Q&A: Dr. Eve Valera on Intimate Partner Violence and Brain Injury
In This Article
- Roughly 41% of women and 26% of men have experienced violence or stalking by an intimate partner, whether a current or former spouse or a dating partner. Nearly one in three women has experienced physical or sexual violence, mostly by an intimate partner
- Impacts of intimate partner violence include traumatic brain injury
- Eve Valera, PhD, uses imaging and other tools to study the relationship between intimate partner violence and brain injury
Intimate partner violence (IPV) is a common problem in the United States, affecting millions yearly. According to the Centers for Disease Control and Prevention (CDC), approximately 41% of women and 26% of men experience contact sexual violence, physical violence, and/or stalking by an intimate partner, whether a current or former spouse or a dating partner. Nearly one in three women has experienced physical or sexual violence, mostly by an intimate partner. The impacts of IPV range from missing work to symptoms of posttraumatic stress disorder (PTSD) and a variety of physical injuries—the latter including partner-inflicted injuries to the brain.
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Eve Valera, PhD, a researcher in the Department of Psychiatry at Massachusetts General Hospital and an affiliated faculty member in the Athinoula A. Martinos Center for Biomedical Imaging, has studied intimate partner violence for the past quarter century, focusing especially on using imaging and other tools to understand the neural, neuropsychological, and psychological consequences of traumatic brain injuries (TBIs) resulting from IPV. In a recent conversation, she elaborated on her work.
Q. What led you to pursue research into intimate-partner violence?
Valera: The primary objective of my work in IPV is to understand the effects of partner-inflicted brain injuries from blunt force trauma and strangulation. In graduate school, over 25 years ago, while working with women who had experienced IPV, I realized the abuse these women were sustaining could contribute to brain injuries. I was very curious about what was known about this issue and discovered that no papers were examining this topic. I decided that needed to change and began my dissertation with the goal of changing it.
Q. How do you use imaging in your work?
Valera: Currently, we are using resting-state fMRI, diffusion MRI, and magnetic resonance spectroscopy to understand better how neural networks and certain neurometabolites are affected by repetitive brain injuries. I emphasize 'repetitive' because most women who sustain partner-inflicted brain injuries sustain more than one. We published the first and—at the time—only imaging papers in this area showing associations between a brain injury severity score (based on the number and recency of brain injuries) and specific functional and structural connectivity metrics in the brain. Although there are a couple of other studies out there now and a few groups working towards this goal, there are still very few people using imaging to address this issue.
Q. Can you describe recent findings with respect to your IPV work?
Valera: We have more recently found that even from women living in the community—that is, women not seeking partner violence support or intervention or medical assistance—the rates of IPV-inflicted brain injuries are high (64%) and that the associations with neurobehavioral symptoms are persisting long after the most recent brain injury. Furthermore, we found an association between balance and the number of brain injuries. We had not previously looked at balance. This is important as it tells us that these associations are not limited to women who are still in crisis or are merely "acute" issues. It is also important as balance problems can predispose women to falls that could result in even more brain injuries. We need to follow up on these findings.
Q. How might your research contribute to broader awareness or prevention of IPV?
Valera: There is a tremendous misunderstanding of IPV and how women are affected. Yet, on the flip side, there is a growing understanding of how dangerous brain injuries are in athletics and the military. I hope that if people can understand the high prevalence and consequences of brain injuries from partner violence, there will be a greater awareness of the need for resources and intervention for these women, as there has been an awareness of such a need for athletes and military personnel.
Q. What's next in your work with IPV?
Valera: A couple of exciting newer projects include our qualitative study as well as the transgender arm of our main study. The qualitative study allows us to hear more directly from women about what they know about brain injuries and how they addressed their injuries when they were in their relationships. This will include answers to questions we may not have thought to ask using a more quantitative approach.
Regarding the transgender arm of the study, although all women have always been welcomed into our studies, there were no trans-specific measures. We have now included such measures and hired experts to help us in these efforts. As we know that interpersonal violence, as well as partner violence, is higher for transgender women than for cisgender women, we must increase our efforts to hear their voices and find out how brain injuries are affecting them as well.
Learn more about the Valera Lab
Learn more about the Martinos Center for Biomedical Imaging