1 Community and Public Health Nursing, Johns Hopkins University School of Nursing , Baltimore, Maryland.
2 Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
J Womens Health (Larchmt). 2018 Jun;27(6):761-767. doi: 10.1089/jwh.2016.6311. Epub 2017 Oct 30.
Abused women often report a wide range of physical and psychological symptoms that present challenges to providers. Specifically, injuries to the head or strangulation, may initiate neurological changes that contribute to central nervous system (CNS) symptoms. These symptoms are often attributed to mental health diagnoses in this population. The purpose of this analysis is to examine the prevalence of and associations between reported probable traumatic brain injury (TBI) and CNS symptoms in a sample of women of African descent.
A convenience sample of 901 women of African descent from Baltimore, MD and the US Virgin Islands, aged 18-55, was used to examine relationships among self-reported intimate partner violence (IPV), TBI, and CNS symptoms. Data were collected via Audio Computer-Assisted Self-Interview.
Abused women who experienced a probable TBI were more likely to report CNS symptoms than those who did not. When controlling for demographics, IPV, and mental health symptoms, probable TBI was associated with a two point increase in CNS symptom frequency score (95% confidence interval: 1.55-2.93, p < 0.001).
Women who reported both probable TBI and IPV were more likely than their abused counterparts who reported no TBI to report CNS symptoms. This relationship held true even when controlling for symptoms of depression and post-traumatic stress disorder (PTSD). Clinicians working with women should be aware of TBI as a possible etiology for symptoms in abused women. Appropriate screening and treatment protocols should be designed and implemented across medical settings to improve outcomes for women who have experienced IPV and TBI.
受虐女性常报告广泛的身体和心理症状,这给医疗服务提供者带来了挑战。具体来说,头部受伤或勒颈可能会引发神经系统变化,导致中枢神经系统(CNS)症状。这些症状在该人群中常归因于精神健康诊断。本分析的目的是检查在马里兰州巴尔的摩和美属维尔京群岛的 901 名非裔女性样本中,报告的可能创伤性脑损伤(TBI)与 CNS 症状之间的患病率和关联。
使用方便样本,对 901 名年龄在 18-55 岁之间的非裔美国女性进行了研究,以检查自我报告的亲密伴侣暴力(IPV)、TBI 和 CNS 症状之间的关系。数据通过音频计算机辅助自我访谈收集。
经历过可能的 TBI 的受虐女性比没有经历过 TBI 的女性更有可能报告 CNS 症状。在控制人口统计学、IPV 和心理健康症状后,可能的 TBI 与 CNS 症状频率评分增加两点相关(95%置信区间:1.55-2.93,p < 0.001)。
报告可能的 TBI 和 IPV 的女性比报告没有 TBI 的受虐女性更有可能报告 CNS 症状。即使在控制抑郁和创伤后应激障碍(PTSD)症状后,这种关系仍然成立。与女性合作的临床医生应该意识到 TBI 可能是受虐女性症状的病因之一。应在医疗环境中设计和实施适当的筛查和治疗方案,以改善经历过 IPV 和 TBI 的女性的预后。