Investigating the Relationship Between Self-Reported and Performance-Based Cognitive Functioning in Women Experiencing Intimate Partner Violence.

Abstract

Women who experience intimate partner violence (IPV) are highly susceptible to sustaining mild traumatic and hypoxic/anoxic brain injuries (mBIs), yet the cognitive and neurobehavioral consequences of IPV-mBI remain understudied. The current study examined the relationships between self-reported cognitive functioning and IPV-related mBI scores on neuropsychological test performance in women who experienced physical IPV. Participants included 48 women recruited from women's shelters and community health programs. All participants completed a neuropsychological battery, clinical interviews, and self-report questionnaires. Performance-based cognitive functioning was assessed through normed z-scores from six indices of neuropsychological tests of memory, learning, and cognitive flexibility. A cognitive composite score was also generated from all six indices. Self-reported cognitive functioning was measured using the cognitive subscale of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ-Cog), and an IPV-mBI frequency and recency score was calculated using the Brain Injury Severity Assessment (BISA). RPQ-Cog scores, BISA scores, and their interaction were entered into distinct hierarchical linear regressions with neuropsychological indices as the dependent variables. All analyses controlled for sociodemographic and psychological health variables that were significantly associated with neuropsychological test performance. There was a significant main effect of self-reported cognitive functioning on tests of immediate verbal memory (t(43) = -2.55, p = 0.015, 95% confidence interval [CI] [-0.50,-0.06]) and planning and initiation (t(42) = -2.03, p = 0.049, 95% CI: [-0.17,0.00]). There was a significant main effect of the IPV-mBI severity score on a test of cognitive switching (t(43) = -2.27, p = 0.029, 95% CI: [-0.78,-0.05]) and the global cognitive composite score (t(43) = -2.42, p = 0.020, 95% CI: [-0.36,-0.03]). There were no significant interactions between the RPQ-Cog scores and BISA scores on neuropsychological test performance. We found that among women who have experienced IPV, both self-reported cognitive problems and IPV-mBI history are independently related to poorer performance on neuropsychological tests. While further research is necessary, our findings suggest that women who have experienced physical IPV and endorse cognitive neurobehavioral symptoms or a history of IPV-mBI may benefit from comprehensive neuropsychological services to guide clinical care. Our findings also attest to the importance of developing screening measures for IPV-mBI history and ongoing neurobehavioral symptoms and implementing these measures in clinical settings.