Globally, about 35% of women experience intimate partner violence (IPV) over the course of
their lives. The COVID-19 pandemic has resulted in a rapid increase of the incidence of IPV
as vulnerable women are more likely to be trapped at home with their abusers. In Canada, IPV
affects one in four women over their lifetime. In a study conducted in the United States, a
heterogeneous (with respect to race, age, education level and employment status) sample of 99
community and shelter women, showed that about 75% sustained at least one IPV-related
traumatic brain injury (TBI) and 50% of women sustained multiple IPV-related TBIs. Similar to
post-concussive signs and symptoms, women with IPV-related TBI demonstrate cognitive
impairments (e.g., deficits in memory, attention, reasoning, planning and executive
functioning), psychopathological problems (such as depression, anxiety, fatigue and
post-traumatic stress disorders), and/or sensorimotor problems (such as paralysis or paresis
of facial or extremity muscles, numbness, loss of sensation, muscle spasms, facial droop, and
unilateral weakness), due to blows to the head, face, or neck and/or strangulation which
ultimately impacts quality of life.
The very few studies conducted in this population have reported the prevalence of IPV-related
TBI, characteristic signs and symptoms, prevalence and primary sequelae of non-fatal
strangulation, and brain network organization associated with TBI and its cognitive effects.
A recent randomized trial on prevention of IPV and relationship problems focused on the
parents of newborns demonstrated that prevention interventions for at-risk couples were not
effective and rather showed iatrogenic effects for some couples. Therefore, therapeutic
treatment for IPV-related TBI survivors is crucial, and any physical or cognitive impairment
in these survivors require therapeutic interventions similar to non-partner related TBIs.
Effective therapeutic interventions would not only improve IPV-related TBI survivors' quality
of life but also has the potential to prevent longer-term neurodegeneration if early
detection is possible and timely treatment is provided. However, women rarely receive any
therapeutic assessment or interventions after sustaining IPV-related TBI due to the lack of
awareness regarding early detection and need of therapeutic interventions. On the other hand,
evidence-based therapeutic interventions to improve the quality of life of survivors of
IPV-related TBI are still lacking.
The Supporting Survivors of Abuse and Brain Injury through Research (SOAR) Project at
UBC-Okanagan is a multidisciplinary, community-based partnership designed to i) investigate
the incidence and characteristics of IPV-related TBI; ii) use integrated knowledge
translation to co-create and disseminate knowledge products designed to increase knowledge
and awareness of TBI in those who provide support for IPV survivors; and iii) evaluate the
effectiveness of a community support network intervention for women with IPV-related TBI.
This MSFHR trainee application will focus on this last aim.
This project will characterize quality of life, resilience, and neurocognitive and
sensorimotor function prior to, immediately after, and 6 months after a 6-month
community-based intervention incorporating executive function, physical activity,
mindfulness/meditation, and health counseling components by comparing with a group receiving
usual care and control participants. In addition, exploratory analyses will demonstrate the
response to the intervention depending upon the severity of the IPV-related TBI, whether
strangulation was part of the experience or not, and the extent of psychopathological
comorbidities (e.g., post traumatic stress disorders, anxiety, depression, adverse childhood
experiences, etc.).
This study aims to disseminate the findings not only through conference presentations and
peer-reviewed journal publications but also through ongoing engagement with our local,
regional, and national community partner organizations. We have already co-developed and
implemented a knowledge product - the Women's Support Workers module of the Concussion
Awareness Training Tool (CATT) to help raise knowledge and awareness of brain injury in those
who provide support to survivors of IPV. We would envision incorporating some of the key
takeaway findings from the SOAR project into an updated version of the CATT module.
The expected outcomes of this study will add strong evidence to the effectiveness of
therapeutic interventions for, and strengthen our understanding of, this understudied
experience. More broadly, this study will (i) enhance professional knowledge and research
skills in understanding this underserved population, (ii) build up research knowledge on this
topic, and (iii) increase knowledge on the efficacy of a novel intervention. Thus, clearly
and objectively characterizing the potential for a community support network to improve
resiliency, quality of life, and neurocognition will have far-reaching implications for
social support policy and funding for this population and their caregivers.