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By On December 18th, 2018

One of the most at-risk groups for TBI continues to go unrecognized

When we think of the victims of traumatic brain injuries, a few groups always come to mind – athletes, veterans, children, and the elderly. But, there is another group that tends to be overlooked, despite strong evidence showing that they face higher risks for TBI and long-term complications than nearly any other population.

Victims of domestic abuse and violence are statistically one of the most at-risk groups for traumatic brain injuries, with some studies showing more than 75% of domestic abuse survivors having experienced at least one TBI.

Considering that at least one-in-three women are estimated to have experienced some form of physical or sexual partner violence in their lifetimes, it is troubling that so many of these survivors may be living with untreated effects of brain injuries.

Dr. Eve Valera, Ph.D., is a research associate at Massachusetts General Hospital and an assistant professor at Harvard Medical School, and is responsible for a significant amount of the research on domestic violence and traumatic brain injuries over the past 20 years.

Not only has she shown that survivors of domestic abuse are at high risk for traumatic brain injuries, but her research indicates that those who have experienced more severe or more numerous head injuries were more likely to be living with greater cognitive impairment.

Dr. Valera says there are a few factors which continue to keep survivors of domestic abuse with traumatic brain injuries from being recognized and prevents access to resources for treatment and long-term management.

Firstly, is the issue of stigma. Because of the stigma of being abused, as well as the short-term risk of increased violence, many women never report or tell anyone about their abuse. This, in turn, contributes to the perception that intimate partner violence (IPV) is a rare occurrence or only occurs in specific socio-economic groups. The truth is that IPV occurs across all socioeconomic groups, with startling regularity.

Rather than being a rare occurrence, intimate partner violence is the leading cause of homicide for women, as well as the number one cause of violence to women.

The issue of brain injuries among IPV survivors faces similar issues. Because the violence is unreported, survivors frequently hide their injuries. This makes it difficult to estimate exactly how common or severe these injuries are, though most researchers agree that millions of women are living with unreported brain injuries from domestic violence.

As Dr. Valera explains, this is the worst-case scenario for those living with brain injuries:

“Sustaining additional TBIs while still symptomatic will likely increase the time to recovery, and possibly increase the likelihood of more long-term difficulties.”

It is also widely believed that repeated head injuries within a short period of time make the chance of dying much higher.

Although terms like traumatic brain injury and chronic traumatic encephalopathy have become household terms thanks to the findings among athletes and veterans, survivors of IPV with traumatic brain injuries still suffer in silence.

The most important thing we can do to start changing this is to increase efforts to raise awareness about the reality of IPV and destigmatize the topic. As Dr. Valera says:

“As we open up this conversation about the commonality of IPV with nonjudgmental acceptance of a woman’s experience, we will be in a better place to hear, understand, and support women who may be unknowing members of this invisible public health epidemic.”

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