Karakurt Gunnur, Whiting Kathleen, Jones Stephen E, Lowe Mark J, Rao Stephen M
Department of Psychiatry, Case Western Reserve University, Cleveland, OH, United States.
University Hospital Cleveland Medical Center, Cleveland, OH, United States.
Front Psychol. 2021 Oct 5;12:710602. doi: 10.3389/fpsyg.2021.710602. eCollection 2021.
Intimate partner violence (IPV) survivors frequently report face, head, and neck as their injury site. Many mild traumatic brain injuries (TBIs) are undiagnosed or underreported among IPV survivors while these injuries may be linked to changes in brain function or pathology. TBI sustained due to IPV often occurs over time and ranges in severity. The aim of this case-series study was to explore risk factors, symptoms, and brain changes unique to survivors of intimate partner violence with suspicion of TBI. This case-series exploratory study examines the potential relationships among IPV, mental health issues, and TBI. Participants of this study included six women: 3 women with a history of IPV without any experience of concussive blunt force to the head, and 3 women with a history of IPV with concussive head trauma. Participants completed 7T MRI of the brain, self-report psychological questionnaires regarding their mental health, relationships, and IPV, and the Structured Clinical Interview. MRI scans were analyzed for cerebral hemorrhage, white matter disturbance, and cortical thinning. Results indicated significant differences in resting-state connectivity among survivors of partner violence as well as differences in relationship dynamics and mental health symptoms. White matter hyperintensities are also observed among the survivors. Developing guidelines and recommendations for TBI-risk screening, referrals, and appropriate service provision is crucial for the effective treatment of TBI-associated IPV. Early and accurate characterization of TBI in survivors of IPV may relieve certain neuropsychological consequences.
亲密伴侣暴力（IPV）幸存者经常报告面部、头部和颈部为受伤部位。许多轻度创伤性脑损伤（TBI）在IPV幸存者中未被诊断或报告不足，而这些损伤可能与脑功能或病理变化有关。因IPV导致的TBI通常随着时间的推移而发生，严重程度各不相同。本病例系列研究的目的是探讨疑似TBI的亲密伴侣暴力幸存者特有的危险因素、症状和脑部变化。本病例系列探索性研究考察了IPV、心理健康问题和TBI之间的潜在关系。本研究的参与者包括六名女性：3名有IPV病史但头部未遭受过震荡性钝器打击的女性，以及3名有IPV病史且头部遭受过震荡性创伤的女性。参与者完成了脑部7T磁共振成像（MRI）、关于其心理健康、人际关系和IPV的自我报告心理问卷，以及结构化临床访谈。对MRI扫描结果进行分析，以检查脑出血、白质紊乱和皮质变薄情况。结果表明，伴侣暴力幸存者在静息状态连接性方面存在显著差异，人际关系动态和心理健康症状也存在差异。在幸存者中还观察到白质高信号。制定TBI风险筛查、转诊和适当服务提供的指南和建议对于有效治疗与TBI相关的IPV至关重要。对IPV幸存者的TBI进行早期准确的特征描述可能会减轻某些神经心理后果。
