Associations Between Head Injury, Strangulation, Cardiometabolic Health, and Functional Disability Among Female Survivors of Intimate Partner Violence

Abstract

Objective

Head injury and strangulation are highly prevalent in intimate partner violence (IPV) contexts, but there is little research examining the potential implications of these injuries on physical health and functional status. This pilot study explored the extent to which injury type (head injury, strangulation) and severity (no injury, subconcussive head injury, traumatic brain injury; no strangulation, strangulation, strangulation with loss of consciousness) were associated with biomarkers of cardiometabolic health and self-reported functioning among female survivors of IPV.

Methods

Participants were 51 individuals assigned female at birth who experienced IPV during their lifetime and screened positive for probable posttraumatic stress disorder (PTSD) on the PTSD Checklist for DSM-5 (average age = 32.6 years, SD = 7.1).

Results

Head injury was associated with statistically significant increases in blood glucose levels (p = .01, d = 1.10). Shifts toward more high-risk values with moderate-strong effect sizes were also found in high-density lipoprotein, low-density lipoprotein, and waist-to-hip ratio (ps: .06–.13; ds: 0.51–1.30). Strangulation was associated with increased cholesterol levels, with a moderate effect size (p = .20, d = 0.59). Regression models accounting for age, education, PTSD symptoms, childhood trauma, strangulation, and head injuries predicted functional disability status (R² = 0.37, p < .01) and several of its associated domains: cognition (R² = 0.34, F(8,42) = 2.73, p = .01), mobility (R² = 0.47, F(8,42) = 4.82, p < .001), and participation in society (R² = 0.33, F(8,42) = 2.59, p = .02).

Conclusions

Findings suggest the need to develop integrated treatments that address physical health comorbidities among female survivors of IPV with a history of head injury to improve daily function and quality of life.