Rethinking Traumatic Brain Injury from Intimate Partner Violence: A Theoretical Model of the Cycle of Transmission

ABSTRACT

Despite growing evidence of the repeated nature of traumatic brain injury (TBI) in women experiencing intimate partner violence (IPV), there is no theoretical model depicting TBIs as a cyclical process throughout a lifetime. Situational analysis methodology was used on interviews with 10 women who self-reported passing out from being hit in the head during an episode of IPV to create a theoretical model depicting the cycle of transmission of TBI. We define the cycle of transmission of TBI as the way that women experience multiple TBIs over the course of their lifetime and how TBI can be perpetuated in a family or community. The cycle begins in childhood or adolescence, when women receive a TBI from abuse, sports, or motor vehicle accident. They enter into abusive relationships with men who are also described as living with a TBI and the women receive other TBIs during this relationship. With repeating head trauma, women described increasing TBI symptoms: problems with memory, cognition, executive functioning, depression, and concentration. If they do seek help, they must choose between healthcare and protective shelter. With either choice, the element of instability could be introduced and the cycle of transmission continues. This theoretical model shows that it is necessary to move beyond individual behaviors to think about how TBIs are transmitted through communities and how untreated symptoms can impact help-seeking behavior and perpetuate other risk factors for receiving a TBI.     

Desiderata for a Viable Secular Humanism

Philip Kitcher has recently worried that the New Atheists, by mounting an attack against religion tout court, risk alienating a large swath of ‘religious’ people whose way of life is, to Kitcher's mind, innocuous. Encouraging a more moderate response, Kitcher thinks certain non‐threatening modes of religious existence should be protected. In this article, I argue that while Kitcher's attempt to provide balance to the secularism debate is a great service, he ultimately fails to distinguish innocuous modes of religious belief from more threatening modes, a failing that allows the debate to return to its previous extremes. In drawing attention to the shortcomings of Kitcher's approach, I make the humanist's argumentative burden explicit: the defender of a ‘moderate’ secular humanism must show that people who arrange their lives around belief in a transcendent being are more likely to do ethical harm than those that don't.     

Influences on Call Outcomes among Veteran Callers to the National Veterans Crisis Line

The association of caller and call characteristics with proximal outcomes of Veterans Crisis Line calls were examined. From October 1–7, 2010, 665 veterans with recent suicidal ideation or a history of attempted suicide called the Veterans Crisis Line; 646 had complete data and were included in the analyses. A multivariable multinomial logistic regression was conducted to identify correlates of a favorable outcome (a resolution or a referral) when compared to an unfavorable outcome (no resolution or referral). A multivariable logistic regression was used to identify correlates of responder‐rated caller risk in a subset of calls. Approximately 84% of calls ended with a favorable outcome, 25% with a resolution, and 59% with a referral to a local health care provider. Calls from high‐risk callers had greater odds of ending with a referral than without a resolution or referral, as did weekday calls (6:00 am to 5:59 pm EST, Monday through Friday). Responders used caller intent to die and the absence of future plans to determine caller risk. Findings suggest that the Veterans Crisis Line is a useful mechanism for generating referrals for high‐risk veteran callers. Responders appeared to use known risk and protective factors to determine caller risk.