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Impact of Mild Traumatic Brain Injury on Physical, Mental, and Cognitive Functioning of Abused Women Admitted To Emergency Department

One in four women will experience intimate partner violence (IPV) at some point in her lifetime. The majority (up to 95%) of injuries caused by IPV are sustained to the head, and about 73% of these traumatic brain injuries (TBIs) are classified as “mild,” also known as a concussion. A significant number of women who have experienced IPV will later require clinical treatment for persistent TBI-related physical symptoms, which can include headaches, irritability, forgetfulness, frustration, depression and anxiety, dizziness, noise sensitivity, and longer thought processing time—all of which can significantly impact daily functioning and quality of life. Early identification of mild TBI among this vulnerable population is critical for promoting wellness during the injury recovery period.

While the interest in and study of partner violence has grown over the past few decades, little research has focused on the effects of IPV-related mild TBI on abused women’s physical and mental wellbeing and cognitive functioning.

To address this, a research team conducted a study of IPV-related mild TBI among patients in four major hospitals in Hong Kong. Emergency department nurses screened 200 women who had voluntarily reported any IPV-related injuries, identifying 86 women eligible for the study. These participants were privately interviewed about their injuries, completing a cognitive assessment and several self-administered questionnaires to gauge their physical, mental, and cognitive functioning. The researchers found that:

  • About one in four of the women sustained a mild TBI as a result of their abuse.
  • Compared to women who were abused but did not sustain head injuries, those with mild TBI had higher rates of depression and anxiety, lower quality of mental wellbeing, and greater severity of post-concussion physical symptoms.
  • Both those with and without mild TBI showed disruptive cognitive function, but there were no significant differences between the two groups, suggesting that the chronic stress associated with any kind of abuse—with or without head injury—can disrupt normal cognition.

These findings strengthen the known association between head injuries and IPV among women. Emergency departments are strongly encouraged to implement universal screening for IPV among TBI patients, and health professionals should be trained to provide brief behavioral-based interventions (such as identifying “red flags” in abuser behavior) and privately tailored safety plans to support women who have experienced abuse. These efforts to support early identification and intervention are critical for improving safety, wellbeing, and quality of life among women experiencing IPV.

Yuen-Ha Wong J, Kit-Shing Wong J, Cheung K-Y, et all. Impact of mild traumatic brain injury on physical, mental and cognitive functioning of abused women admitted to emergency units. Health and Social Care Community. (Oct 2020).

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