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亲密伴侣暴力所致创伤性脑损伤与女性未来心理社会健康风险之间的关联。

Associations between traumatic brain injury from intimate partner violence and future psychosocial health risks in women.

机构信息

National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA 02130, United States of America; Boston University School of Medicine, Boston, MA 02118, United States of America.

Department of Psychology, Towson University, Towson, MD 21252, United States of America.

出版信息

Compr Psychiatry. 2019 Jul;92:13-21. doi: 10.1016/j.comppsych.2019.05.001. Epub 2019 May 14.

Abstract

OBJECTIVE

The effects of traumatic brain injury (TBI) incurred during military service are widely studied; however, less is known about TBI resulting from intimate partner violence ("IPV-related TBI"). Women Veterans are at high risk for IPV, yet no research has examined future psychosocial health risks associated with IPV-related TBI history in this population.

METHODS

We examined psychiatric and physical health outcomes, as well as IPV, in a sample of women Veterans who, at Time 1, reported IPV-related TBI with (n = 13) or without (n = 20) persistent symptoms; that is, symptoms such as memory problems, balance problems or dizziness, sensitivity to bright light, irritability, headaches, and sleep problems that began or got worse immediately following the IPV-related TBI and occurred within the past week. These women completed web-based surveys 18 months later (Time 2), which included validated measures of psychiatric and physical health symptoms as well as past-year IPV. We conducted linear regressions to model whether T1 IPV-related TBI with persistent symptoms predicted worse health outcomes at T2, in comparison to T1 IPV-related without persistent symptoms.

RESULTS

Controlling for significant covariates (i.e., military sexual trauma; MST), IPV-related TBI with persistent symptoms at Time 1 was associated with significantly worse outcomes at Time 2 across all health outcome domains (sr range: 0.12-0.37). After controlling for MST and probable posttraumatic stress disorder (PTSD) at Time 1, IPV-related TBI with persistent symptoms at Time 1 remained significantly associated with worse Time 2 symptoms of insomnia, depression, and physical health (sr range: 0.12-0.25).

CONCLUSION

Women who experience IPV-related TBI with persistent symptoms are at higher risk for worse psychosocial health outcomes 18 months later. Findings necessitate screening IPV survivors for TBI with persistent symptoms and tailoring TBI and psychosocial interventions to reduce risk for ongoing health sequelae.

摘要

目的

军人颅脑创伤(TBI)的影响已得到广泛研究;然而,由亲密伴侣暴力(“与 IPV 相关的 TBI”)引起的 TBI 则知之甚少。女性退伍军人有很高的遭受 IPV 的风险,但目前尚无研究调查该人群中与 IPV 相关的 TBI 史相关的未来心理社会健康风险。

方法

我们研究了一组女性退伍军人的精神健康和身体健康结果,以及 IPV 情况。在时间 1 时,这些女性报告了与 IPV 相关的 TBI,其中(n=13)或没有(n=20)持续症状;也就是说,症状如记忆问题、平衡问题或头晕、对强光敏感、易怒、头痛和睡眠问题,这些症状在与 IPV 相关的 TBI 后立即开始或恶化,并且在过去一周内发生。这些女性在 18 个月后(时间 2)完成了基于网络的调查,其中包括验证过的精神健康和身体健康症状以及过去一年中 IPV 的测量。我们进行线性回归,以比较 T1 时有无持续症状的与 IPV 相关的 TBI 是否预测 T2 时的健康结果更差。

结果

在控制了重要协变量(即军事性创伤;MST)后,T1 时与 IPV 相关的持续症状 TBI 与所有健康结果领域在 T2 时的结果更差相关(sr 范围:0.12-0.37)。在控制了 T1 时的 MST 和可能的创伤后应激障碍(PTSD)后,T1 时与 IPV 相关的持续症状 TBI 与 T2 时的失眠、抑郁和身体健康症状更差仍显著相关(sr 范围:0.12-0.25)。

结论

经历过持续症状的与 IPV 相关的 TBI 的女性在 18 个月后有更高的发生心理健康恶化的风险。这些发现需要对 IPV 幸存者进行 TBI 与持续症状的筛查,并对 TBI 和心理社会干预进行调整,以降低持续健康后果的风险。

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