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.     

Involving Police Departments in Early Awareness of Concussion Symptoms during Domestic Violence Calls

ABSTRACT

Police officers around the world respond to and investigate calls regarding domestic violence (DV) daily. Police departments operate with standard protocols, particularly when engaging in investigations that involve allegations of strangulation or sexual assault. Operating under advisement of the Maricopa County Attorney’s Office, the Mesa Police Department (Mesa, AZ) has established protocols for detecting, recording, and prosecuting DV cases that involve strangulation and sexual assault. Allegations of strangulation (defined as impeded breathing) or sexual assault prompt officers to offer a forensic nursing exam (FNE) combined with strangulation treatment by forensic nurses at the Mesa Family Advocacy Center. Recognizing the potential for head injury to the assault victim in all DV situations, including intimate partner violence (IPV), the police department has added concussion-awareness training, as well as a point-of-incident investigative tool for its officers to record neurological function of the victim. Officers were instructed to use the ConQVerge device to measure and record the Near Point of Convergence (NPC) as a test of neurological impairment in suspected head injuries. In this article, we discuss the challenges and opportunities for assisting victims of DV strangulation and sexual assault (including non-DV sexual assault) with on-site assessment and consent for further medical assessment and treatment. Additionally, rates of domestic assault victims that report a crime, but decline to follow through with forensic medical tests, are reported for the first time. Lessons learned from the project that inform strategic operations in this space are offered to other agencies prior to the implementation of similar procedures.     

The Latent Threat of Community Violence: Indirect Exposure to Local Homicides and Adolescents’ Mental Health in Colombia

This study examines the relation between adolescents’ indirect exposure to local homicides and mental health disorders and post‐traumatic stress disorder (PTSD) symptoms. We employ a sample of 300 adolescents ( representative for Bogotá, Colombia, and geocoded data on violent crimes recorded by the national police. Findings show that one SD increment in local homicides is associated with increments by 0.17 SD in the mental health disorder index and a 0.14 SD increase in the PTSD score index, even after accounting for adolescents’ direct exposure to violence. The estimated effect for PTSD was larger for adolescents’ who were directly exposed to violence and for those living in multidimensionally poor households, whereas no detectable effects were found for adolescents who perceived their residential neighborhood as relatively safe.     

Trauma is not the whole story: Trajectories of responses to childhood disasters intertwining with Life following the Indian Ocean tsunami

In an era of global threats, understanding the implications of disasters on young people's life course is of central importance. A particular emphasis should be placed on non-Western economically developing societies that are considered as vulnerable and are less studied, and on social groups within these societies that are underrepresented. The present study focuses on young Sri Lankan women who experienced the 2004 Indian Ocean tsunami as children. Thirteen young women generated their life stories in semi-structured interviews, 12 years after the disaster had elapsed. Holistic narrative analysis revealed new variations and in-depth meanings in disaster response trajectories and presented the intertwining courses of the responses to the Potentially Traumatic Event (PTE) with ecological aspects throughout development, as in Trajectories intertwining with Life (TiL). This study provides empirical, methodological, conceptual and practical innovations to the study of human development throughout the life course, within the interdisciplinary fields of trauma and disasters.

Highlights

• This research is interested in how childhood disaster response trajectories among an understudied population are understood through an ecological-developmental perspective.
• Life stories uncover Trajectories intertwining with Life (TiL) among Sri Lankan women who were children during the Indian Ocean tsunami.
• The TiL unique outcomes, integrating trauma responses as inseparable from ecological and developmental aspects, offer various theoretical and applied implications.