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Intersection of TBI and IPV in Harris County

Intimate partner violence (IPV) is abuse by current or former intimate partners, and it exists in many forms (Breiding et al., 2015). The Center for Disease Control and Prevention (CDC) defines and assesses five types of IPV including sexual violence, physical violence, stalking, psychological aggression, and control of reproductive or sexual health (Black et al., 2011). IPV is a prevalent health crisis among women. In the United States, approximately 1 in 5 women experience severe physical abuse by intimate partners. Further, severe physical abuse and violence by intimate partners can be a precursor to homicide. The CDC finds that murder is one of the leading causes of death for women 44 years and older (Center for Disease Control and Prevention, n.d.). Moreover, the stay-at-home orders during the COVID-19 pandemic have increased the concern about the prevalence and lethality of IPV (Kaukinen, 2020; Wood et al., 2020).
The ubiquity of IPV has led researchers to identify the impact of IPV. Numerous studies consistently find that IPV can have lasting impacts on women’s wellness (Becker et al., 2010; Campbell, 2002; Coker et al., 2000; Valera & Kucyi, 2017). For example, chronic health problems and central nervous system issues such as fainting and seizures, as well as traumatic brain injury can arise as a result of IPV-related injuries and trauma (Campbell, 2002; Valera & Kucyi, 2017). Most women who have suffered from physical and/or sexual abuse by their intimate partners do not present with obvious injuries. However, when injuries exist, battered women are more likely to present physical injuries to their head, face, neck, thorax, breasts, and abdomen (Campbell, 2002). IPV has also been associated with cardiac and gastrointestinal disorders (Campbell, 2002). Women of sexual violence are also at risk for sexually transmitted infections such as HIV, trichomonas, and gonorrhea (Gaensslen & Lee, 2001).

While much of the existing research focuses on the physical consequences of IPV, the effects of emotional and psychological abuse by intimate partners can also be damaging. Mental health consequences of IPV can linger long after physical wounds heal. Depression and post-traumatic stress syndrome (PTSD) are two of the most commonly reported mental health consequences of IPV (Black et al, 2011; Breiding et al., 2015). Women are also at risk for suicidal ideation after IPV (Campbell, 2002). In efforts to cope with the trauma of IPV, women may engage in maladaptive methods including drug and alcohol abuse (Campbell, 2002).
Though recent estimates of IPV emphasize its prevalence and negative consequences, violence against women, especially violence committed by intimate partners, is rarely reported. Only about one-third of women report IPV to police (Akers & Kaukinen, 2009). Given the significant gap between victimization and reporting, as well as the impact of violence against women, researchers and policymakers have attempted to understand the nature of IPV and develop strategies to adequately support survivors.

Strategies and Tips for Support Providers

After experiencing abuse, women may seek help from informal networks, such as family, friends, and coworkers. They may also seek formal help from police, medical personnel, or advocacy agencies. Service providers’ treatment of survivors can influence survivors’ well-being and their downstream decisions to seek further help if needed. For example, when survivors experience blaming attitudes and mistreatment by support providers, they may become retraumatized and withdraw from seeking help. This puts survivors at risk for exacerbated negative physical, mental, and emotional outcomes and revictimization.
Accordingly, support providers should consider implementing the following recommendations to adequately meet survivors’ needs. First, when survivors seek help, their needs may be multi-layered. For example, they may need shelter, treatment for physical injuries, and emotional support. Therefore, advocacy agencies, police, and medical personnel should collaborate in assisting survivors with multiple needs. Second, culturally-sensitive and survivor-centered responses are critical to appropriately respond to women’s needs from various racial-ethnic backgrounds. Thus, support providers should consider the intersections of race, socioeconomic class, sexuality, and IPV when women seek help to promote positive rapport building and engagement with survivors from different backgrounds. Importantly, this knowledge can assist support providers in addressing survivors’ explicitly and implicitly stated needs. Not least, support providers should engage in outreach services. These efforts are essential to providing education to the community about the prevalence and impact of IPV as well as available resources. Outreach endeavors also actively demonstrate agencies’ commitment to serving their communities which is important for establishing and maintaining community trust.

Conclusion

IPV is a ubiquitous health crisis with lasting physical, mental, and emotional consequences. Though formal assistance for IPV is underutilized, survivors can experience positive health outcomes when they seek help. Therefore, support agents should collaborate to provide holistic care for survivors while utilizing culturally-sensitive and trauma-informed practices. Support providers should also extend their services to outreach endeavors to educate and build community relations.

REFERENCES

Akers, C., & Kaukinen, C. (2009). The police reporting behavior of intimate partner violence victims. Journal of Family Violence, 24(3), 159-171.

Becker, K. D., Stuewig, J., & McCloskey, L. A. (2010). Traumatic stress symptoms of women exposed to different forms of childhood victimization and intimate partner violence. Journal of Interpersonal Violence, 25, 1699-1715.

Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., . . .Stevens, M. R. (2011). The national intimate partner and sexual violence survey (NISVS): 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Center for Disease Control and Prevention.

Breiding, M., Basile, K. C., Smith, S. G., Black, M. C., & Mahendra, R. R. (2015). Intimate partner violence surveillance: Uniform definitions and recommended data elements, Version 2.0. Atlanta (GA): National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Campbell, J. C. (2002). Health consequences of intimate partner violence. The Lancet, 359(9314), 1331-1336.

Center for Disease Control and Prevention (n.d.). Fast Facts: Preventing Intimate Partner Violence. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html

Coker, A. L., Smith, P. H., Bethea, L., King, M. R., & McKeown, R. E. (2000). Physical health consequences of physical and psychological intimate partner violence. Archives of Family Medicine, 9, 451-457.

Gaensslen, R. E., & Lee, H. C. (2001). Sexual assault evidence: National assessment and guidebook. National Institute of Justice, Washington DC, USA.

Kaukinen, C. (2020). When stay-at-home orders leave victims unsafe at home: Exploring the risk and consequences of intimate partner violence during the COVID-19 pandemic. American Journal of Criminal Justice, 45(4), 668-679.

Valera, E., & Kucyi, A. (2017). Brain injury in women experiencing intimate partner-violence: neural mechanistic evidence of an “invisible” trauma. Brain imaging and behavior, 11(6), 1664-1677.

Wood, L., Schrag, R. V., Baumler, E., Hairston, D., Guillot-Wright, S., Torres, E., & Temple, J. R. (2020). On the front lines of the COVID-19 pandemic: Occupational experiences of the intimate partner violence and sexual assault workforce. Journal of Interpersonal Violence, 1-22.

About the Author

Dr. Shamika M. Kelley is the research director at Texas Forensic Nurse Examiners – The Forensic Center of Excellence where she creates and implements a structured research agenda focusing on the needs of crime victims and criminal justice stakeholders to enhance support and case processing. She received her doctoral degree in Criminal Justice from Sam Houston State University. Her research focuses on survivors’, criminal-legal, and medical responses to sexual assault with special attention to survivors of Color.

Her work appears in Crime & Delinquency, Journal of Interpersonal Violence and Journal of Police and Criminal Psychology. She is also a forensic DNA consultant who provides forensic reports, DNA reviews, and expert testimony in criminal cases. Shamika was recently awarded the American Society of Criminology, Division on Women and Crime’s Saltzman Award for Contributions to Practice, which recognizes a criminologist whose professional accomplishments have increased the quality of justice and the level of safety for women.