Survey of depressive symptomatology in brain injury resulting from intimate partner violence

ABSTRACT

Objective

A high prevalence of depression exists in specific sub-samples of survivors of brain injury (BI) sustained from intimate partner violence (IPV). However, the experience of depression by survivors of IPV-related BI from general civilian populations remains unclear. This study documents the symptom profile of depression reported by individuals who screened positive for sustaining an IPV-related BI.

Methods

36 individuals who screened positive for possible IPV-related BI completed the Beck Depression Inventory-2^nd Edition (BDI-II). Subscales characterizing the nature of the symptoms were created. Frequency and descriptive statistics were calculated for item responses on the BDI-II. Participants were also assigned to high or low symptom severity groups to examine between-group differences.

Results

Participants endorsed experiencing somatic symptoms more severely than self-evaluative and affective symptoms. Additionally, self-evaluative and cognitive symptoms correlated with total BDI-II scores for the high symptom severity group but not for the low symptom severity group.

Conclusions

The findings highlight somatic symptoms of depression, in particular as a common experience among survivors of IPV-related BI. Further, self-evaluative and cognitive symptoms may be more sensitive in detecting depression after IPV-related BI. These results may aid in the development of guidelines to better diagnose and treat depression in IPV-related BI.

KEYWORDS:

• Intimate partner violence
• head trauma
• depression
• mental health
• brain injury

Biographical note

Kathy S. Chiou, Ph.D., is an Assistant Professor in the Department of Psychoogy at the University of Nebraska-Lincoln. Broadly, Dr. Chiou’s research examines the effect of traumatic brain injury (TBI) on processes of self-awareness and metacognition, as well as other higher order domains of neurocognitive function. She also has a particular interest in working with subsamples of civilian populations that are at high risk for sustaining or having un-diagnosed TBIs. To this end, Dr. Chiou partners with community organizations who serve survivors of intimate partner violence (IPV) to identify, screen, and assess individuals who have probable IPV-related brain injuries. She hopes that research in this area will bring about systematic changes to service delivery that ultimately improve outcomes and quality of life for surivivors with IPV-related brain injury.

Jeremy A. Feiger, M.S., is a 4^th year graduate student in the Clinical Psychology Training Program at the University of Nebraska–Lincoln. He is broadly interested in the neural underpinnings of cognitive outcomes associated with traumatic brain injury, and the recovery and rehabilitation from brain injury. Additionally, he is interested in examining neurocognitive and biological substrates, including within the central nervous system, immune, and endocrine systems, associated with the comorbidity of psychiatric symptomology (i.e., psychosis, depression and aggression) and traumatic brain injury. Jeremy received his master’s degree in psychological research from Cal State Long Beach where he also received a bachelor’s degree in psychology. At Long Beach, he conducted research examining relationships between frontal lobe functioning, as measured by EEG and neuropsychological testing, and crime and mental disorders. Jeremy’s passion for neuropsychological research began when he worked with Veterans in the neuropsychological testing lab, and as a clinical research coordinator at the VA hospital in Long Beach. He currently works as a neuropsychology extern at a midwestern brain injury rehabilitation hospital.

Mackenzie Cissne, B.A., is a second-year Clinical Psychology doctoral student at the University of Missouri. Mackenzie is a member of the Clinical Neuropsychology Lab under the mentorship of Dr. Shawn Christ. Her current research interests involve studying the cognitive outcomes of individuals with autism spectrum disorder (ASD), specifically outcomes in executive function. Prior to starting her graduate program, Mackenzie received her Bachelors of Arts from the University of Nebraska–Lincoln, where she worked as an undergraduate research assistant and post-baccalaureate lab manager for the Clinical Neuroscience and Neuropsychology lab under Dr. Kathy Chiou studying neuropsychological outcomes and neuro underpinnings of individuals with traumatic brain injury.

Matthew Garlinghouse, Ph.D., completed his Ph.D. in Clinical Psychology at the University of North Dakota and his internship and fellowship in Neuropsychology and Neuroimaging at Dartmouth Medical School (now Geisel School of Medicine). He has served as faculty at Harvard Medical School, Henry Ford Health Systems/Wayne State School of Medicine, and is currently an Assistant Professor of Neurological Sciences at the University of Nebraska Medical Center, where he works as a Clinical Neuropsychologist. At the clinic, Dr. Garlinghouse primarily evaluates patients undergoing presurgical evaluations for refractory epilepsy and CNS cancer. His research interests include the impact of cannabis on cognition and behavior, as well as the impact of brain injuries on survivors of intimate partner violence.

Kate Higgins, Psy.D., ABPP-CN, is a sports neuropsychologist at the University of Nebraska-Lincoln Athletics and University of Nebraska Medical College Neurological Science. She completed a doctorate in clinical psychology at the Forest Institute, a 2-year fellowship in clinical neuropsychology at the University of Nebraska-Lincoln Center for Brain, Biology, and Behavior and the University of Nebraska Medical Center, and is board certified in Clinical Neuropsychology by the American Board of Professional Psychology. Her research interests include concussion management, post-injury testing in athletes with ADHD and learning disabilities and assessment of children with traumatic brain injury. She received research merit awards for her Master’s thesis and doctoral dissertation and was the UNL Postdoc Scholar of the Year.

Peggy Reisher, MSW has a Master’s Degree in Social Work and is the Executive Director of the Brain Injury Alliance of Nebraska (BIA-NE) whose organizational mission is to create a better future for all Nebraskans through brain injury prevention, education, advocacy, and support. Reisher has over 25 years of experience working and advocating for individuals with brain injuries and their families across the state of Nebraska. Her personal goal is to create system improvement for those living with the effects of brain injury. Reisher is currently the chair-elect of the US Brain Injury Alliance.

Shireen S. Rajaram, Ph.D., is an Associate Professor in the Department of Health Promotion at the College of Public Health at the University of Nebraska Medical Center (UNMC). Her research interests include domestic violence, human trafficking and sexual assault. She is a public health advocate and has provided expert testimony for the Nebraska Unicameral to improve the lives of survivors of sex trafficking in Nebraska. In 2018, she was one of the 10 women selected to be a Woman Honoree by the Women’s Center for Advancement (WCA) in Omaha, Nebraska. In 2017, she received the UNMC Visionary Educational Leader Award. In 2016, she received the College of Public Health Excellence in Teaching Award at UNMC. In 2014, she was awarded the UNMC Dr. Carruth J. Wagner Faculty Award in Public Health. Dr. Rajaram is a former director of the Center for Reducing Health Disparities at UNMC. Prior to that, she was a Professor of Sociology and Chair of the Department of Sociology and Anthropology at the University of Nebraska at Omaha.

David DiLillo, Ph.D., is a Willa Cather Professor and Chair of the Department of Psychology at the University of Nebraska-Lincoln. His research and clinical interests lie in the areas of trauma and interpersonal violence. Within those areas, he is particularly interested in intimate partner violence, sexual assault, and the long-term adjustment of adults who have experienced various forms of childhood maltreatment. He has received grants from the Nationa Institute for Mental Health (NIMH), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the National Institute of Alcohol Abuse and Alcoholism (NIAAA).

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by Women Investing in Nebraska.