Hillary NIH grant stock photoThe BART Foundation’s mission is to promote better outcomes for brain injury survivors by answering three questions – which alternative therapies are likely to work, where can they be found, and how can they be afforded? One of the ways we fulfill our mission is by carefully watching global research and clinical trial outcomes and sharing that information, in user-friendly language, with the TBI/ABI community.

Today, we’d like to share with you an opinion piece from STAT: Reporting from the frontiers of health and medicine that appeared earlier in 2022 about the underresearched area of TBI and domestic violence. In this post, we will share segments of the article but encourage everyone to read the entire piece online (no paywall or log-in needed).

“Traumatic brain injury, long linked to military service and sports, has another more insidious source: domestic violence, also known as intimate partner violence. In fact, the number of people who sustain traumatic brain injuries during domestic violence episodes may outstrip their combined incidence in athletes and military personnel. Unfortunately, this connection isn’t often discussed.

In the United States, an estimated one in four women and one in ten men will experience some form of domestic violence in their lifetimes. It can happen to anyone, regardless of race, ethnicity, socioeconomic status, gender identity, sexual orientation, ability, or age.

Even mild cases of traumatic brain injury, like concussion, can impart significant and long-lasting impairments. A single incident in which traumatic brain injury occurs can result in long-term cognitive damage, or even increase the likelihood that a person who experiences domestic violence becomes an abuser.

Linking traumatic brain injury and domestic violence is difficult. Due to stigma and perceived safety, many people cannot disclose they are experiencing domestic violence, and those with a traumatic brain injury do not always seek medical attention. Many screening tools specific for traumatic brain injury are not explicitly related to domestic violence and, unless they are developed using a trauma-informed approach, could lead to more harm. In addition, symptoms of traumatic brain injury, like slurring words or unsteadiness, may be mistaken for alcohol or drug use, and thus prevent individuals from receiving appropriate and timely treatment.

The Barrow Neurological Institute in Phoenix opened a center in 2012 not only to look specifically at traumatic brain injuries among domestic violence survivors but also to connect them with treatment and assistance in navigating health systems that can be challenging even on the best of days, regardless of a person’s health and resources. Although one published study from this center is small, it hints at what may emerge given the time and effort of research on a much larger scale. Of the 115 patients in this retrospective study, 92% of those who reported one or more brain injuries related to domestic violence reported “too many injuries to quantify.”

Finding proper funding to look into or address the connection between traumatic brain injury and domestic violence can be tricky. Funding from the federal Centers for Disease Control and Prevention (CDC) has allowed some states to look at this intersection: Nebraska, for example, used block grant funding from the CDC to call attention to improved domestic violence screening that addresses traumatic brain injury. According to its 2020 report, of the 255 brain injury screenings completed at domestic violence shelters in Nebraska during the four-year funding period, 61.2% of women were positive for a brain injury.

While domestic violence must also be recognized beyond just physical abuse, the chances of an attack causing traumatic brain injury deserves more attention. The connection between the two may be obvious in retrospect, but until these injuries are consistently screened for in domestic violence cases and also more regularly discussed, they cannot be addressed as they need to be.