Intimate partner violence (IPV) is a global public health issue worldwide characterized by physical, sexual, psychological, and/or emotional aggression by a current or former intimate partner. It is the most common form of violence against women. Moreover, a large proportion of survivors experience repeated IPV incidents from their abusers. Brain injury is often a critical consequence of IPV. IPV-caused brain injuries (IPV-BI) are often mild (termed IPV-mBI) and repeated in nature, which ultimately impacts quality of life (QoL) of survivors. It is critical to confirm whether or not an mBI has occurred in survivors of physical IPV in order to help both survivors and clinicians navigate through an effective care pathway. Existing tools that are currently being used in the IPV-mBI-specific context are explicitly screening and/or research based. The current American Congress of Rehabilitation Medicine (ACRM) diagnostic criteria are intended to diagnose traumatic brain injury resulting from head impacts through various causes. However, IPV-mBI also includes nonfatal strangulation as a distinct mechanism of injury, and its multifactorial nature is often combined with coexisting and co-occurring emotional and psychological distress. Thus, both IPV and IPV-mBI have unique, parallel influences, both simultaneously impacting QoL. Consequently, given the unique characteristics of IPV-mBI, the mechanisms of injury, the presence of additional coexisting and co-occurring comorbidities, and distinct impacts on QoL, the current ACRM diagnostic criteria would likely lead to low degree of diagnostic certainty in survivors of IPV-mBI. Therefore, a clinical decision-making process that is IPV context-specific is justified.
Adhikari et al. (Thu,) studied this question.