- Naomi Maldonado-Rodriguez
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Clara Val Crocker
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Edward Taylor
- School of Social Work, University of British Columbia, Kelowna, British Columbia, Canada
| | - K Elisabeth Jones
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Krystal Rothlander
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jon Smirl
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Colin Wallace
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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White TL, Gonsalves MA. Dignity neuroscience: universal rights are rooted in human brain science. Ann N Y Acad Sci 2021; 1505:40-54. [PMID: 34350987 PMCID: PMC9291326 DOI: 10.1111/nyas.14670] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/25/2021] [Accepted: 07/08/2021] [Indexed: 01/22/2023]
Abstract
Universal human rights are defined by international agreements, law, foreign policy, and the concept of inherent human dignity. However, rights defined on this basis can be readily subverted by overt and covert disagreements and can be treated as distant geopolitical events rather than bearing on individuals’ everyday lives. A robust case for universal human rights is urgently needed and must meet several disparate requirements: (1) a framework that resolves tautological definitions reached solely by mutual, revocable agreement; (2) a rationale that transcends differences in beliefs, creed, and culture; and (3) a personalization that empowers both individuals and governments to further human rights protections. We propose that human rights in existing agreements comprise five elemental types: (1) agency, autonomy, and self‐determination; (2) freedom from want; (3) freedom from fear; (4) uniqueness; and (5) unconditionality, including protections for vulnerable populations. We further propose these rights and protections are rooted in fundamental properties of the human brain. We provide a robust, empirical foundation for universal rights based on emerging work in human brain science that we term dignity neuroscience. Dignity neuroscience provides an empirical foundation to support and foster human dignity, universal rights, and their active furtherance by individuals, nations, and international law.
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Affiliation(s)
- Tara L White
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island.,Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island.,Carney Institute for Brain Science, Brown University, Providence, Rhode Island.,University of Cambridge, England, Cambridge, UK
| | - Meghan A Gonsalves
- Neuroscience Graduate Program, Brown University, Providence, Rhode Island
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15
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Ebert C, Steinert JI. Prevalence and risk factors of violence against women and children during COVID-19, Germany. Bull World Health Organ 2021; 99:429-438. [PMID: 34108753 PMCID: PMC8164185 DOI: 10.2471/blt.20.270983] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To assess the prevalence and exacerbating factors of violence against women and children in Germany during the coronavirus disease 2019 pandemic. METHODS We conducted a representative online survey with partnered women (18-65 years) between 22 April and 8 May 2020, when participants had been under lockdown for a month. We determined the prevalence of several forms of violence within the previous month using both direct elicitation and a list experiment. We conducted a multivariable logistic regression to assess the impact of pandemic-associated risk factors. FINDINGS Of our 3818 survey respondents, 118 (3.09%; 95% confidence interval, CI: 2.54 to 3.64) reported incidents of physical conflict, 293 (7.67%; 95% CI: 6.83 to 8.52) reported emotional abuse, and 97 (6.58%; 95% CI: 5.31 to 7.85) of 1474 respondents with children reported child corporal punishment. We estimated that 3.57% (95% CI: -0.33 to 7.46) had non-consensual intercourse with their partner. Our regression analysis revealed an increased risk of physical conflict with home quarantine (odds ratio, OR: 2.38; 95% CI: 1.56 to 3.61), financial worries (OR: 1.60; 95% CI: 0.98 to 2.61), poor mental health (OR: 3.41; 95% CI: 2.12 to 5.50) and young (< 10 years) children (OR: 2.48; 95% CI: 1.32 to 4.64); we obtained similar results for other forms of violence. Awareness and use of pertinent support services was low. CONCLUSION Our findings of an increased risk of domestic violence during the pandemic should prompt policy-makers to improve the safety of women and children. Interventions to alleviate risks factors and extend support services are required.
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Affiliation(s)
- Cara Ebert
- RWI - Leibniz Institute for Economic Research, Essen, Germany
| | - Janina I Steinert
- Technical University of Munich, Richard-Wagner-Strasse 1, 80333 München, Germany
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16
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Bichard H, Byrne C, Saville CWN, Coetzer R. The neuropsychological outcomes of non-fatal strangulation in domestic and sexual violence: A systematic review. Neuropsychol Rehabil 2021; 32:1164-1192. [PMID: 33432860 DOI: 10.1080/09602011.2020.1868537] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This systematic review draws together evidence from the literature for the pathological, neurological, cognitive, psychological, and behavioural outcomes of non-fatal strangulation in domestic and sexual violence. A systematic search of PubMed, PsycINFO, CINHAL, Proquest, ASSIA, Web of Science, WestLaw, Open Grey, and Ethos was conducted, with no date limits set, to identify eligible studies. Thirty empirical, peer-reviewed studies were found which met the inclusion criteria. Pathological changes included arterial dissection and stroke. Neurological consequences included loss of consciousness, indicating at least mild acquired brain injury, seizures, motor and speech disorders, and paralysis. Psychological outcomes included PTSD, depression, suicidality, and dissociation. Cognitive and behavioural sequelae were described less frequently, but included memory loss, increased aggression, compliance, and lack of help-seeking. However, no studies used formal neuropsychological assessment: the majority were medical case studies or based on self-report. Furthermore, few authors were able to control for possible confounds, including other physical violence and existing psychosocial difficulties. There is therefore a need for further neuropsychological research, focusing on cognitive and behavioural outcomes, using standardized tools, and control groups where possible. This is urgent, given societal normalization of strangulation, and legal systems which often do not reflect the act's severity and its consequences.
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Affiliation(s)
- Helen Bichard
- North Wales Brain Injury Service, Betsi Cadwaladr University Health Board, Liverpool, UK.,School of Psychology, Bangor University, Bangor, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Christopher Byrne
- North Wales Brain Injury Service, Betsi Cadwaladr University Health Board, Liverpool, UK.,School of Psychology, Bangor University, Bangor, UK
| | | | - Rudi Coetzer
- North Wales Brain Injury Service, Betsi Cadwaladr University Health Board, Liverpool, UK.,School of Psychology, Bangor University, Bangor, UK
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