Identifying the Cognitive, Psychological, and Neuroimaging Signatures of Head Trauma in Female Survivors of Intimate Partner Violence

亲密伴侣暴力(IPV)，身体暴力，性暴力，心理攻击，或跟踪 现在或以前的亲密伴侣，是一个重大的公共卫生问题，影响到大约1000万人 在美国每年都有很多人。大约33%接触IPV的女性报告说身体受到了创伤 导致这一人群头部受伤的风险增加。最近的研究表明，40%-90%的 女性因IPV而经历头部创伤。与IPV相关的头部创伤是由钝器创伤引起的， 被推或猛烈摇晃，和/或勒死，可导致局部创伤或挫伤，加速 和减速损伤，以及窒息所致的缺氧和缺氧。有限的研究 研究表明，头部创伤后接触IPV的女性表现出更高的抑郁、焦虑和创伤后症状 应激障碍症状，以及与IPV和NO女性相关的认知功能受损 暴露于头部创伤。尽管在IPV中发现了反复暴露于头部创伤的临床特征 与军事创伤性脑损伤(TBI)和运动相关脑震荡的效果相似，有限 已经做了一些工作来了解与IPV相关的头部创伤，特别是它的慢性认知和 心理影响以及相关的大脑变化。通过多站点研究协作 由通过荟萃分析增强神经成像和遗传学(谜)IPV的成员组成 工作组，拟议的研究将表征IPV的认知、心理和神经特征-- 相关的头部创伤，以及确定特定的症状群是否与可辨别的 IPV亚组。此外，这项提议启动了创建IPV研究队列的进程，该队列将被重新 每5年评估一次，以长期评估与IPV相关的头部相关的大脑和行为变化 生命中的创伤。将使用半结构化访谈来获取IPV特定信息，例如 虐待和头部创伤病史和频率。将使用一个全面的神经心理学电池来 确定认知和心理状态，同时将使用复杂的神经成像技术来 与头部创伤相关的IPV患者的神经结构、功能和脑代谢产物的特征 没有暴露于头部创伤的IPV。最后，我们将使用数据驱动的方法来确定 症状群可区分IPV的亚组。在目标1中，我们将确定认知和心理 IPV亚群概况。AIM 2将检查IPV亚组的神经成像特征。在目标3中，我们 将确定症状群是否与IPV的可辨别亚组相关。结果来自于 这项研究将提供有关IPV相关头部创伤在认知和治疗中的作用的关键信息。 心理结果，以及潜在的神经变化。这一点不仅对理解 反复脑损伤的慢性效应，也直接对IPV亚群的不同亚群进行鉴定 对发展以患者为中心的IPV护理方法的启示。

Intimate partner violence (IPV), the physical violence, sexual violence, psychological aggression, or stalking by a current or former intimate partner, is a significant public health concern affecting approximately 10 million people in the United States annually. Approximately 33% of women exposed to IPV report physical trauma resulting in heighted risk of head injury in this population. Recent work suggests that anywhere from 40-90% of women experience head trauma due to IPV. IPV-related head trauma is caused by blunt force trauma, being pushed or violently shaken, and/or strangulation, which can result in focal trauma or contusions, acceleration and deceleration injuries, as well as hypoxia and anoxia due to strangulation, respectively. Limited research has shown that women exposed to IPV with head trauma report higher depression, anxiety, and post-traumatic stress disorder symptomatology, as well as impaired cognitive function relative to women with IPV and no exposure to head trauma. Although the clinical features of repeated exposure to head trauma identified in IPV are similar to the effects observed in military traumatic brain injury (TBI) and sports-related concussion, limited work has been done to understand IPV-related head trauma, in particular its chronic cognitive and psychological effects as well as associated brain changes. Through a multi-site research collaboration consisting of members of the Enhancing NeuroImaging and Genetics through Meta-Analysis (ENIGMA) IPV Working Group, the proposed study will characterize the cognitive, psychological, and neural profiles of IPV- related head trauma, as well as determine whether specific symptoms clusters are associated with discernable IPV subgroups. Furthermore, this proposal initiates the process of creating an IPV study cohort that will be re- assessed every 5 years to chronically assess brain and behavioral changes associated with IPV-related head trauma over the lifespan. Semi-structured interviews will be used to obtain IPV specific information such as abuse and head trauma history and frequency. A comprehensive neuropsychological battery will be used to determine cognitive and psychological status, while sophisticated neuroimaging techniques will be used to characterize neural structure, function, and brain metabolites in IPV with exposure to head trauma relative to IPV without exposure to head trauma. Finally, we will use a data-driven approach to determine whether symptom clusters differentiate subgroups of IPV. In aim 1, we will identify the cognitive and psychological profiles of subgroups of IPV. Aim 2 will examine the neuroimaging signatures in subgroups of IPV. In aim 3, we will determine whether symptom clusters are associated with discernible subgroups of IPV. The results from this study will provide critical information about the role of IPV-related head trauma in cognitive and psychological outcomes, as well as the underlying neural changes. This is important not only for understanding the chronic effects of repetitive brain trauma, but also the identification of distinct subgroups of IPV has direct implications for development of patient-centered care approaches for IPV.