The Silent Epidemic of Invisible Injuries: Domestic Violence and Traumatic Brain Injury

When you hear the term “traumatic brain injury,” or TBI, you might immediately think of common causes like car accidents, falling or a sports-related injury. Yet, there is another frequent cause of TBIs talked about far less: domestic violence. www.oxeiabiopharma.com

In a March 2022 report by the New York Times, Eve M. Valera, an associate professor of psychiatry at Harvard University and a leading researcher on traumatic brain injuries among survivors of domestic violence, estimated that while hundreds of concussions occur in the NFL each year, there could be nearly 1.6 million annual brain injuries among survivors of domestic abuse. 

This isn’t as surprising when you consider the epidemic of domestic violence. Statistics from the National Coalition Against Domestic Violence show that 1 in 4 women and 1 in 9 men will experience physical violence from their partner. Physical abuse isn’t the only form of domestic violence; emotional abuse, sexual abuse, and financial abuse are among the other ways that an intimate partner will exercise power and control. But physical abuse resulting in traumatic brain injury (TBI)  is frighteningly common. A paper published in the Journal of Aggression, Maltreatment & Trauma in 2019 predicted that upwards of 90% of all people that have a history of domestic violence have symptoms and signs of traumatic brain injury.

Acts of violence that can cause TBIs include hits to the face or head, hitting the head while falling or being shoved, and severely shaking someone (most often recognized in the incredibly dangerous “shaken baby syndrome”). Brain injury can also occur because of strangulation and oxygen deprivation, and as an estimated 50% of domestic violence victims are strangled at some point in the course of their relationship, often repeatedly.

On April 1, 2022, The Protecting Survivors From Traumatic Brain Injury Act was introduced by Senator Catherine Cortez Masto (D-Nev) and Senator Joni Ernst (R-Iowa). The legislation would require HHS to collect data every two years to better document the occurrence of TBI. The immediate goal is to help HHS in “understanding, addressing, and allocating resources to reduce and treat such injuries and the cause of such injuries”. Another important goal of the legislation is to ensure that providers get the training on TBIs so they can help connect survivors to the services they need. Most advocates receive training on trauma and safety planning and oppression, but we don’t have enough training in neuro knowledge or where the local neurorehabilitation services are.

In addition to recent media coverage on this issue, the overdue passage of the Violence Against Women Act (VAWA), and the introduction of The Protecting Survivors From Traumatic Brain Injury Act, there is also movement in the healthcare field.

In February 2022, a report by the National Academies of Sciences, Engineering, and Medicine (NAS) was published and calls for a new classification system for traumatic brain injury. The report criticizes the current system of classifying TBI as either “mild, moderate, or severe” stating that it is outdated and that this diagnosis should be based on the Glasgow Coma Scale, neuroimaging results, and blood biomarker results.

The NAS report also calls for the formation of a national TBI task force to create the framework and plan to improve the treatment of TBI.

There are no effective pharmacological FDA-approved treatments for head injuries and there is a dearth of research into TBI and domestic violence. We need Congress to support research focused on female IPV victims with head injuries, better data collection and sharing of data so that we understand the full impact of brain injury on all IPV victims and can respond with effective population- and culturally-specific programs for prevention, education, support services and treatment programs. 

Please contact  your senators to impress upon them the need to focus more resources to identify, reduce and effectively treat TBIs in domestic abuse survivors.

Note: For survivors, if you are concerned for your safety or would like to speak with someone about a relationship where you do not feel safe, the National Domestic Violence Hotline is available 24/7 at 1 (800) 799-SAFE; you can also text START to 88788 or chat with someone at their website www.thehotline.org.

Suzanne Dubus is the CEO of the Jeanne Geiger Crisis Center and has led the organization since 1997.  Throughout her career, she has advocated for survivors of domestic violence through programming, innovative approaches, collaboration, policy issues, and systems change. Suzanne was named a Champion of Change by the White House in October 2011. The Geiger Institute was created to help communities prevent domestic violence homicides.

Michael Wyand, DVM, PhD, is the CEO of Oxeia Biopharmaceuticals. Oxeia is conducting Phase 2 human clinical studies for its therapeutic drug, OXE-103, to treat concussions.  www.oxeiabiopharma.com