Intimate Partner Violence and Other Trauma Exposures in Females With Traumatic Brain Injury.
Intimate Partner Violence and Other Trauma Exposures in Females With Traumatic Brain Injury.
复制标题
患有创伤性脑损伤的女性遭受亲密伴侣暴力和其他创伤。
DOI：
10.1089/neu.2023.0225
复制
发表时间：
2024
影响因子：
4.2
通讯作者：
Dams-O'Connor,Kristen
中科院分区：
文献类型：
--
作者：
deSouza,NicolaL;Kumar,RajG;Pruyser,Ariel;Blunt,EmilyE;Sanders,William;Meydan,Anogue;Lawrence,Phoebe;Venkatesan,UmeshM;MacDonald,ChristineL;Hoffman,JeanneM;Bodien,YelenaG;Edlow,BrianL;Dams-O'Connor,Kristen
我们研究了是否有创伤性脑损伤（TBI）和亲密伴侣暴力（IPV）的历史的女性有更大的暴露于终身创伤相对于女性TBI，但没有IPV的历史。此外，我们评估了TBI后终身创伤对心理结局的影响。TBI女性受试者（n= 70;年龄M [标准差-SD] = 50.5 [15.2]岁）（自受伤时间中位数[四分位数间距-IQR] = 10.2 [5.3-17.8]年）完成了TBI终身史的结构化评估，包括IPV模块，以查询亲密伴侣身体暴力造成的头部损伤。我们用不良童年经历（ACE）问卷和社区暴力暴露调查（CV）描述了终身创伤暴露的特征。我们用创伤后应激障碍（PTSD）、抑郁和焦虑症状的自我报告问卷评估心理功能。与无IPV病史的受试者（n= 51）相比，（n= 19; 27.1%）报告的ACE更多（M[SD] IPV：4.5[2.9];无IPV：1.6[1.8]，p<0.001，d = 1.08）和更大的CV（IPV：17.5[8.4];无IPV：7.6[6.1]，p<0.0001，d = 1.26）。在全部样本中，ACE（β = 0.21，95%置信区间[CI] = 0.04-0.39）和CV（β = 0.07，95% CI = 0.01-0.13）预测PTSD症状更严重，而单独使用IPV则不能。暴露于所有三种创伤源（ACE、CV和IPV）与创伤较少的PTSD症状更严重相关。研究结果强调了创伤性脑损伤幸存者的创伤暴露范围，以及在评估和管理创伤性脑损伤时考虑IPV和其他终身创伤暴露的重要性。针对TBI相关损害进行修改的创伤知情干预可能会改善心理症状的管理结果。
We examined whether females with a history of traumatic brain injury (TBI) and intimate partner violence (IPV) have greater exposure to lifetime trauma relative to females with TBI but no IPV history. Further, we assessed the effects of lifetime trauma on psychological outcomes after TBI. Female participants (n= 70; age M [standard deviation–SD] = 50.5 [15.2] years) with TBI (time since injury median [interquartile range –IQR] = 10.2 [5.3–17.8] years) completed a structured assessment of lifetime history of TBI, including an IPV module to query head injuries from physical violence by an intimate partner. We characterized lifetime trauma exposure with the Adverse Childhood Experiences (ACEs) questionnaire and Survey of Exposure to Community Violence (CV). We evaluated psychological functioning with self-report questionnaires of post-traumatic stress disorder (PTSD), depression, and anxiety symptoms. Compared with those with no IPV history (n= 51), participants reporting IPV-related head injuries (n= 19; 27.1%) reported more ACEs (M[SD] IPV: 4.5[2.9]; No IPV: 1.6[1.8],p< 0.001,d= 1.08) and greater CV (IPV: 17.5[8.4]; No IPV: 7.6[6.1],p< .0001,d= 1.26). Within the full sample, ACEs (β = 0.21, 95% confidence interval [CI] = 0.04–0.39) and CV (β = 0.07, 95% CI = 0.01–0.13) predicted worse PTSD symptoms, while IPV alone did not. Exposure to all three sources of trauma (ACEs, CV, and IPV) was associated with worse PTSD symptoms relative to fewer traumas. The results highlight the scope of traumatic exposures among TBI survivors and the importance of considering IPV and other lifetime trauma exposure in assessing and managing TBI. Trauma-informed interventions that are modified for TBI-related impairment may offer improved outcomes in managing psychological symptoms.