The Polytrauma Clinical Triad Among Women with a History of Intimate Partner Violence.

Abstract

Women with a history of intimate partner violence (IPV) are at risk for traumatic brain injury (TBI) with persistent neurobehavioral symptoms, post-traumatic stress disorder (PTSD), and chronic pain, which, together, characterize the polytrauma clinical triad. Among predominantly male Veteran samples, research has suggested that the triad may exacerbate health problems, compared with the presence of any component of the triad alone. The current study is the first to explore the polytrauma clinical triad among a sample of cisgender women who have experienced IPV (N = 198; M = 39.6 years old, SD = 11.9; 83.3% White, 7.1% Hispanic; 59.1% college-educated). Compared with participants without TBI history, participants with IPV-related TBI had higher rates of chronic pain (43.8% vs. 29.0%, p = 0.045, odds ratio [OR] = 1.87 [95% confidence interval: 1.01, 3.43]), PTSD with chronic pain (19.0% vs. 6.5%, p = 0.009, OR = 3.84 [1.41, 10.46]), neurobehavioral symptoms with chronic pain (40.0% vs. 22.6%, p = 0.030, OR = 2.01 [1.07, 3.79]), and the polytrauma clinical triad (19.0% vs. 6.5%, p = 0.009, OR = 3.84 [1.41, 10.46]), after adjusting for age and education. After controlling for IPV severity, however, there were no statistically significant group differences, suggesting that IPV severity may be closely linked to both risk of TBI and elevated symptomatology associated with the polytrauma clinical triad. Additionally, as the number of lifetime TBIs increased, the odds of having chronic pain (p = 0.011, OR = 1.17 [1.04, 1.33]) and chronic pain with concurrent neurobehavioral symptoms (p = 0.007, OR = 1.05 [1.05, 1.34]) also increased. These findings suggest that, especially when comorbid with IPV-related TBI, chronic pain may be a priority treatment target among individuals with a history of IPV. Considering that women with a history of IPV often experience concurrent health conditions, multicomponent interventions that address each condition within the polytrauma clinical triad may benefit this population.