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Domestic violence often leads to traumatic brain injury

STOP domestic violence

Rarely does the general public see such a horrific act of domestic violence like what we saw this week in the video of former Baltimore Ravens player Ray Rice hitting his then-fiancée and rendering her unconscious. The media firestorm that followed has been focused on the management of Rice’s professional career, as well as how the NFL generally responds to domestic violence.

However, the video should also help the public to understand one of the more insidious consequences of domestic violence, which is the incidence of traumatic brain injury (TBI). Concussions, a form of TBI, occur in individuals who sustain domestic violence, also called intimate partner violence (IPV), at an alarming rate.

According to a review of head injuries sustained because of IPV by Dr. Laura Kwako and her colleagues, the rates of TBI in women who are seen in the emergency room or in a domestic violence shelter are between 30 and 74 percent. Most of these injuries occur from a direct blow to the head or from strangulation, which can result in loss of oxygen to the brain.

Mild TBI, including concussions, can result in a variety of symptoms. Among them are changes in mood, such as depression, increased irritability, memory loss, difficulty with thinking or processing information, headaches and dizziness or vertigo. The research also shows that of women who sustain a TBI from their partner, at least 72 percent report having sustained multiple TBIs (Valera and Berenbaum).

Multiple TBIs have been associated with more negative symptoms, including depression and increased problems with thinking and memory. Domestic violence can take many forms, but the evidence suggest that even a mild TBI can lead to more long-term consequences.

We do not know what, if any, symptoms Ray Rice’s wife, Janay Rice, suffered in the weeks and months since the assault. But these serious medical problems ought to be considered as the public continues to discuss and critique Janay Rice’s response to the incident. TBI and psychological issues related to TBI may impact one’s planning and decision-making regarding the complexities of leaving a relationship.

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Any injury by a partner — not just a TBI — should be viewed as a significant warning sign that someone is in an abusive relationship. In fact, domestic violence is the leading cause of injury for women ages 15 to 44 in the United States. Anyone who sustains a TBI following an injury by their partner should seek emergency medical treatment immediately.

It is also important to know that domestic violence can mean any type of abuse, including psychological, emotional, physical and sexual abuse, by a partner. Typically, violent relationships began with more subtle forms of physical and emotional abuse, followed by more severe violence. That is often followed by a period where the abuser expresses remorse and attempts to make up with their partner, promising never to hurt again. Often, a new round of abuse follows.

The reasons why women stay in abusive relationships are complex, thus questioning or blaming someone in this situation is of little value. Getting the person help and education is critical.

Help is available if you or someone you care about is experiencing any type of partner abuse. In the Dallas area, Genesis Women’s Shelter and Support provides a 24-hour hotline at 214-946-HELP (4357). They also offer services including emergency shelter, counseling and education about domestic violence.

The National Domestic Violence Hotline offers help 24/7 at 1-800-799-SAFE (7233).

Baylor University Medical Center’s Trauma Department also provides education and information on domestic violence prevention. Baylor Dallas Trauma also works with our community partners, such as Genesis, to provide continued counseling and support for those who sustain injuries from domestic violence.

About the author

Dr. Ann Marie Warren
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Dr. Warren is a clinical psychologist at Baylor Dallas' Level 1 Trauma Center. She provides psychological intervention for patients who sustain severe injuries and is the principal investigator for research that focuses on how trauma impacts patients.

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Domestic violence often leads to traumatic brain injury