Linking Domestic Violence and Traumatic Brain Injury

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Linking Domestic Violenceand Traumatic Brain
Injury
Alabama Department of Rehabilitation Services

• Supported by Grant CFDA93.234 TBI Post
  Demonstration Maternal and Child Health Bureau
• United States Department of Health Human
  Services

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Learning Objectives

• Become aware of the high incidence of traumatic
  brain injury in victims of domestic violence by a
  review of the research on the subject.
• Be able to recognize typical descriptions of
  women who have experienced a brain injury.
• Increase your awareness of how repeated brain
  injury leads to greater dysfunction over time.

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Session agenda

• Review literature linking Domestic Violence (DV)
  with a high incidence of Traumatic brain injury
  (TBI)

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Domestic Violence is defined as

• A deliberate pattern of
• abusive tactics used by one partner in an
  intimate relationship
• to obtain and maintain
• power and control over the other.
• (Alabama Coalition Against Domestic Violence)

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The Challenge

• U.S. Surgeon General (1995) declared partner
  abuse as the greatest cause of major injury to
  women seeking medical attention.
• the most frequent cause of injury to women
  seeking medical attention and the primary reason
  women ages 15-44, seek emergency room services.
  (American Medical Association 1992, Boss 1994)

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Each Year

• 1.5 million women experience domestic violence
• (National Violence Against Domestic Violence
  Annual Report).
• Incidence rates range from 8.4 to 22.
• (Plichta Weisman and Meridith, Abbott Adams)

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Domestic Violence

• Only 1 of abused women are appropriately
  identified by the health care system.
• (Boss 1994)

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Domestic Violence

• Greater than 90 of all injuries secondary to
  domestic violence occur to the head, neck or face
  region.
• (Monahan OLeary 1999)

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Brain Injury a contributing factor to Ongoing
Victim Abuse

• In 53 women living in a DV shelter - On average
  women experienced five brain injuries in the
  prior year.
• - Almost 30 reporting 10 brain injuries the
  previous year.
• (Jackson Phillips 1998)

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In women reporting to ERs for injuries associated
with DV

• 30 of battered women reported a LOC at least
  once.
• 67 reported residual problems that were
  potentially head-injury related.
• (Corrigan 2003)

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Domestic violence...

• Of 99 battered women
• 75 sustained at least 1 partner-related brain
  injury and
• 50 sustained multiple partner-related brain
  injuries
• (Valera, 2003)

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Of the abused women with prior brain injuries,

• 81 reported cognitive, emotional, and physical
  complaints identical to individuals who have
  experienced a brain injury.
• (Ross 2002)

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Typical Descriptions

• Unmotivated
• Unfocused
• Poorly organized
• Unable to plan ahead
• Unable to follow a train of thought
• Forgetful
• Koss 1997, Walker 1991, Warshaw 1993

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Repeated Brain Injury

• Typical of ongoing domestic violence.
• Leads to increased cognitive, physical, and
  emotional dysfunction over time.
• (Hibbard 2002)

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combinedDomestic Violence and Brain Injury
increase the womans risk of continued harm,
repeated brain injuries and program intervention
failure
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In conclusion, research suggests that victims of
domestic violence are at increased risk of a
co-occurring TBI