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Traumatic Brain Injuries Caused by Intimate Partner Violence

In This Video

  • Eve Valera, PhD, discusses her work to better understand the prevalence of traumatic brain injuries (TBI) in women who have experienced intimate partner violence
  • In her initial study, 75% of women who had experienced intimate partner violence had sustained at least one TBI and nearly 50% had experienced sustained mild TBI
  • Her additional research using neuroimaging has revealed alterations in the way that certain brain networks interact with one another as a result of these injuries

Eve Valera, PhD, a psychiatry researcher with the Martinos Center for Biomedical Imaging, discusses her work to better understand the prevalence of traumatic brain injuries (TBIs) in women who have experienced intimate partner violence and how TBIs impact victims' everyday cognitive and physiological functioning.

Transcript

I'm very interested in understanding the prevalence of traumatic brain injuries in women who have experienced intimate partner violence and also the sequelae of those brain injuries on these women's everyday cognitive and physiological functioning.

In my first study I found that 75% of the women who I interviewed sustained at least one traumatic brain injury, whereas nearly 50% sustained repetitive mild traumatic brain injuries, and this doesn't mean just like, okay, there was two or three. For many of these women it was more than they could count: literally over 20 brain injuries, for example, a couple of times a week for several years or something like that.

That was the first finding in terms of prevalence, so I also looked at those data in relationship to measures of cognition and psych pathology. So using neuropsychological measures, I got measures of memory, learning, cognitive flexibility; and what I showed was that the more brain injuries a woman sustained, the more poorly she performed on these measures of memory, learning, cognitive flexibility, and the more brain injuries she sustained, the higher the rates of things like depression, anxiety, PTSD symptomatology and general distress were.

More recently, I've used neuroimaging to look at the effects of brain injuries in these women, and I found alterations in the way that certain networks are interacting with one another. So based on what we know in terms of other brain injury populations and how, for example, the salience and the default network interact with one another, we know that they tend to increase certain nodes of those networks, increase their interactions when one is doing a sort of complex task. However, in brain injury groups, that increased interaction does not occur.

There was a relationship between the number of brain injuries, and the higher the brain injuries were, the lower the connectivity between two regions of these networks were—so real-life consequence. And not only that, but there was also an association with that connectivity and these women's ability to learn a list of words and remember that list of words 20 minutes later.

Women aren't aware of this themselves. They don't necessarily know they're sustaining these brain injuries, and they're much more worried about the broken arm or the punctured lung. So these go unnoticed and unacknowledged but may have long-lasting detrimental effects. But who else should be aware of these are people like police officers, first responders and judges.

For example, if a police officer shows up at a scene and he sees a woman who says, "I was in the bathroom and we were doing this," and then the next second she says, "Well, I was in the bedroom," and he says, "Well, gee, your story is changing. Come on, what's going on?" It may be that she sustained a concussion, and instead of giving the benefit of the doubt to the woman, most likely a police officer, without knowing anything about traumatic brain injury, will think either she's lying or maybe she's on a substance and can't keep her story straight. That goes the same for medical personnel or even judges who are hearing a woman's story in the courtroom.

So if we take an analogous example in terms of athletics or the military, right now people are highly aware of the dangers that repetitive brain injuries in athletes or military personnel may have. And if you look at chronic traumatic encephalopathy, for example, people are terrified that they may be getting early dementia and this horrible disease because they've sustained repetitive concussive blows to the head. The same thing could be happening for these women, and without studying this, we'll never know.

Learn more about the Martinos Center for Biomedical Imaging

Learn more about psychiatry research at Mass General

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Many women who experience intimate-partner violence sustain at least one traumatic brain injury, which can lead to problems with memory, learning and cognitive flexibility. Mass General researchers searched for neural mechanistic evidence of an association between these TBIs and cognitive dysfunction.

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Researchers from the Department of Psychiatry at Massachusetts General Hospital discuss their collaborative work in clinical and translational research.