The Effect of Intimate Partner Violence and Probable Traumatic Brain Injury on Mental Health Outcomes for Black Women

ABSTRACT

Severe intimate partner violence (IPV) including loss of consciousness from head injuries and/or strangulation can result in traumatic brain injury (TBI), a brain pathology characterized by altered brain function, cognitive impairment, and mental health disorders, including depression and posttraumatic stress disorder (PTSD). This study examines the prevalence of probable TBI (defined as loss of consciousness from a blow to the head and/or strangulation) and its association with comorbid PTSD and depression among Black women, who experience both higher rates of IPV and greater mental health burden than White and Latina women. Data come from a retrospective cohort study of 95 Black women with abuse history including IPV, forced sex, and childhood maltreatment. About one-third of women (n = 32) had probable TBI. Among them, 38% (n = 12) were hit on the head, 38% (n = 12) were strangled to unconsciousness, and 25% (n = 8) were strangled and hit on the head. Women with IPV history and probable TBI had significantly greater odds of various physical injuries including those that required medical care compared to other abused women. Probable TBI significantly increased comorbid PTSD and depression by 8.93 points (SE = 3.40), after controlling for past violence (F_{(4, 90)} = 3.67, p < .01). Findings from this study reinforce the need to screen women who lost consciousness due to IPV for TBI and facilitate referrals to IPV interventions and mental health treatment.

KEYWORDS:

• Intimate partner violence
• domestic violence
• physical abuse
• sexual abuse
• depression
• posttraumatic stress disorder
• strangulation
• unconscious

Acknowledgments

We would like to thank the study participants who provided information for this report. Thanks are also due to the Baltimore City Health Department and ESSENCE Project staff who facilitated data collection for the study.

Additional information

Funding

This research was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD077891-J.K. Stockman, J.C. Campbell, A.N. Cimino, K. Tsuyuki), the National Institute on Minority Health and Health Disparities (L60MD003701-J.K. Stockman; L60MD011184-K. Tsuyuki), and the National Institute of Alcohol Abuse and Alcoholism (K01AA025009-K. Tsuyuki). This research was also supported by the Center for AIDS Research (CFAR) at Johns Hopkins University (P30AI094189-A.N. Cimino) and University of California, San Diego (2P30AI036214-24), an NIH-funded program which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLB, NIA, NIGMS, and NIDDK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.