Health and Functioning Among Women with Brain Injury due to Intimate Partner Violence: Analysis of a U.S. National Sample

Abstract

The health and functional consequences of brain injury due to intimate partner violence (IPV-BI) have been underexamined compared with neurotrauma due to sport- and military-related injuries in predominantly male samples. This study examined whether IPV-BI was associated with worse physical and mental health and missed work or school among women survivors in the general U.S. population. Participants included women respondents from the 2015 National Intimate Partner and Sexual Violence Survey who reported IPV (n = 2922; M = 48.4 years old, SD = 16.50, range: 18–100), categorized into three groups based on self-report of lifetime injuries due to IPV: women with IPV-BI (n = 352), bodily injuries unrelated to the head (IPV-Body; n = 540), and IPV history without reported bodily injuries (No Injury group; n = 2030). Participants completed a phone survey including self-report questions on mental and behavioral health conditions and duration of missed work or school. The estimated prevalence of IPV-BI was 5.6% [95% confidence interval: 5.0%, 6.2%] among adult women in the U.S. population and 12.1% [10.9%, 13.2%] among adult women survivors of IPV. The three groups were compared using logistic regression on the prevalence of headaches (IPV-BI = 39.4%; IPV-Body = 28.0%; No Injury = 21.2%), chronic pain (IPV-BI = 48.6%; IPV-Body = 35.4%; No Injury = 26.1%), sleep problems (IPV-BI = 60.5%; IPV-Body = 45.5%; No Injury = 36.1%), post-traumatic stress disorder (PTSD) (IPV-BI = 84.4%; IPV-Body = 56.9%; No Injury = 22.0%), missed work (IPV-BI = 24.7%; IPV-Body = 18.1%; No Injury = 5.9%), and missed school (IPV-BI = 59.1%; IPV-Body = 35.2%; No Injury = 9.1%). Results are reported with an odds ratio (OR) as an effect size, with a 95% confidence interval. In unadjusted analyses, women with IPV-BI reported significantly higher odds of headache (vs. IPV-Body: p < 0.001, OR = 1.68 [1.20, 2.16]; vs. No Injury: p < 0.001, OR = 2.44 [1.86, 3.02]), chronic pain (vs. IPV-Body: p < 0.001, OR = 1.72 [1.25, 2.19]; vs. No Injury: p < 0.001, OR = 2.68 [2.06, 3.30]), sleep problems (vs. IPV-Body: p < 0.001, OR = 1.83 [1.33, 2.33]; vs. No Injury: p < 0.001, OR = 2.71 [2.08, 3.34]), PTSD (vs. IPV-Body: p < 0.001, OR = 4.11 [2.73, 5.48]; vs. No Injury: p < 0.001, OR = 19.26 [13.36, 25.16]), and missed work (vs. IPV-Body: p < 0.001, OR = 2.66 [1.92, 3.39]; vs. No Injury: p < 0.001, OR = 14.31 [10.57, 18.05]) and school (vs. IPV-Body: p < 0.001, OR = 1.48 [0.99, 1.96]; vs. No Injury: p < 0.001, OR = 5.21 [3.61, 6.80]) than both comparison groups. These group differences remained significant when adjusting for sociodemographic characteristics (e.g., age, race/ethnicity, education). When additionally adjusting for lifetime physical and sexual IPV severity, women with IPV-BI still had significantly higher odds of PTSD than the IPV-Body group (p < 0.001, OR = 2.34 [1.61, 3.40]) and no injury group (p < 0.001, OR = 7.94 [5.49, 11.50]); and significantly higher odds of missed work (p < 0.001, OR = 5.49 [3.93, 7.65]) and school (p < 0.001, OR = 4.25 [2.84, 6.36]) than the no injury group, but not the IPV-Body group. Women with IPV-BI experience physical and mental health problems and disrupted occupational and academic functioning at high frequencies, highlighting potentially unaddressed health care needs among IPV survivors nationally.